Nursing Columbia
Spring 2019
Meet the
New Dean Lorraine Frazier, Columbia Nursing’s new dean, has a world view that prioritizes social justice and health equity
The Magazine of Columbia University School of Nursing
SPECIAL RESEARCH REPORT An homage to Elaine Larson and a celebration of the culture of scholarly inquiry she helped shape
“I am proud of the degrees I earned at Columbia Nursing, and cherish the connection with the school that has nourished me as both a member of Nursing’s Alumni Association board and through my role as Nurse Practitioner Program director at Morgan Stanley Children’s Hospital. Columbia Nursing students continue to inspire me, and I give each year to support this future generation of nurses. I give so others can receive.” — Rose Chapman Rodriguez ’87 ’06
JÖRG ME YER
Why I For more information about giving to Columbia Nursing, visit nursing.columbia.edu/giving or contact Janice Grady, Executive Director of Development and Alumni Relations, at 212-305-1088 or jar2272@cumc.columbia.edu.
From the Dean
Celebrating Columbia’s Culture of Inquiry
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n a special three-part feature, this issue of Columbia Nursing showcases the school’s commitment to nursing research. That couldn’t be more serendipitous, because— as is evident from the issue’s other feature, starting on page 6— one of the many things that drew me to Columbia was its dedication to research. Columbia is a national leader in nursing research and, as a result, in advancing patient care, especially among underserved populations. As a clinician and a National Institutes of Health–funded researcher myself, I appreciate the essential link between scientific inquiry and patient care. I am thus especially proud to introduce this issue’s celebration of the school’s expansive research enterprise and its commitment to supporting both established and emerging nurse-scientists. The vigor of this enterprise is due in no small part to Elaine Larson, senior associate dean for research and the Anna C. Maxwell Professor of Nursing Research. During the past 30 years, Elaine has steered Columbia’s transformation into the research powerhouse it is today. In the opening to this issue’s three-part research report, starting on page 12, she explains her commitment to helping “cultivate what has become a vibrant culture of scholarly inquiry.” Her retirement at the end of this year will be a loss for our community, but I know that the culture of inquiry and the supportive environment she has nurtured will continue to inspire our researchers at all levels— from predoctoral students to senior research faculty—and thereby to improve patient care, health systems, and public health outcomes. Such research abounds at Columbia, as part two of the research report makes clear. Many current projects explore how genetics, environment, health behaviors, and interpersonal relationships interact to affect illness, especially in underserved communities. And each of these projects aims to meet Columbia’s longtime research goals: improving patient care, eliminating health disparities, and ensuring that all populations, including the most marginalized, have access to high-quality care. To this end, our predoctoral students and faculty are studying interventions designed to help older Latinos with HIV/AIDS, as well as Latinos with asthma, manage their symptoms; are assessing the risks and benefits of antibiotic use in nursing home residents—includ-
ing whether antibiotic use influences goals for palliative care; and are weighing the effects on LGBT women of stress, stigma, and trauma in childhood or adulthood—including sexual abuse and intimate partner violence. Always on the cutting edge, our researchers are also harnessing mobile technologies—including apps that teach HIV prevention strategies or that remind patients with HIV or sickle cell anemia to take their medication—and then are evaluating these approaches’ efficacy. Of course, patient outcomes reflect the health systems and health policies that drive them. And so we also have researchers who focus on the best ways to educate nurses about health policy methods, preparing them to inform local, state, and national policymakers about how best to improve public health. The more that nurses learn about policies—like mandatory physician oversight—that influence and sometimes impede their delivery of optimal care, the better equipped they’ll be to challenge or even change them. To aid this effort, some of our researchers have developed a Nurse Practitioner Primary Care Organizational Climate Questionnaire to help health care systems gauge their use of nurse practitioners. These are just some highlights of the research projects taking place at Columbia—projects that would not have gotten off the ground without academic and technical support from the Office of Scholarship and Research (OSR). As you’ll learn in part three of the research report, the OSR, together with our Grants Management Office, are invaluable in helping our scholars conceive, produce, and fund the research projects whose findings are critical to improving nursing practice and patient care. Nearly 20 years ago, as a postdoc, I felt fortunate to discover my own passion for research. I feel even more fortunate today to be leading this extraordinary institution, where nurse-led research advances patient care for all.
LORRAINE FRAZIER, PhD, RN, FAAN Dean, Columbia University School of Nursing Mary O’Neil Mundinger Professor of Nursing Senior Vice President, Columbia University Irving Medical Center
Nursing Columbia
Lorraine Frazier, PhD, RN, FAAN Dean, Columbia University School of Nursing Mary O’Neil Mundinger Professor of Nursing Senior Vice President, Columbia University Irving Medical Center
Columbia Nursing is the magazine of the Columbia University School of Nursing and is published twice a year
Spring 2019 Contents
Produced by the Office of Strategic Communications and Marketing
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Linda Muskat Rim, Editor-in-Chief Associate Dean, Strategic Communications and Marketing Lara Philipps, Production Supervisor Manager, Strategic Communications and Marketing
ALUMNI NEWS EDITORS:
Reva Feinstein, MPA Associate Dean, Development and Alumni Relations Janice Rafferty Grady Executive Director, Development and Alumni Relations Janine Handfus Associate Director, Annual Fund
DESIGN AND ART DIRECTION:
Eson Chan
CONTRIBUTING WRITERS:
Andrea Kott Kenneth Miller
Paul Coyne ’13 ’15 ’16, DNP, MBA, MSF, RN, AGPCNP-BC President & Co-Founder, Inspiren; Senior Director of Advanced Practice and Clinical Informatics, Hospital for Special Surgery New York, New York Delphine Mendez de Leon ’78, MBA, MPH, RN New York, New York Dorothy Simpson Dorion ’57, MS, RN Jacksonville, Florida Angela Clarke Duff ’70, RN Forest Hills, New York Marjorie Harrison Fleming ’69, RN Chair Seabrook Island, South Carolina Kenneth A. Forde, MD Scarborough, New York Susan Fox ’84, MBA, RN President & CEO, White Plains Hospital White Plains, New York Susan Furlaud ’09 ’12, MS, RN New York, New York Karen Hein, MD Jacksonville, Vermont
Adolescents Less Likely Than Whites to Have Undiagnosed Asthma
· Nurses’ Attitudes Influence Compliance with Infection-Control Practices
BOARD OF VISITORS:
Brenda Barrowclough Brodie ’65, RN Durham, North Carolina
· Latino, African-American Urban · LINK’S Effectiveness Confirmed
Mairead Moore Associate Director, Alumni Relations
Tina Alvarado ’81, MHA, BSN Rear Admiral (Retired), Senior Health Care Executive, US Navy, Nurse Corps Raleigh, North Carolina
4 Research Roundup
Mary Turner Henderson ’64, RN San Francisco, California Mary Dickey Lindsay ’45, RN New York, New York Wilhelmina Manzano, MA, RN, NEA-BC Senior Vice President, Chief Nursing Executive, & Chief Quality Officer, NewYork-Presbyterian Hospital and Regional Hospital Network New York, New York Duncan V. Neuhauser, PhD Blue Hill, Maine Janet Ready ’81, MBA, MPH, RN, FACHE President, Penn Medicine/ Princeton Medical Center; Senior Vice President, Princeton Health Princeton, New Jersey Patricia Riley ’76 BS, MPH, RN, CNM, FACNM, FAAN Captain (Retired), US Public Health Service Atlanta, Georgia Susan Salka, MBA President & CEO, AMN Healthcare San Diego, California Sara Shipley Stone ’69, MS, RN Brooksville, Maine Keville Frederickson Tomasson ’64, EdD, RN, FAAN Professor & Founding Director, Nursing PhD Program, Pace University Pleasantville, New York
30 Alumni · Letter from the Alumni Association President · Class and Program Notes · In Memoriam · A Glimpse of Some Alumni Events
38 Faculty Publications Please address all correspondence to: press.nursing@columbia.edu
Alumni are invited to update their contact information by emailing nursingalumni@columbia.edu or calling 212-305-5999
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A Citizen of the World By Andrea Kott Columbia Nursing’s new dean, Lorraine Frazier, is driven to address health inequities both close to home and around the globe.
Special Research Report PART I: BUILDING A RESEARCH ENTERPRISE By Elaine Larson, PhD, Senior Associate Dean for Research As she prepares for retirement, Larson reflects on the vibrant culture of scholarly inquiry she has helped shape at Columbia Nursing.
PART II: DIGGING FOR GOLD By Kenneth Miller Researchers at Columbia Nursing are unearthing dazzling data in a broad range of fields—a treasure trove that could help improve patient care everywhere.
12 ON THE COVER: Photograph by Amelia Panico
PART III: POLISHING SCIENTIFIC GEMS The Office of Scholarship and Research Development helps nurse-scientists burnish their investigative ideas.
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Research
Roundup
G E T T Y IM A G E S
Latino, African-American Urban Adolescents Less Likely Than Whites to Have Undiagnosed Asthma
D
espite their symptoms, a large proportion of Asian-American and white adolescents with asthma were at greater risk than Latino and African-American youth of going undiagnosed, according to a study from Columbia Nursing. Keenly aware of the health and health care disparities among Latino and African-American youth, providers may be more likely to assess them for asthma, leading to fewer undiagnosed cases in comparison with Asian-Americans or whites, reported Jean-Marie Bruzzese, PhD, associate professor. “We need to become better at identifying risk factors for adolescents with undiagnosed asthma in order to ensure they can be treated,� Bruzzese said. In the first study of its kind to identify risk factors associated with adolescents going without an asthma diagnosis, Bruzzese and coinvestigators surveyed 33,596 students from 44 New York City public schools between 2008 and 2012 to assess whether they had ever been diagnosed with asthma or were experiencing symptoms. Of the students surveyed, whose mean age was 16, approximately 45 percent were Latino and 31 percent were African-American. The study revealed that undiagnosed asthma may be nearly twice as prevalent as diagnosed asthma in urban adolescents overall.
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Columbia Nursing Spring 2019
Compared with whites, Asian-American adolescents were 41 percent more likely to be symptomatic but undiagnosed, while 33 percent and 34 percent of Latinos and African-Americans, respectively, were less likely to be undiagnosed. Living in a neighborhood with a shortage of health care providers was associated with a 29 percent lower risk of being undiagnosed. Easily accessible, extensive public transportation systems may also have contributed to lower odds of Latinos and African-Americans going without an asthma diagnosis. Asthma, the most common chronic pediatric illness, can lead to reduced physical activity, higher school absenteeism, diminished quality of life, and increased risk for other diseases and disorders, such as obesity and depression. When uncontrolled, it contributes significantly to morbidity. The study emphasized the need for increased public health education and outreach for adolescents and their families, and for health care providers who could be screening more young people for asthma. This study appeared in the January 2019 issue of the Journal of Urban Health.
T
he Linking to Improve Nursing Care and Knowledge (LINK) project, which fosters research by clinical nurses by partnering them with nurse-scientist mentors and statistical consultation, proved to be “feasible, sustainable, and reproducible,” according to the results of a yearlong evaluation at Columbia Nursing. The 12-month feasibility study found that LINK’s comprehensive research support, including assistance with data analysis and securing funding, helped nurses to conceptualize and complete scholarly investigations. This, ultimately, produces evidence that is vital to improving nursing practice and health outcomes, as well as providing justification to build upon such projects and increase institutional-academic center partnerships, said lead author Kenrick Cato ’08 ’14, PhD, assistant professor. “By providing comprehensive support, you can get nurses to ask and answer more clinical research questions, and enjoy greater professional satisfaction, all of which improve patient care,” Cato said. To assess LINK’s impact on increasing nurse-led clinical research, Cato evaluated the project after one year of its full implementation in a 299-bed children’s hospital, a 745-bed adult hospital, and a 300bed community hospital. His colleagues and study authors included: Carolyn Sun ’15, PhD, associate research scientist; Eileen Carter ’14, PhD, assistant professor; Elaine Larson, PhD, Anna C. Maxwell Professor of Nursing Research and senior associate dean for scholarship and research; and Jianfang Liu, PhD, assistant professor, as well as Reynaldo Rivera, DNP, director of nursing research and innovation at NewYork-Presbyterian Hospital. The authors recorded 35 LINK consultation requests during the evaluation year; of these, 31 extended past initial follow-up, most of which RNs initiated, largely for help with data analysis or study design. Significant results from the project were a 367 percent increase in the number of nurseled Internal Review Board-approved research protocols, from three in the previous year to 11 in the year of the assessment; two publications in press in peer-reviewed journals; and near total (98 percent) satisfaction among nurses who had a LINK research consultation. Nursing science undergirds evidence-based practice, which is key to improving patient care and outcomes. To promote it, NewYorkPresbyterian Hospital and Columbia University School of Nursing in 2014 created LINK, a collaboration in which nurse-researchers, who have dual appointments with the school and the hospital, provide clinical nurses with the conceptual, statistical, and logistical support they need to transform ideas into research projects. Said Cato, “Helping nurses translate their questions and ideas into research projects is how you advance nursing science, nursing satisfaction, and patient care.” This study appeared in the January 2019 online edition of The Journal of Nursing Administration.
G E T T Y IM A G E S
LINK’S Effectiveness Confirmed
Nurses’ Attitudes Influence Compliance with InfectionControl Practices
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ttitudes and organizational policies, rather than knowledge base, were much more likely to lead to greater compliance with infection control among homehealth-care nurses. As a result, efforts to increase nurses’ compliance with infection-control practices in home health care should focus on strategies that change attitudes, including perceptions about infection risk, a Columbia Nursing study suggested. “Infection is a leading cause of hospitalization among homehealth-care patients, and nurses have a key role in reducing infection by compliance with infection-control procedures in the home-care setting,” said lead author and associate professor Jingjing Shang, PhD. “This study tells us that knowledge is not enough. Our efforts to improve compliance need to focus on ways to alter nurses’ attitudes and perceptions about infection risk.” In a survey of 359 home-health-care nurses in the U.S., Shang and colleagues analyzed knowledge of, attitudes toward, and compliance with infection-control practices. They also examined the relationships between knowledge, attitudes, and compliance. More than 90 percent of home-health-care nurses self-reported compliance with infection-control practices for most of the measured behaviors. However, knowledge of infection-control practices was not associated with compliance. For example, 30 percent of respondents failed to identify the need to perform hand hygiene after touching their nursing bag, which may transport infectious pathogens between patients. Meanwhile, more than 80 percent of nurses reported wearing a disposable facemask whenever there was a possibility of a splash or splatter, and nearly that many reported wearing a gown if they were likely to soil themselves with blood or bodily fluids. Slightly fewer nurses — about 70 percent — reported wearing goggles or an eye shield if they anticipated exposure to bloody discharge or fluid. This study was funded by the Agency for Healthcare Research and Quality and appeared in the November 2018 issue of the American Journal of Infection Control.
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Columbia Nursing’s new dean, Lorraine Frazier, is driven to address health inequities both close to home and around the globe.
A
Citizen of the
World
JĂ–RG ME YER
By Andrea Kott, MPH
W BELOW: At the end of her first year of nursing school, Frazier (right) earned her cap and took part in a candle-lighting ceremony to mark her initiation into the profession. OPPOSITE PAGE: Frazier shares a moment with students in Columbia Nursing’s new building.
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hen Lorraine Frazier, PhD, arrived at Columbia Nursing, she felt she’d come home. That may sound odd, since Frazier was born in Northern Ireland and has spent much of her life in Houston, Texas. But feeling at home for the school’s new dean is less about how long she’s lived someplace and more about belonging to a community that shares her passion for social justice and health equity. “Coming here has really been coming home to a place that values what I value,” she says. Her arrival at Columbia last fall capped a decadeslong journey to live a purposeful life as a clinician, educator, researcher, and nursing leader. “I have always been driven by a sense of purpose,” she says. That purpose has been to help others. Frazier’s journey began in Northern Ireland, where she lived until age eight, amidst growing political and social upheaval. “My father was from a Catholic family and my mother was from a Protestant family, and they struggled to settle in the divided country,” she says. Her parents instilled in her the importance of inclusion and of respect for all people—a focus that laid the foundation for her professional passions today. They also instilled in her the importance of living a life of purpose and of achieving the education
Columbia Nursing Spring 2019
to accomplish it. Money was tight for her workingclass parents—too tight to send Frazier to university, her dream since childhood. “I was always academic, always thinking of the future,” she says. Her parents, also thinking of the future, relocated the family to the United States, settling in Houston when Frazier was eight. “They wanted us to have more opportunity and to live in a country where religion wouldn’t be a problem for us,” she says. It was a difficult move for the family in many ways, and Frazier’s parents urged her and her siblings to make every opportunity count, she notes. “My parents would say, ‘You have to make your life purposeful.’ That has driven me a lot.” Frazier lived in Houston long enough to lose any obvious hint of an Irish accent. “If you were from Northern Ireland, you’d hear it,” she says with a smile. But the family didn’t stay there long. Her father’s work—and, later, treatments he needed for a kidney disease he contracted—necessitated moves back and forth between the U.S. and Northern Ireland. His work also took them to Malaysia through Frazier’s graduation from high school. “I was always changing schools, which was challenging for me when school meant so much to me,” she recalls. Fortunately, school grounded her, no matter where she lived. “I was always hungry for information, and school was always my home.” Instead of feeling displaced or insecure as a result of constantly moving, Frazier grew resilient. “None of us is ever certain or secure about anything,” she says, matter-of-factly. “I feel the world is beautifully complex, life’s journey is always a bit of good and a bit of a challenge. I’m happy to have a challenge.” Later, as a Robert Wood Johnson Nurse Executive Fellow, she learned that if you are not uncomfortable, you are not where you need to be. “Life prepared me to be comfortable with the in-between-ness of fitting and not fitting in,” she says, adding that the famous 19th-century philosopher William James also believed that it is in life’s between-nesses, its transitions, that life happens. In the process, she discovered where she fit in best: first, as a child of 11, by her father’s hospital bed, marveling at the caliber of doctors and nurses who cared for him and for her family, and, later, in nursing herself. “I remember as a child thinking, ‘These people have all these answers and the information we need.’ I wanted to be one of those people because I knew what people needed and, more importantly, how they needed to be approached. I understood at a young age the devastation of illness and the financial stress on families. I wanted to do the kind of work where I could be part of the solution.”
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Hungry to learn, eager for a challenge, resilient and empathic, Frazier believed she had the makings of someone who could have an impact on the care of patients and their families. “I knew what it was like to be in the patient’s room, I understood their fears,” she says. She had found her life’s purpose early. After earning her associate’s degree in nursing from Southwest Texas State University (now Texas State University), she quickly advanced in her nursing career. “My interest was in the complexities of individuals living with chronic illness and disability and the challenge of including their voice in the type of care delivered,” she explains. She was particularly interested in the relationship between social class, health equity, and health outcomes. She went on to earn her bachelor’s in nursing from the University of Oklahoma; a few years later, she added a master’s in nursing from the Cizik School of Nursing at the University of Texas Health Science Center at Houston (UTHealth) and completed her doctorate there in 2000. Her interests grew to encompass understanding risk and why some individuals are more susceptible than others to stressors that result in disease. This work led her to pursue her interest in genetics, and, with National Institutes of Health (NIH) funding, she did postdoctoral research
“ I understood at a young age the devastation of illness and the financial stress on families. I wanted to do the kind of work where I could be part of the solution.” just as the Human Genome Project was getting underway. She concentrated on the link between genetics and heart disease and conducted numerous original investigations, including an NIH-funded study of the interactions between behavior and genetics in patients with acute coronary syndrome. A clinician, educator, scientist, and leader, Frazier also attended the executive education program at the University of Pennsylvania’s Wharton School and has won numerous honors, including fellowships from the Robert Wood Johnson Foundation’s Executive Nurse Fellows program and the American Heart Association. In addition to her renown for pioneering state-of-theart translational research programs, Frazier is a national expert in biobanking and has served as director of the UTHealth Biobank and as project director for TexGen, a biobank consortium of academic institutions across Texas. She has also held appointments as a professor
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A
Citizenof the
ABOVE: Frazier is welcomed by Lee Goldman, MD, dean of the Faculties of Health Sciences and Medicine, and chief executive, Columbia University Irving Medical Center, and Lee Bollinger, president, Columbia University. RIGHT: Frazier enjoying her favorite pastime, fly-fishing. OPPOSITE PAGE: Frazier gets acquainted with Columbia Nursing Board of Visitor members Dorothy Simpson Dorion ’57, CU Trustee Kenneth Forde ’59PS, and Karen Hein ’70PS.
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and dean at the University of Arkansas for Medical Sciences College of Nursing and as a distinguished professor and dean at her alma mater, UTHealth’s Cizik School of Nursing. The opportunity to combine her wealth of clinical, academic, and leadership experience is what drew Frazier to Columbia Nursing. “I love the nursing profession. I’m interested in research and education within the framework of social justice and health equity for all people. That quest to have an impact on health and health policy makes Columbia a great fit,” she says. Columbia saw Frazier as a great fit from its perspective, too. She “stood out because of her combination of academic accomplishments and very strong leadership experience,” observes Lee Goldman, MD, dean of the Faculties of Health Sciences and Medicine. “The search committee was especially impressed with her leadership in the field of biobanking, because it cuts across so many disciplines—nursing, medicine, basic science, and data science. Being able to lead across organizational boundaries is essential to advancing health care, and she has a talent for doing that.” Frazier’s vision for the school—which, she says, will build on the tremendous achievements of previous administrations—includes increasing student scholarship funding. “How do we make it possible for more students to come to Columbia?” she muses. “Our students dedicate so much time and money to their education. We’d love to see the day when we can support them 100 percent.”
Columbia Nursing Spring 2019
D AV ID F R A ZIE R
LOU ROCCO
World
Increasing the school’s sizable global outreach efforts is another goal. Currently, some 40 percent of the students in the Masters Direct Entry program gain international educational and clinical experience through the school’s Office of Global Initiatives (OGI). With support from the Global Fellows Fund, OGI gives students an opportunity to apply their classroom learning to different countries’ health care settings. It also allows them to learn about different cultures, health care systems, and practices by interacting with local nurses and patients and their families at 11 clinical sites around the world. “At Columbia, we are having impact nationally and globally,” Frazier says. “I think this is undeniably one of the most important experiences we can give our students if we are to help them understand what health equity means and the vital role nursing plays in promoting it.” In addition to expanding the school’s global focus, Frazier hopes to enlarge its already substantial community health footprint. One of her key initiatives in this area will be to sharpen the curricular focus on delivering primary and palliative care to hard-to-reach populations—particularly patients who are homebound, elderly, recovering from strokes, or living with Alzheimer’s disease. “Palliative care focuses on the relief of symptoms from a serious illness. Nevertheless, some families and some cultures don’t like the term ‘palliative care’ because they feel you’ve given up on them,” she says. “So how do you take palliative care into patients’ homes in a way that they and their families want it?”
MI C H A E L D I V I T O
Another important goal for Frazier is sensitizing students to inequities in health and health care, while preparing them to think about ways of increasing health care access. “I want our students to look critically at health disparities, to look not just at the patients in their clinics but also at the neighborhoods and environments surrounding those clinics,” she says. “I want there to be aspects of health equity and social justice in every case study and every simulation and for our nursing graduates to be leaders in health and policy.” Frazier underscores the importance of increasing health care access for patients as well as for family members who are caring for loved ones. “We need to create options that are centered on families. We need to incorporate families into patient care with innovations such as telehealth systems,” she says. Being part of a loved one’s care is an issue close to Frazier’s heart. Although she could only observe her father’s care, she and her husband of 39 years, David, play an integral role in the care of their developmentally disabled daughter, Molly, now an adult. “Molly has given me a new understanding of the health care challenges that families with a disabled family member face,” she says, noting that many disabled or otherwise vulnerable individuals do not have family to help them navigate the health care system. “She has been
“ I want our students to look critically at health disparities, to look not just at the patients in their clinics but also at the neighborhoods and environments surrounding those clinics.” the greatest influence in helping me to understand that disabled adults need a voice. She’s part of what drives me to make sure that people have health care access.” All the issues that Frazier champions happen to be among those that have long driven Columbia Nursing’s curriculum, research, and practice. This synchrony is what makes Columbia feel like home. As for New York City, it, too, feels like home already. “New Yorkers, like the Irish, are easy to talk to, and I enjoy that,” Frazier says. A voracious reader, she’s also happy to spend time alone with a book, or with a sketchpad. But she has yet to try her much-loved bicycle on the city’s roads or to locate a spot to pursue her favorite pastime, fly-fishing. “My life is my work,” she says, beaming. “What I love about leadership is being part of a great team that is making a difference. It’s what I love about Columbia. “I think for institutions, transitions are also where life happens,” she adds. “I am excited to see how we as a school will grow with this transition.”
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BUILDING A RESEARCH ENTERPRISE BY ELAINE LARSON, PHD, RN, SENIOR ASSOCIATE DEAN FOR RESEARCH
[ RESEARCH REPORT ]
T
he scholarly endeavors of Columbia University School of Nursing’s faculty, postdoctoral researchers, and graduate students are tremendously diverse — while being bound together by a vision that was first articulated 15 years ago and that has continued to evolve ever since. In 2004, a faculty task force developed Columbia Nursing’s first Statement of Research Focus, with the aim of setting priorities for the School’s research enterprise and guiding its future growth. The idea was to assess the strengths and interests of the faculty, and to suggest how those qualities could further the school’s overall mission — particularly its commitments to “develop and test advancements in nursing practice and in research”; to “assume active accountability for the quality and excellence of nursing practice through leadership in research, practice, education, advocacy, and policy”; and to
“continuously improve the opportunities for nurses in research and practice to fully use their knowledge and skills to the betterment of science and care.” Our statement identified two areas of expertise that enabled the school to make unique contributions to the nursing knowledge base. “First,” the team wrote, “members of the faculty conduct their research in settings and with populations that are difficult to reach and seldom studied. These populations include … recent immigrants, the urban poor, non-English speakers with chronic health problems, and other vulnerable and underserved groups. Second, faculty members work at all levels of the health care and public health systems that are needed to translate research from the individual recipient of care to health systems and policy.” By leveraging these skill sets, we explained, Columbia Nursing could help close the “national gap” between researchers, administrators and planners, and policymakers — and help reduce health disparities across the country. The document also identified three core processes that formed the backbone of the school’s investigative efforts: clinical effectiveness research (for improved care outcomes), systems research (for improved health systems), and health policy research (for improved public-health outcomes). The Statement of Research Focus, and a simplified conceptual model known as Translational Research for Quality Health Outcomes, were disseminated through an article in the Journal of Professional Nursing, in
Elaine Larson, PhD, RN
which we described the processes that led to the development of these documents. These two guides provided a template for other schools, and served Columbia Nursing well for nearly a decade. Eventually, however, a group of faculty and staff volunteered to re-examine our research agenda, to ensure that it reflected changes in national priorities and in our faculty expertise. In a 2013 paper published in the same journal, the conceptual model was revised to include new research approaches and areas of focus (see below). This article also included a detailed strategic plan to enhance faculty development, increase institutional support for faculty researchers, and expand collaboration among those investigators. One important change that emerged from this process of renewal involved the School’s PHOTOGRAPHS BY JÖRG MEYER
[ RESEARCH REPORT ]
Office of Scholarship and Research (OSR), whose services were refined and expanded to better support both clinical and research scholarship (see p. 28 for more details about these efforts). In addition, the OSR, directed since its inception by Kristine Kulage, MA, MPH, took on a new and crucial role: assessing the impact and outcomes of the programs it administers. Because research support requires significant outlays of cash and other resources, it is vital that we examine whether these investments are paying off. We firmly believe that just as any research study needs to generate measurable results, so does the school’s support of its researchers — not only to avoid wasteful spending, but to ensure that the intended beneficiaries truly benefit. We also believe that these find-
ings must be disseminated, so that other institutions can learn from our experience. Studies conducted by the OSR in recent years (all published in peer-reviewed journals) have included assessing the return on investment of our global research program; testing new cost- and facility-sharing protocols across schools to promote interdisciplinary research; measuring the cost-benefit ratio of submitting federal grant applications; tracking the outcomes of manuscriptand grant-writing workshops; quantifying the results of our intramural pilot-funding and grant-review mechanisms; and measuring the impact of a scholarly-writing course to enhance publication efforts by Doctor of Nursing Practice students. As in many other areas, our careful analysis of our own
endeavors puts us in the vanguard among schools of nursing nationwide. When I first joined the faculty in 1998, Columbia Nursing had just begun its transformation into a leading center of nursing research. Since then, I have had the privilege of helping to cultivate what has become a vibrant culture of scholarly inquiry. This year, after two decades at this extraordinary institution — and more than five decades in this glorious profession — I’ve made the difficult decision to begin my retirement. But as I move on to the next phase of my life, I’m confident that the passion and skill of our researchers, and the “living documents” that help bring out the best they have to offer, will ensure an exciting and marvelously productive future for the school.
IMPROVED HEALTH
OUTCOMES
AREAS OF FOCUS • High Risk, Underserved, and Vulnerable Populations • Models of Health Care Delivery • Patient Safety and Quality • Prevention • Primary and Comprehensive Care • Symptom Management • Urban and Global Health
IMPROVED HEALTH
SYSTEMS
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Columbia Nursing Spring 2019
RESEARCH APPROACHES Clinical • Comparative Effectiveness • Dissemination and Implementation • Economic Analysis • Health Services and Policy • Informatics • Interdisciplinary • Precision Health • Translational •
IMPROVED HEALTH
POLICY
BY EXPANDING RESEARCH AND SCHOLARLY CAPACITY, Columbia Nursing strives to attain international renown for high-quality scholarship, particularly in collaborative research between clinicians and researchers within nursing and across disciplines. In the conceptual model at left, the three circles represent the areas in which Columbia Nursing strives to achieve improvement: health outcomes, health policy, and health systems. The two arrows depict the synergistic relationship between the school’s areas of focus and its research approaches used to achieve improvement in health outcomes, systems, and policy.
DIGGING FOR GOLD Researchers at Columbia Nursing are unearthing dazzling data in a broad range of fields— a treasure trove that could help improve patient care everywhere. | By Kenneth Miller
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n the late 1980s, Columbia University School of Nursing, whose emphasis had always been on preparing superb clinicians, set out to transform itself into a research powerhouse. First came the so-called Columbia Model, a groundbreaking approach to nursing education, which required all instructors to engage in research or scholarly practice. A part-time doctor of nursing science (DNSc) program was launched a few years later and had morphed into a full-time PhD program by 2008. Eminent nurse-scientists flocked to the school, as did students eager to follow in their footsteps. Today, three decades after the initiative began, its success can be expressed in numbers. Columbia Nursing is one of the largest
per-capita recipients among nursing schools of grants from the National Institutes of Health (NIH). Its doctoral program is among the top 10 percent of nursing school recipients nationwide of federal training grants for predoctoral and postdoctoral scholars. The school’s faculty members have more than 70 active research grants and publish dozens of articles each year in peer-reviewed journals. Columbia Nursing’s research enterprise is organized around an array of programs, including two centers funded by the National Institute of Nursing Research (NINR). In all these settings, veteran investigators pursue their own ambitious projects, while mentoring those just starting their careers. Together,
masters and novices focus on improving clinical effectiveness, health systems, and health policy, often wielding powerful new digital tools—mobile technologies, artificial intelligence, informatics—to track patients’ symptoms and behaviors, enhance their interactions with health care providers, and find meaningful patterns amid petabytes of data. “No matter their area of study,” says Elaine Larson, PhD, RN, senior associate dean for research and the Anna C. Maxwell Professor of Nursing Research, “our nurse-scientists share the same basic goals: to better serve underserved populations, to reduce health disparities, and to improve care for all patients.” Read on for a sampling of their pioneering work. >
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Helping Patients Help Themselves The NINR-funded Precision in Symptom Self-Management (PriSSM) Center strives to advance the science of symptom self-management for Latinos, considering variables such as genetics, environmental factors, health behaviors, and interpersonal relationships. PriSSM is directed by Suzanne Bakken, PhD, RN, a professor of biomedical informatics and the Alumni Professor of Nursing, and Arlene Smaldone ’03, PhD, RN, a professor of nursing. “Our research is informed by what’s known as the socio-ecological model, which starts with the individual and then broadens out to look at the family and the community,” Bakken explains. Every PriSSM pilot study captures a set of common data elements for each participant, including physical activity with a Fitbit-like wearable accelerometer and saliva samples that are tested for DNA and other biomarkers. One of those studies, led by Michelle Odlum, BSN, EdD, an assistant professor of nursing, is testing a fatigue self-management intervention for older Latinos with HIV/AIDS. Nearly half of the 1.1 million people living with HIV/AIDS in the United States are estimated to be over age 50, thanks to medications that have greatly extended survival in recent years. Studies suggest that up to 88 percent of this population suffers from fatigue—a symptom that can
Suzanne Bakken, PhD, RN
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interfere with patients’ self-management (including adherence to their antiretroviral regimen) and their overall quality of life, yet one for which few therapies exist. And because low income and unemployment are among the risk factors for fatigue, Latinos with AIDS and HIV may be especially vulnerable. “I really wanted to help these patients with their symptom management,” says Odlum, who’d previously worked with Bakken to develop a system enabling low-income individuals with AIDS and HIV to access their electronic health records online and to share them with caregivers and case managers. For the new intervention, Odlum and her team adapted a fatigue management curriculum designed for multiple sclerosis patients, the Energy Conservation Course, by working with focus groups of Latino AIDS and HIV patients to modify it for their needs. The customized course uses lectures, discussions, and practice exercises to teach energy-conserving skills, such as taking frequent rest breaks, paying attention to body mechanics and ergonomics, living a balanced lifestyle, and managing priorities. Odlum has completed the three-session curriculum with about 30 subjects and is now conducting follow-up research. A pleasant surprise has been the participants’ enthusiasm for the wearable accelerometers that the study uses to monitor patients’ sleep and activity patterns. “We’ll say, ‘You had 20 episodes in the middle of the night
Michelle Odlum, BSN, EdD
where you were tossing and turning. What was going on?’ They love it, because it helps them understand what’s affecting their energy levels and learn to manage their days.” This data, along with clues found in participants’ saliva, is also helping the researchers pursue a deeper understanding of the dynamics of HIV-related fatigue. One question is whether genetic factors predispose some patients to this symptom. Odlum also plans to investigate whether her intervention affects participants’ levels of proinflammatory cytokines (signaling molecules linked to many chronic conditions) or the length of their telomeres (cap-like structures at the ends of chromosomes that tend to shorten with age or illness). “If we can establish these benchmarks, they could be applicable to people from other ethnic groups as well,” she explains. But whatever scientific findings eventually emerge, the study is already producing encouraging results. “These patients are eager to know about their health, and eager to make changes,” Odlum says. “It’s a wonderful thing when we’re able to help.”
Making Research a Two-Way Street Besides their biometric and sociological aspects, studies under the PriSSM umbrella have two other features in common: They were designed with help from people in the population being studied, and the results are being shared with the study participants as well as with professionals. In a recent project, for example—aimed at developing a family information management system for caregivers of people with dementia—assistant professor Adriana Arcia, PhD, RN, worked with community members to develop information visualizations that would help caregivers recognize their own health risks, including depression symptoms and caregiving burdens. Arcia (the daughter of a Cuban refugee and a Nicaraguan immigrant, both social scientists) also led an intramurally funded study in
“ No matter their area of study,” says Elaine Larson, “our nurse-scientists share the same basic goals: to better serve underserved populations, to reduce health disparities, and to improve care for all patients.” which she consulted with Hispanic patients with asthma to create easily comprehensible infographics explaining their test results—including pulmonary function tests, which are typically not shared with patients because they’re considered too difficult to interpret. “Our graphic walks the patient through it,” she says. “Let’s say you blew out three liters in one second, and four would be normal for a woman your age, race, and height. We show that you blew out enough to fill one and a half two-liter bottles of soda, compared to two full bottles, to indicate that you have 75 percent of your lung function.” The illustrations are printed on a pamphlet, with space for a clinician to write instructions for the patient. “People don’t just want to understand
Adriana Arcia, PhD, RN
their health status, they want to know ‘What do I do about it?’ Facilitating that conversation is a critical piece of the process.” Such participatory approaches to research are woven into pre doctoral and postdoctoral training at Columbia Nursing. While studying for her bachelor’s in nursing, associate research scientist Samantha Stonbraker ’13 ’16, PhD, RN, spent a month as part of the school’s clinical integration program at Clínica de Familia La Romana, an outpatient clinic in the Dominican Republic that specializes in HIV prevention and treatment for adults and children. For her student project, she developed a patient-education talk and a brochure about mental health for adolescent mothers. Yet despite her fluent Spanish, she recalls, it struck her that “none of the moms had any idea of what I was talking about.” Later, as a doctoral student, Stonbraker returned to the clinic to learn more about patient education in that context and the factors that influence it. With guidance from Larson, she conducted a retrospective chart review to characterize the HIV-positive patient population and then developed surveys to measure patients’ health literacy and to explore how they sought and used health information. These studies were the focus of her doctoral dissertation. “It turned out that levels of literacy and understanding were very low,” Stonbraker says. “Even people who’d been coming to the clinic for six or seven years couldn’t tell you what a CD4 count or a viral load is.” For her postdoctoral project, she worked with Bakken and Rebecca Schnall ’09, PhD, RN, the Mary Dickey Lindsay Associate Professor of Disease Prevention and Health Promotion, to develop a tool that would improve the way information is provided to patients at the Clínica de Familia. Stonbraker conducted more interviews
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with patients and staff, as well as a literature review, to determine what content was most vital to communicate; the answer proved to be information about medications and the importance of patients’ adherence to taking them. She then worked with both patients and providers—adapting participatory-design methods developed by Arcia—to create graphics for use as visual aids in patient-education sessions. These illustrations, bound into a small, laminated booklet, are currently being tested at the clinic. “I can’t speak highly enough about the mentoring I’ve received at Columbia,” says Stonbraker, who completed her postdoc in August 2018 and is continuing her research thanks to a career development award from the NINR. “My advisors have struck the perfect balance between letting me be independent and being available if I needed help. Whenever I come up with a new idea, they take a deep breath, think about it for a second, and say, ‘Yeah! Let’s figure out how to make this work.’” Postdoctoral fellow Maichou Lor, PhD, RN, is pursuing a similar line of inquiry with a very different patient population. The daughter of ethnic Hmong parents who fled Laos during the Vietnam War, Lor was born in a Thai refugee camp and immigrated with her family to Madison, Wisconsin, at age 6; by her teens, she was serving as the interpreter when her parents or other relatives went to medical appointments. As a nursing student at the University of Wisconsin–Madison, she began to see that the challenges her family members faced in navigating the health care system reflected larger policy issues. “I realized that populations who don’t speak English aren’t a part of the conversation in a lot of the research we do,” she explains. That led her to become the first Hmong-American nurse to earn a PhD in the United States—after which she came to Columbia Nursing for a postdoc. With Bakken as her adviser, Lor is conducting a study among Hmong patients in Wisconsin, investigating how they describe pain and how that affects their interactions with providers. She’s also working on a study with providers to determine what kinds of information tools might help them better communicate with Hmong patients who are in pain. The goal of both projects is to use visualization methods to develop a culturally and linguistically appropriate pain-assessment tool that serves the needs of patients and clinicians alike. “Although I’m focusing on Hmong patients now,” Lor explains, “I hope that the work I’m doing will have applications for other immigrant groups, particularly those that have low literacy and English proficiency and aren’t used to the American system of practicing health.”
to infection prevention in health care systems and nursing homes, its mission extends to topics ranging from reducing antibiotic overuse to improving end-of-life care. “As nurses, we know that health policy informs our practice,” says Stone. “So it’s crucial that nursing best practices inform health policy.” In 2018, the CHP secured more than $8 million in federal and foundation funding. The largest award was a $2.7 million grant from the NINR to fund the new Center for Improving Palliative Care for Vulnerable Adults with MCC (CIPC), co-directed by Stone and associate professor Jingjing Shang, PhD, RN. The prevalence of multiple chronic conditions (MCCs) in older adults represents one of the nation’s most daunting—and fastest-growing—health care challenges. Patients with MCCs represent 93 percent of Medicare spending, with 75 percent going to the one-third of beneficiaries who have four or more chronic conditions. Elderly patients with MCCs are likely to have more complications and longer hospital stays than other patients their age and to experience end-of-life crises that lead to high use of health care resources without significant increases in their quality of life or survival. In partnership with the Visiting Nurse Service of New York, the CIPC provides support and guidance to nurse-scientists researching better ways to care for these so-called superutilizers. (Columbia Nursing researcher Maxim Topaz, PhD, RN, the Elizabeth Standish Gill
Shaping Policy to Improve Care The Center for Health Policy (CHP), directed by Patricia Stone, PhD, RN, the Centennial Professor of Health Policy, is dedicated to educating nurses in health policy methods as well as developing and disseminating knowledge that informs policymakers at the local, state, and national levels. Faculty members also work with interdisciplinary partners to develop and evaluate policies aimed at improving public health. Although the center focuses primarily on policies related
Patricia Stone, PhD, RN
Carolyn Sun ’15, PhD, RN; Eileen Carter ’14, PhD, RN; Jingjing Shang, PhD, RN
Associate Professor of Nursing, serves as the Visiting Nurse Service’s site principal investigator.) “We want to understand what patients with MCCs actually need as they face the end of life,” Shang explains, “and to find methods that meet those needs while reducing burdensome treatments and transitions.” Two CIPC pilot studies are currently underway. One, led by assistant professor Eileen Carter ’14, PhD, RN, is exploring the risks and benefits associated with antibiotic use from the perspective of nursing home residents and their families. “In the last six months of life, over half of nursing home patients receive an antibiotic, but about 40 percent of prescribed antibiotics in nursing homes are thought to be unnecessary,” Carter points out. “Although antibiotics can save lives, overuse can fuel the rise of antibiotic-resistant microbes. It also needlessly exposes patients to the risks of adverse drug reactions, such as nausea and diarrhea, as well as painful and potentially fatal opportunistic infections, such as Clostridium difficile. Yet no study has looked at whether antibiotic use actually serves the wishes of these patients and their loved ones.” Carter and her team will follow approximately 120 nursing home patients in New York City over a six-month period. One aim of the study is to assess the quantitative relationship between antibiotic use and the symptom burden in this cohort, to better understand why and how often these medications are being administered. Patients and family members will also be surveyed to determine the degree to which antibiotic use conforms to or conflicts with their goals for palliative care. “We want to know how engaged they were in decisions to administer the drugs and how aware they are of the risks,” Carter explains. The second CIPC pilot study, led by associate research scientist Carolyn Sun ’15, PhD, RN, is exploring the symptoms experienced by
and the amelioration strategies used by Chinese-Americans with endstage renal disease. Her goal is to develop culturally appropriate, evidence-based care strategies. Sun, whose doctorate is in global health, has done extensive research on nursing practices in Africa and the Middle East. Her current project grew in part from her experience when her husband’s Chinese-born grandfather was dying of cancer; the family declined to place him in hospice care, believing that it would be perceived as giving up on him and therefore disrespectful. Later, Sun learned that Asian-Americans are less likely than members of other ethnic groups to use hospice or palliative care, for reasons that include different cultural expectations at the end of life, as well as language barriers. For patients with end-stage renal disease, however, palliative care can help avoid months of suffering—and the prevalence of the condition is about 1.5 times higher in Asian-Americans than in Caucasians. (Most such patients have other chronic conditions as well, making them candidates for a CIPC study.) Sun and her colleagues are working to develop a palliative care model incorporating elements from traditional Chinese medicine—such as acupuncture, cupping, and herbal remedies—as well as other methods that might make such care more acceptable to this cohort of patients and their families. The interdisciplinary team will recruit more than 30 elderly Chinese-Americans with end-stage renal disease who receive care from the Visiting Nurse Service, collecting data on their symptoms and existing care strategies and enlisting them in focus groups to help develop the new approach. “Many things that Asian-Americans do for their health, like tai chi and yoga, have crossed over into Western medicine,” Sun notes. “As we become a more global society, I think both sides will increasingly learn from each other.”
Aluem Tark ’16, MSN, RN; Laura Starbird, PhD, RN
Getting More Bang for the Health Care Buck Another NINR grant to the CHP funds a five-year-old program known as Comparative and Cost-Effectiveness Research Training for Nurse Scientists (CER2). The U.S. spends far more on health care than any other country, yet studies consistently show that our outcomes are poorer than those of our peer nations. Comparative and cost-effectiveness research is a set of methodologies that generate patient-centered evidence to determine which interventions achieve the best care for the least cost. The CER2 program provides six trainee nurse-scientists with research support, didactic courses, networking opportunities, and financial assistance to build their skills in this vital discipline. Each fellow is matched with two faculty mentors—one within nursing and one from another field—to advise them as they pursue original research projects using these techniques. CER2 postdoctoral fellow Laura Starbird, PhD, RN, was first drawn to health care policy research while studying for her master’s in nursing at the University of California, San Francisco, where she grew frustrated with the obstacles that prevented her patients who were both HIV- and hepatitis C-positive from getting the full array of support they needed. During her doctoral studies at Johns Hopkins, she came to realize that it takes more than a great idea to change policy in the real world. “When you walk into a room with policymakers,” she says, “their question is always going to be, ‘Okay, what does this cost and how does it compare to what we’re already doing?’” Now, as a postdoc at Columbia Nursing, Starbird is learning how to find the answers. She’s using her CER2 fellowship to research two different interventions for people living with HIV and hepatitis C—
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patient navigators to link individuals to care, and practice coaches to help substance-abuse clinics implement HIV and hepatitis C testing for their clients. “Rather than just focusing on individual patients’ behavior,” she says, “it seems more feasible and sustainable to make our health systems work better. A well-run organization makes it easier for patients to make healthy choices and prevents them from falling through the cracks.” Predoctoral scholar Aluem Tark ’16, MSN, RN, is focusing her CER2 studies on variations in implementing Physician Orders for Life Sustaining Treatment (POLST) across the country. Like Starbird, Tark came to her topic from personal experience: working as a pediatric oncology nurse at a New York City hospital, where she often found herself caring
“ For me, the main question was ‘If I can’t add to the quantity of this kid’s life, how can I improve its quality?’” says predoctoral scholar Aluem Tark. for young patients at the end of life. “For me, the main question was ‘If I can’t add to the quantity of this kid’s life, how can I improve its quality?’” she recalls. “I went into research because I wanted to find ways to do that not just for individual patients, but for the health care system as a whole—and to be surrounded by other people with the same goal.” At Columbia Nursing, Tark is examining policy issues around palliative care in nursing homes, particularly advance directives such as POLST forms. What she finds most valuable about CER2 is the opportunity to learn from researchers in a wide variety of fields. “We work with
Tonda Hughes, PhD, RN; Cindy Veldhuis, PhD
epidemiologists, economists, public health researchers,” she explains. “Every week, we have a conference where we share our perspectives. That’s priceless.” After earning her PhD, Tark aims to become an independent researcher, eventually bringing her expertise to her native South Korea, where palliative care remains an unfamiliar concept. “I want to be a bridge,” she says, “so that this kind of care can be implemented effectively everywhere.”
Improving Care for the LGBT Community The mission of the Program for the Study of LGBT Health—a collaboration between Columbia University School of Nursing, Columbia University Department of Psychiatry, and the New York State Psychiatric Institute—is to promote the health and wellness of LGBT people in the U.S. and abroad. Led by Walter Bockting, PhD, and Anke Ehrhardt, PhD, both professors of medical psychology, the program focuses on five basic areas: youth and families, aging, lesbian and bisexual women’s health, transgender health, and the neuroscience of gender. Tonda Hughes, PhD, RN, a professor of nursing and of psychiatry and the director of global health research at Columbia Nursing, is working with the program on a number of major studies. For the past 20 years, she has led the NIH-funded Chicago Health and Life Experiences of Women (CHLEW) study, the longest-running study of sexual minority women’s health currently in existence. Hughes is also conducting a series of scoping reviews (surveys of existing research) of LGBT health studies around the world, a crucial step in determining the knowledge gaps that need to be filled. And she recently completed
a study on the experiences of lesbian and bisexual women in Rwanda. “Although the country lacks the legal sanctions on homosexuality found elsewhere in Africa, the stigma remains huge,” Hughes explains. “Several of the women we interviewed had been raped by a family member or someone brought in by the family to try to change their sexual orientation. Many of their parents had stopped paying their school fees, and they were living in poverty. In a country known for its tolerance, we found lingering, deep-seated negative attitudes.” Before Hughes joined Columbia Nursing in 2017, research psychologist Cindy Veldhuis, PhD, was one of her trainees at the University of Illinois at Chicago. After earning her doctorate in psychology, Veldhuis followed her mentor to her new academic home. Now a postdoctoral fellow at Columbia Nursing, she is studying how stress and stigma affect LGBT women, particularly in the areas of relationships and health behaviors. Veldhuis gained national attention for a study she led on worries over violence and discrimination among LGBT women and gender minorities in the wake of the 2016 presidential election; in an online survey of more than 1,000 people, nearly 70 percent reported having higher concerns about their safety than before the election. More recently, she completed data collection for a project titled the Study of Queer Intimate Relationships (SOQIR—pronounced “so queer”), which examines stress and health behaviors among women in samesex/gender couples. In interviews with eight couples and online surveys of over 500, Veldhuis and her team explored the impacts of race/ ethnicity and sexual identity on relationship dynamics and behaviors such as drinking, marijuana use, and other forms of avoidant coping, such as binge-watching television. Veldhuis is also studying les-
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bian and bisexual women’s relationships and risky alcohol use on a Ruth L. Kirschstein Postdoctoral Research Fellowship from the NIH, the first such grant awarded at the school. “In previous studies, we’ve found that women in same-sex couples are at higher risk of hazardous alcohol use if they have multiple marginalized identities—that is, if they’re a racial/ethnic minority as well as a sexual minority,” she explains. “We’re analyzing the results of SOQIR to examine the effects of the stress that comes from multiple marginalized identities within couples.” While working as a cardiovascular surgery nurse and studying for his MSN, postdoc Billy Caceres, PhD, RN, noticed that LGBT patients often had multiple risk factors for heart disease that went untreated, leading to repeated readmissions. He began wondering whether stress related to sexual or gender identity might itself be a risk factor, and, if so, whether nurses could play a role in mitigating that risk. By the time he finished his PhD, he’d decided to focus his research on sexual minority women—an interest that led him to Columbia Nursing for a postdoctoral research fellowship supervised by Hughes. Caceres recently applied for a grant from the National Heart, Lung, and Blood Institute (NHLBI) to recruit women from the CHLEW study and their heterosexual sisters to investigate the impact of adverse life experiences and familial factors on the risk of cardiovascular disease. To
Billy Caceres, PhD, RN
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gain a broader range of insights, he’s also a trainee in Columbia Nursing’s CER2 program and is leading a pilot study funded through PriSSM on symptoms of post-traumatic stress disorder and cardiovascular disease in Latinas. Last year, he led a preliminary study of 547 lesbian and bisexual women from the CHLEW study, showing that trauma in childhood or adulthood—including sexual abuse and intimate partner
“ In a small way, I’m out to change the world,” says first-year PhD student Kodiak Soled. violence—is associated with higher cardiovascular risk. (Co-authored by Hughes, Veldhuis, and Kathleen Hickey, EdD, RN, a professor of nursing, the study won the Cardiovascular and Stroke Nursing Best Abstract Award from the American Heart Association.) “All my work is centered on the idea that different people are exposed to different stressors, so different interventions may be necessary to help reduce the associated risks,” he explains. “But we’ve only started scratching the surface of how these factors impact health.” Postdoctoral research fellow Kasey Jackman ’05 ’10 ’17, PhD, RN, is leading a PriSSM pilot study investigating the associations between
Kodiak Soled, MSN, RN
discrimination based on gender identity or ethnicity and sleep disturbance and fatigue outcomes in Latinx transgender people. Jackman is also a member of the research staff at Project AFFIRM, a multiyear study led by Bockting that follows more than 300 transgender and gender-nonconforming people in New York, San Francisco, and Atlanta, assessing the dynamics that influence their vulnerability, risk, and resilience. Jackman previously led a sub-study that investigated the role these dynamics play in non-suicidal self-injury. In two recently published papers, Jackman’s team reported that non-suicidal self-injury was more closely associated with felt stigma (individuals’ perceived or anticipated rejection on the basis of their transgender identity) than with active stigma (such as discrimination or harassment). They also found that trans people were less likely to self-injure when they felt that their appearance represented their gender identity—whether or not that involved gender-affirming interventions, such as hormones or surgery. In a separate study, researchers led by Jackman found to their surprise that older trans women reported lower levels of internalized transnegativity and psychological distress compared to a younger group. “We think that, over time, people may learn to cope with the challenges they’re facing and become more accepting of their own identity,” Jackman explains. “We still have very high rates of suicidality in the trans community, but this research suggests that trans people develop resilience over time.” Kodiak Soled, MSN, RN, a first-year PhD student, is researching family-building desires and experiences in transgender and genderexpansive people. Soled’s path began in Boulder, Colorado, where she spent several years as a therapeutic chef, clinical herbalist, maternity wellness coach, and postpartum doula; she also founded a parenting support group for LGBT people. Eventually, she landed in the graduate nursing program at Johns Hopkins, where she researched provider knowledge gaps regarding transgender health as a barrier to care. After earning her master’s degree, she decided to pursue her doctorate at Columbia Nursing because of the mentoring and sense of community for which the Program for the Study of LGBT Health is known. “It was hard to find another top-tier school with such a mutually supportive group of people,” she says. With Bockting as her adviser, Soled is focusing on reducing the challenges that face gendernonconforming people who choose to have children. “My goal is to help providers learn more about the gestational experience in this population, so that care is delivered in a more competent and sensitive manner,” she adds. “In a small way, I’m out to change the world.”
Strengthening the Nursing Workforce In 2010, the U.S. Institute of Medicine called for a rapid expansion of the nurse practitioner (NP) workforce in primary care to meet the needs of an aging population. The number of NPs has been booming ever since; today, they constitute about 20 percent of all primary care providers. Yet many barriers hinder their ability to deliver optimal care. Associate professor Lusine Poghosyan, PhD, RN, focuses her research on identifying those obstacles and finding ways to remove them.
Lusine Poghosyan, PhD, RN
Born in a small village in Armenia, Poghosyan followed her mother into nursing and immigrated to America in 2004; she joined Columbia Nursing’s faculty in 2011, after earning her PhD, and quickly gained recognition as one of the country’s leading experts on nursing workforce development. “Most of my papers are about increasing awareness about who NPs are, what they’re capable of doing, and what kind of support they need to do their jobs well,” she explains. “Often, health care organizations have no idea what to do with them.” Although multiple studies have shown that patients treated by NPs have outcomes equal or superior to those of patients treated by physicians alone, she notes that regulations in 29 states require NPs to have physician oversight for their delivery of care. Poghosyan’s research has shown that in many practice environments, relations with administrators and access to resources are poor. Fewer than 40 percent of NPs have their own patient panel to whom they deliver continuous care. In a 2018 study, she and her team found that quality of care for patients with chronic illnesses improves when NPs work in practices with favorable environments—but that such practices remain in the minority. “Physicians sometimes get two exam rooms, while NPs get only one, even though they see the same number of patients,” she says. “That’s just not realistic or productive.” Poghosyan has developed a tool called the Nurse Practitioner Primary Care Organizational Climate Questionnaire to help health care systems gauge their use of NPs. She is also partnering with researchers around the country and abroad to identify better practices and policies and is mentoring a handful of investigators who share her professional passion. Associate research scientist Allison Norful ’17, PhD, RN, for example, changed her career course from medicine to nursing after
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being hospitalized for a cardiac condition when she was a premed. The experience made her realize that, as she puts it, “nurses are the glue that hold health care together.” After she became a cardiology nurse, her gift for creative organizational problem-solving propelled her up the administrative ladder. She returned to school for an MSN and NP certification, then worked for several more years in managerial positions, where she became increasingly convinced that nursing workforce fixes could improve patient outcomes. She recalls that the organization’s leaders “kept saying, ‘Show me the evidence.’ Finally, I said, ‘I’m going to go build the evidence.” She chose Columbia Nursing for her doctorate, largely so that she could work with nursing policy experts like Poghosyan. For her doctoral and postdoctoral research, funded through Columbia Nursing’s Center for Health Policy and later the National Center for Advancing Translational Sciences, Norful focused on the role of interprofessional teams within primary and acute care settings—particularly on provider co-management, a process involving representatives of two different disciplines working together to manage the same patients. She went on to develop the first instrument to gauge the quality of such collaborations, the Provider Co-Management Index, which she’s now testing with 3,000 primary care providers in New York State. “This tool measures dimensions of a
Allison Norful ’17, PhD, RN
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practice environment that are crucial to effective co-management,” she explains, “like effective communication, mutual respect and trust, and a shared philosophy of care.” Another of Poghosyan’s advisees is predoctoral scholar Cilgy Abraham, BS, RN—who is also receiving mentorship from Norful. (Graduate students at the school often receive guidance from both senior and junior faculty, before going on to become mentors themselves.) Abraham, the recipient of a Future of Nursing Scholarship from the Robert Wood Johnson Foundation and a Margaret E. Mahoney Fellowship from the New York Academy of Medicine, is researching topics such as the cost-effectiveness of using NPs in managing patients with chronic illness and predictors of burnout among primary care providers. “In my mind, all of this connects,” she says. “The relationship between costs, work environment, and staffing is key to patient outcomes.”
Harnessing the Power of Mobile Tech One of the biggest obstacles to improving health care for underserved populations is that such populations can be difficult for caregivers to reach. In recent years, for example, one in four new HIV infections have been in youth aged 13 to 24, mostly young men who have sex with men. Yet few evidence-based HIV-prevention interventions exist for this cohort, and they are often reluctant to attend the group sessions that are typically required. Rebecca Schnall ’09, PhD, RN, the Mary Dickey Lindsay Associate Professor of Disease Prevention and Health Promotion, has developed a potential solution—an app called MyPEEPS Mobile. Schnall’s focus on HIV grows out of her experience as a pediatric nurse and AIDS educator; she learned to leverage mobile technology while studying for her doctorate in nursing informatics under Bakken. For MyPEEPS, she adapted an existing HIV intervention, designed for racially and ethnically diverse young men who have sex with men, by working with potential users aged 13 to 24 to hone the app’s design. The six-module curriculum covers social and personal factors, including knowledge (for example, the correct way to use a condom), self-efficacy for safer sex, and communication skills. Schnall is currently leading a five-year, randomized trial of the app—with 700 participants in New York, Seattle, Chicago, and Birmingham, Alabama—funded by a $7.9 million grant from the NIH, the largest in Columbia Nursing’s history. She’s also working on several other federally funded studies to develop and test other mHealth tools (as mobile health apps are known), including an applinked pillbox to boost medication adherence in HIV patients and an app that helps patients interpret and act on their HIV test results. “My vision for health care is to give patients resources to take better care of themselves,” she says. “I want them to have information at their fingertips, so that they can make better decisions.” Arlene Smaldone ’03, PhD, RN assistant dean for scholarship and research, directs the PhD program at Columbia Nursing and also pursues investigative projects of her own—most of them centering on youth and adult self-management of chronic health conditions. She’s currently co-principal investigator, with Columbia pediatrician
Rebecca Schnall ’09, PhD, RN
Nancy Green, MD, of a study in which mobile technology is used to help adolescents with sickle-cell anemia remember to take their medication—hydroxyurea—which prevents the buildup of abnormal hemoglobin in their blood cells, which in turn causes the painful and potentially lethal crises associated with the disease. “Because symptoms seldom follow immediately after a dose is skipped,” Smaldone explains, “patients often forget to take it— especially in adolescence, when responsibility for adherence transi-
“ M y vision for health care is to give patients resources to take better care of themselves,” says Rebecca Schnall. “I want them to have information at their fingertips, so that they can make better decisions.” tions from parent to child.” In the intervention that she and her team developed, a community health worker consults with parents and their kids (aged 10 to 18) to turn medication-taking into a habit by tying it to other daily routines. Once such a routine is identified, the family begins receiving automated text messages—written by the participants themselves—reminding them to perform their parts. A parent’s task might be to put the vial on the nightstand before bedtime; the child’s might be to reach over and take the pill. The Hydroxyurea Adherence for Personal Best in Sickle Cell Disease (HABIT) study began in 2016 with a feasibility trial that suggested the intervention improved adherence. In the phase now underway—a
Arlene Smaldone ’03, PhD, RN
randomized, controlled, multisite trial that will follow about 200 participants from four clinical sites in New York City and Philadelphia for a year—the text messages will end after six months, to determine whether the habit sticks. The researchers will also investigate whether the protocol reduces sickle-cell crises. “In interventions for chronic diseases, one size doesn’t fit all,” says Smaldone. “What’s exciting about mobile technologies is that they give us a bigger toolbox.” As a recent graduate student, Meghan Reading ’18, PhD, RN, explored that toolbox in another way. Reading (who was an NINR Ruth L. Kirschstein Predoctoral Fellow and a Jonas Nurse Leader Scholar) entered the PhD program after several years as a staff nurse on a cardiac unit, where she saw how chronic disease disproportionately impacts the most vulnerable members of society. “I was attracted to Columbia Nursing because of how intimately they were working with the community in which they were situated and how involved they were in returning research data to the people who provided it,” she says. Supervised by Hickey and professor of nursing informatics Jacqueline Merrill ’98 ’06, PhD, RN, Reading did her dissertation research on factors that influence how patients with atrial fibrillation engage with mobile apps that allow them to monitor their own heart rates. Her investigation required her to develop skills bridging two disparate fields—electrophysiology and informatics—and to collaborate closely with researchers at Columbia University Irving Medical Center’s Vagelos College of Physicians and Surgeons and Department of Biomedical Informatics. “My mentors not only supported my work, but they served as role models for this kind of interdisciplinary investigation,” says Reading, who’s now a postdoc at Weill Cornell Medical Center. “They gave me a blueprint for the rest of my career.”
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Columbia Nursing 25
[ RESEARCH REPORT ]
Columbia Nursing Research
BY THE NUMBERS
5th IN NIH FUNDING *
Columbia Nursing reached its historical high ranking among Schools of Nursing with $7.4 million in Fiscal Year 2017
155% INCREASE in NIH* annual awards from FY09 to FY18
$1,293,796 RANKED #1 IN TOTAL AHRQ* GRANT FUNDING IN 2018
$36.7 million Total amount of new funding since 2016 26
Columbia Nursing Spring 2019
65
Number of new external grants and sponsored projects since 2016
$7.9 MILLION
This cooperative agreement, funded by NIH/NIMHD* in 2016, is testing a novel and evidencedriven intervention using mobile technology to deliver HIV prevention information developed for diverse young men who have sex with men.
LARGEST SINGLE RESEARCH GRANT
2 INSTITUTIONAL TRAINING GRANTS Reducing Health Disparities through Informatics Program:
Comparative and Cost-Effectiveness Training for Nurse Scientists Program:
• 4 predoctoral trainees • 3 postoctoral trainees
• 2 predoctoral trainees • 3 postdoctoral trainees
Training the Next Generation of Nurse-Scientists . . .
. . . and Launching New Research Trajectories
NINR*
2 CENTER GRANTS Precision in Symptom Self-Management (PriSSM) Center:
Center for Improving Palliative Care for Vulnerable Adults with MCC (CIPC):
• NINR* Center of Excellence • 6 Pilot Projects
• NINR* Exploratory Center • 6 Pilot Projects
* National Institutes of Health; Agency for Healthcare Research and Quality; National Institute on Minority Health and Health Disparities; National Institute of Nursing Research.
Spring 2019
Columbia Nursing 27
[ RESEARCH REPORT ]
POLISHING SCIENTIFIC GEMS The Office of Scholarship and Research Development helps nurse-scientists burnish their investigative ideas. | By Kenneth Miller
T
he nurse-scientists profiled in this issue all have one thing in common: They’ve been supported in their efforts by Columbia Nursing’s Office of Scholarship and Research Development (OSR). The mission of the OSR is to increase the scholarly and research capacity of Columbia Nursing’s researchers by helping improve the quality of grant applications and manuscripts submitted for publication. Its work complements that of the Grants Management Office, which assists with the nuts and bolts of putting grant applications together, such as filling in forms, developing budgets, and ensuring regulatory compliance. For the past 15 years, the OSR has been an essential resource for faculty, associate research scientists, postdoctoral fellows, and predoctoral students in their pursuit of external research funding and in their dissemination of the resulting findings via peer-reviewed articles and conference presentations. Through its broad scope of services and programs, and its one-on-one mentorship and guidance, the OSR plays a crucial role in fostering a culture of scholarly inquiry at the school and in advancing research that improves nursing practice and patient care. Helping Researchers Secure Funding The OSR provides a variety of services to help researchers strengthen their case for external funding. An intramural pilot grant program supports small research projects that enable new and early-stage investigators to generate preliminary data that they can use to apply for larger grants. When grants get to the project development and writing stages, investigators can draw on statistical support from two dedicated faculty members—Haomiao Jia, PhD, and Jianfang Liu, PhD—who have expertise in biostatistics, data analysis, and data management and programming. To ensure that applications are as persuasive as possible, OSR director Kristine Kulage, MA, MPH, leads grant-writing workshops for all levels of investigators, beginning with a three-day intensive session for predoctoral students seeking to fund their dissertation research. She also assists postdoctoral trainees and junior-level researchers by editing their drafts. “I look at each document as a piece of writing,” she explains. “I help with clarity, conciseness, and cohesiveness, as well as consistency in formatting and compliance with guidelines.”
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Columbia Nursing Spring 2019
Internal grant reviews are another valuable service coordinated by the OSR. Before submitting a grant application, all Columbia Nursing researchers participate in a process called Specific Objectives and Aims for Research (SOAR), during which they present their proposals’ specific goals to faculty members for feedback and suggested revisions. They also take part in a mock review protocol, modeled after an NIH study section, in which they receive a real-time, presubmission peer review from experts. Providing Technical Help The assistance continues after a grant is funded and the research gets underway. For projects dealing with “big data,” the OSR offers sophisticated database support from Liu. Office coordinator Joshua Massei, MBA, helps researchers master the intricacies of complex software—for example, survey programs such as Qualtrics and REDCap—and find creative solutions to the IT challenges of interdisciplinary research. Helping the Work Find an Audience Once a research project has been completed, it is critical for nursescientists to disseminate their findings. The OSR provides tools to help them do so effectively. One key offering is Writing Workshops, inaugurated in 2013, which have become a staple part of the dissemination process at Columbia Nursing, with nearly 50 participants to date. Led by Kulage, the workshops enroll from four to seven participants per semester, including predoctoral students and postdoctoral fellows, as well as faculty members; after an initial orientation session, each one-hour meeting is devoted to constructively critiquing one manuscript intended for publication in a specific peerreviewed journal. In addition, the OSR recently hired a dedicated informationist— John Usseglio, BS, MPH—who consults with individual faculty and students one day a week on researching and writing scholarly manuscripts. To support researchers who plan to present their findings at professional conferences, the OSR arranges rehearsal sessions at which they can practice in front of colleagues. The office also provides presenters with financial support to help offset travel costs.
OFFICE OF SCHOLARSHIP AND RESEARCH DEVELOPMENT WORKFLOW MODEL
RESOURCES AND SUPPORT FOR A PROGRAM OF NURSING RESEARCH • Statistical Support • Editing and Formatting • Grant Writing Workshops 1 • Intramural Pilot Grants 2 • Internal Grant Reviews 2
SECURING RESEARCH FUNDING
• What does it cost the school to submit a federal grant application? 6 • What are alternative methods for assessing research productivity? 7
• Database Support • Software Support • Systems Support 3
• Manuscript Writing Workshops and Courses 4, 5 • Informationist Support • Conference Rehearsals • Conference Travel Funds
CONDUCTING RESEARCH
DISSEMINATING RESEARCH FINDINGS
IMPROVED HEALTH AND QUALITY OF CARE
• What are the school’s research priorities? 8, 9 • How can the school expand its research impact globally? 10
CULTURE OF SCHOLARLY INQUIRY
8. Peirce, A., Cook, S., Larson. E. (2004). 6. Kulage, K.M., Schnall, R., Hickey, K.T., 3. Kulage, K.M., Larson, E.L., Begg, M.D. 1. Kulage, K.M., Stone, P.W., Smaldone, A.M. Focusing Research Priorities in Schools of Travers, J., Zezulinski, K., Torres, F., (2011). Sharing Facilities & Administrative Implementation and Outcomes of a Federal Nursing. Journal of Professional Nursing, Burgess, J., Larson, E.L. (2015). Time and Cost Recovery to Facilitate Interdisciplinary Grant Writing Workshop in a Nursing PhD 20(3), 156-159. Costs of Preparing and Submitting an Research. Academic Medicine, 86(3), 394-401. Program, 2014-2017. Podium Presentation NIH Grant Application at a School of Nursing. at the American Association of Colleges of 9. Kulage, K.M., Ardizzone, L., Enlow, W., 4. Kulage, K.M., Larson, E.L. (2016). ImplemenNursing Outlook, 63(6), 639-649. Nursing 2018 Doctoral Education Conference, Hickey, K.T., Jeon, C., Kearney, J., Schnall, tation and Outcomes of a Faculty-Based, Peer Naples, FL, January 19, 2018. R., Larson, E.L. (2013). Refocusing Research Review Manuscript Writing Workshop. Journal 7. Kulage, K.M., Massei, J.R., Larson, E.L. NIH Priorities in Schools of Nursing. Journal of Funding Ranked “Per Capita”: An Alternative of Professional Nursing, 32(4), 262-270. 2. Kulage, K.M., Larson, E.L. (2018). Intramural Professional Nursing, 29(4), 191-196. Method for Assessing Research Productivity. Pilot Funding and Internal Grant Reviews 5. Kulage, K.M., Bargad, A., Miller-Saultz, D., Western Journal of Nursing Research, 2019 Increase Research Capacity at a School of 10. Kulage, K.M., Hickey, K.T., Honig, J., Opiola-McCauley, S. Creation and Impact of a Feb 22 [Epub ahead of print]. Nursing. Nursing Outlook, 66(1), 11-17. Johnson, M., Larson, E.L. (2014). Scholarly Writing and Dissemination Course in Establishing a Program of Global Initiatives a Doctor of Nursing Practice Program. Poster for Nursing Education. Journal of Nursing Presentation at the American Association of Education, 53(7), 371-378. Colleges of Nursing 2018 Doctoral Education Conference, Naples, FL, January 18-19, 2018.
Finding the Most Effective Ways to Help An important priority for the OSR is to systematically examine the impact of its own initiatives—and to disseminate these findings, so that nursing leaders at other institutions can judge whether similar measures might be worth pursuing. For example, a 2017 study by Kulage and Elaine Larson, PhD, RN, senior associate dean for research and the Anna C. Maxwell Professor of Nursing Research, published in the journal Nursing Outlook, found that the OSR’s intramural pilot funding and internal grant review programs significantly increased the school’s research capacity. “Grant applications that underwent any type of internal review were more than twice as likely to be funded compared with those that did not undergo internal review,” the co-authors wrote. Out of 88 applications, 42 percent of those that underwent SOAR and/or
mock review received funding, compared with 20 percent of those that did not participate in any internal review process. Over a five-year period, 14 intramural pilot grants—with a total outlay of just over $127,000—resulted in 16 peer-reviewed articles, 33 presentations, and 11 externally funded grants totaling over $3 million. In addition, the internal review process “stimulates interdisciplinary collaboration and models a professional attitude of openness and mutual support for predoctoral students,” the researchers noted. “Based on our results,” they concluded, “it would seem that these initiatives represent a clear return on investment in the future success of nursing faculty as well as expand the funding portfolio of the school.” By evaluating the effectiveness of such programs, the OSR helps ensure that they are focused in areas of greatest need and that they have the strongest possible impact.
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Columbia Nursing 29
From the Alumni Association President Dear Columbia Nursing Alumni,
G
reetings on behalf of the Alumni Association. I am humbled to once again serve as your president. We had an exciting start to the 2018–19 academic year, welcoming Lorraine Frazier as our new dean at Columbia Nursing. Beginning this fall, we are excited to host Meet the Dean events across the country. More information can be found on the back of this magazine. We hope you’ll mark your calendars and join us for the events in your area— attend and show your Columbia Nursing pride! My role as president of the school’s Alumni Association is to assist in representing the voice of nearly 11,000 Columbia Nursing alumni living and working around the world. The Alumni Association is your opportunity to stay involved in the life of the school. We are a vibrant community where graduates have the opportunity to learn, network, give back to their community, mentor, socialize, and grow. The Alumni Association is committed to engaging alumni through networking events, volunteer opportunities with students, service projects, and special events on and off campus. The many events sponsored by the Alumni Association enable you to maintain a lifelong relationship with your alma mater and allow you to meet students, faculty, and one another. The Alumni Association has several committees—making it easy for you to stay engaged. I encourage you to join one: • Recent Alumni Engagement Committee: Develop and deepen recent graduates’ involvement with Columbia Nursing, including events and initiatives that drive engagement and increase recent graduates’ participation in the Annual Fund. • Community Outreach Committee: Identify opportunities for community involvement for alumni, students, faculty, and staff to actively strengthen and support volunteer initiatives within New York City and regionally. Participants work together to benefit local organizations and causes to engage in the community. • Reunion Committees: Take the lead on specific areas of Reunion with a core group of volunteers for each class/program. Participants serve as liaisons for their class or program during the Reunion planning process. • Annual Fund Committee: Assist the Annual Fund chair with fundraising as an important part of Columbia Nursing’s fundraising efforts. Committee members encourage classmates to support the Annual Fund and communicate with donors. If you would like to participate in any of these committees, wish to become more engaged with the school, or would like to update your contact information, please contact our alumni office at nursingalumni@columbia.edu or 212-305-5999. On behalf of the Alumni Association, I hope you have a wonderful summer and I look forward to hearing from you and seeing many of you at future events. Warm Regards,
Laura Ardizzone ’04 ’10, DNP, CRNA, ACNP, DCC President, Columbia Nursing Alumni Association Director, Nurse Anesthesia Services, Memorial Sloan Kettering Cancer Center
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2018-2019 Alumni Association Board of Directors Ellen Soley Adkins ’81 Laura Ardizzone ’04 ’10 Paige Mackey Bellinger ’10 ’12 Daniel Billings ’15 ’17 ’18 Kevin Browne ’92 Monica Buff Burrell ’09 ’12 Kenrick Cato ’08 ’14 Patricia DeAngelis Fife ’68 Mollie Finkel ’11 ’12 Elizabeth Gary ’14 ’15 Christa Simpson Heinsler ’76 Denise DeMarzo Houghton ’78 Matthew Jenison ’10 ’12 Rosalind Riordan Kendellen ’74 Wanda Montalvo ’15 Kathleen McCooe Nilles ’89 Rose Chapman Rodriguez ’87 ’06 Marty Cohn Romney ’81 Natalie Wilson ’09 ’11 Connie Yip ’11 ’13
Congratulations to Don Boyd ’06 ’17 on receiving the 2019 Columbia Alumni Medalist Award. This distinguished award recognizes alumni across Columbia University for their service of 10 years or more to the University—including its schools, alumni associations, cross-campus initiatives, regional Columbia Clubs, and University-wide initiatives.
2018–2019
Class Notes
1960s Deena Penchansky Lisak ’64 has retired, but
volunteers at the Multiple Sclerosis Society of Michigan. Mary Anne Kowles Phemister ’64 published
her fifth book, My Six Brilliant Careers: A Memoir of Vocation and Calling, a personal story of remembrance, growth, risk taking, and transitions. Susan Evans ’65 had a 50-year career in mental health after receiving her master’s in nursing at the University of Pennsylvania.
Christine writes that her husband is retired and that they have two daughters, both living in New York City, as well as four grandchildren: Zachary (13), Ava (12), Lily (9), and Stella (7). She has spent the last 37 summers on Fire Island, which is the perfect place for academic writing and visits with the grandkids. Peggy Akers ’69 was awarded the American
Association of Nurse Practitioners 2018 State Award for Excellence for Maine, a capstone for a career approaching 50 years.
1970s
Judith McLaughlin Martin ’66 has been
staying in touch with various classmates on a regular basis. She is still very active and knits booties for The Baby Place at Adventist Health System in Asheville, North Carolina, and is also involved in various activities through Daughters of the American Revolution, including projects related to Columbia Nursing graduate Anne Penland, class of 1912. Susan Green Cooksey ’68 received the
Columbia Nursing 2018 Award for Distinguished Career in Nursing. Helene DeMontreux ’68 published her second book, Well-Come to Retirement: Thriving in Your Third Act. Christine Tassone Kovner ’69 is the Mathy Mezey Professor of Geriatric Nursing at New York University.
Ruth Dodt Palmer ’70 retired last year after
40 years of practicing psychotherapy. She had several interesting jobs in nursing, including labor and delivery, public health, and hospital nursing in Denmark. After receiving her master’s in mental health nursing at University of California, San Francisco, she began her new career at Highland Hospital working in the psychiatric unit as a staff therapist. Eventually, she found her way to private practice, then to training as a Jungian analyst. She notes that 40 years of practice was deeply satisfying work, through which she felt privileged to know so many people intimately. Ruth is eternally grateful for the strong foundation the Columbia Nursing program gave her. Nanci Simmons McLeskey ’71 was successful in getting end-of-life education into
the University of Utah College of Nursing curriculum. In 2018 she received the Distinguished Educator in Gerontological Nursing award from the National Hartford Center of Gerontological Nursing Excellence. Barbara Luke ’72, professor at Michigan State
University College of Human Medicine, was inducted into the American Academy of Nursing in 2018. Marsha Bronsther ’74 has lived all over the country with her husband and four children. She is currently working as a school nurse for a county health department in Maryland. Marsha received a master’s in public health from Hebrew University many years ago and has also raised bernese mountain dogs for over 20 years. Susan Mascitelli ’74 was named among the 2018 Notable Women in Health Care by Crain’s New York Business. Leslie Kessler ’77 has been working as a
pediatric nurse practitioner in private practice since she graduated from University of California, Los Angeles, in 1981 with a master’s degree in nursing. She also has her own business, a home/Skype visit program for new parents to educate and coach called Rhythmic Parenting. She also became an online coach at Circle4parents. Leslie notes that her Columbia Nursing education was a springboard for a very rewarding career that enabled her to grow professionally while raising four children.
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Columbia Nursing 31
Class and Program Notes 1980s Rear Admiral Tina Alvarado ’81 has retired as
Deputy Chief, Reserve Policy & Integration, Bureau of Medicine and Surgery, US Navy. Her official retirement ceremony took place in November 2018. The Surgeon General spoke during the program, where there was a detail of eight women—all nurses—who took part in the flag ceremony portion. Each represented one of the ranks that Tina held during her career in the Navy. Tina was also featured in a panel discussion on how to navigate the workplace in She Opened the Door: Columbia University Women’s Conference, hosted by the Columbia Alumni Association in February 2018. Kathleen White ’82 is the director of the Patient & Family Education Department at
the Medical University of South Carolina (MUSC) Medical Center in Charleston, South Carolina, and leader of MUSC’s health literacy initiatives.
Barbara Reale ’85 received a 2018 Excellence
Ruth Wittman-Price ’83, dean of the
1990s
Francis Marion University (FMU) School of Health Sciences, was named FMU’s J. Lorin Mason Distinguished Professor for 2018–19. Susan Fox ’84 was named among the 2018 Notable Women in Health Care by Crain’s New York Business. Josefina Morales ’85 writes that she is the proud grandmother of a baby boy named Cayden and always looks forward to hearing news of Columbia Nursing and the world of nursing in general.
in Teaching Award from the American College of Nurse-Midwives.
Kimberly Otto ’90 went to the University of
Pennsylvania to earn her MSN as a pediatric nurse practitioner in 1992. In 2010 she completed her post-master’s certification as a family nurse practitioner. Then, in 2014, she graduated from the University of Mass achusetts, Boston, with a DNP in nursing leadership. She has focused on rural and urban clinics for the underserved for the majority of her career. She currently lives in Scranton, Pennsylvania, with her husband, Phillip. Together, they have four adult children: Kelsey, Matthew, Lauren, and Taylor.
2018-2019
Program Notes Acute Care Lisbeth Vortuba ’00 relocated to Michigan
after graduating from Columbia Nursing. She has held a number of positions at Mercy Health Saint Mary’s: ICU bedside nurse, clinical nurse specialist, and Magnet program director. She led the successful effort to gain Magnet program designation in 2013. After demonstrating good outcomes in 1:1 sitter reductions and fall prevention, she was asked to join AvaSure, the makers of the TeleSitting solution, in 2014. She is currently the vice president of clinical quality and innovation at AvaSure. Lisbeth
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Columbia Nursing Spring 2019
is a charter member of the AONE Corporate Advisory Council and is the nursing representative appointed by the Michigan Board of Nursing to serve on the Health Providers Recovery Council, which is a monitoring program for health care providers struggling with mental health and/or substance use issues in Michigan.
Adult Stasi Lubansky ’80 was elected to the Board
of Directors of the American Holistic Nurses Association.
Shazia Mitha ’16 ’18, PhD student, was selected to be a Robert Wood Johnson Foundation Future of Nursing Scholar. Kimberly Nojima ’16 ’18 serves as co-chair
of the NP Council at Columbia’s Herbert Irving Comprehensive Cancer Center. Laura Ridge ’10 founded the nonprofit Nursing for All, which she directs with fellow Columbia Nursing alum Jennifer Walsh ’10. They celebrated five years of nurse-led programming in Liberia last fall. Since 2013 they have fought Ebola and offered free family planning, mental
health care, and diabetes and blood pressure management. Kerri Anne Scanlon ’93 ’97, deputy chief
nurse executive at Northwell Health, was inducted into the American Academy of Nursing in 2018.
Anesthesia James Doran ’02 was reappointed by then
New Jersey Governor Chris Christie to the New Jersey Board of Nursing. He was also recently elected secretary/ treasurer of the board.
Midwifery
Karen Desjardins ’98 ’05 received the Adam Solomon Award from the Tanenbaum Center, a nonprofit focused on combating religious prejudice, for exemplifying leadership, strategic vision, and creativity.
Elizabeth Gary ’14 ’15 is pleased to share the news of the birth of her son, Mason Birch Myshrall, on Aug. 14, 2018.
Melissa Kramps ’04 ’13 was named the
Barbara Hackley ’81 received a 2018
clinical coordinator of the lung screening program at Lenox Hill.
Excellence in Teaching Award from the American College of Nurse-Midwives.
Ruth Madden Foreman ’12 was appointed
Patricia Loftman ’82 was featured in a ProPublica video on “How More Midwives May Mean Healthier Mothers.”
to assistant professor in the family nurse practitioner program at Carlow University in Pittsburgh, Pennsylvania.
Anne Miller ’86 received a 2018 Outstanding
ETP
Preceptor Award from the American College of Nurse-Midwives.
Anita Lesko ’89 was featured in a spotlight arti-
cle by the Florida Association of Nurse Anesthetists, which highlighted her life and work.
Jordana Morgenstern ’02 was jointly honored with her husband by Young Israel of Scarsdale for 18 years of community service.
Critical Care
Sunoz Soroosh ’13 is currently working
Kevin Browne ’92 received his Doctor of
Nursing Practice from St. Peter’s University on Dec. 13, 2018. His doctoral work targeted practice drift among nurses.
as a nurse at a clinic and birth center in rural Guatemala. She assists the midwives and doctor with general health visits, prenatal consults, births, and their mobile clinics, which entails driving out to remote communities in the mountains.
Patricia Riley ’76 retired after 43 years at the
Family
Frances Cartwright ’92 ’93, CNO at Mount
Margaret Walsh ’94 received the Columbia
Sinai Hospital, was inducted into the American Academy of Nursing in 2018.
Maureen Swick ’93 was appointed senior
vice president and system nurse executive for Atrium Health.
DNP
Nursing 2018 Distinguished Alumni Award for Nursing Practice.
Joyce Anastasi ’05 received a $3.5 million NIH grant to study non-pharmacologic treatment for neuropathic pain in people with HIV.
Thundermist Health Center in Rhode Island.
Daniel Billings ’15 ’17 ’18 serves as co-chair
Nadia Santana ’13 ’15 ’16 published her
of the NP Council at Columbia’s Herbert Irving Comprehensive Cancer Center.
first book, The Ultimate Nurse Practitioner Guidebook.
Paul Coyne ’13 ’15 ’16, a member of the
Board of Visitors at Columbia Nursing, is now the senior director, clinical informatics and advanced practice nursing, at Hospital for Special Surgery. Paul was also named a Rising Star Under 40 in Health Care by Becker’s Hospital Review.
Susan Papera ’76 was honored with an award related to her long-standing commitment and dedication to midwifery at North Central Bronx Hospital.
Centers for Disease Control and Prevention as health systems lead in the Division of Global HIV & TB.
Oncology
Pediatrics
Hillary Greene ’04 ’07 has a new position at
Master’s Direct Entry (MDE) Ithamar Turenne ’18 received the President’s Award for Excellence in Leadership from the LCU Fund for Women’s Education in 2018.
Rose Joseph ’96 established a pediatric
practice in Brooklyn 22 years ago and is now retired. She was inspired by many of her fellow nurses and patients and is proud to be a Columbia Nursing alum. Laura Grossman Nissim ’88 was a part-time
student in the clinical nurse specialist program and also an employee of Columbia University Irving Medical Center. For the last 13 and a half years, she has been employed in a large law firm as a certified legal nurse consultant.
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Columbia Nursing 33
Program Notes and In Memoriam Martha Cohn Romney ’81 received the Faculty Achievement Award at Jefferson College of Population Health in 2018. She was also promoted to associate professor.
PhD
Wanda Montalvo ’15 was named executive director of Jonas Nursing and Veterans Healthcare. Wanda was also named a Fellow of the New York Academy of Medicine. Patricia Moreland ’03 ’10 is now an assistant
Ann-Margaret Navarra ’92 ’11 received the
to the International Nurses Association with her publication in the Worldwide Leaders in Healthcare.
Columbia Nursing 2018 Distinguished Alumni Award for Nursing Research.
for patients with X and Y chromosome variations. Sharron was also named the recipient of Atlanta Business Chronicle’s 2018 Health Care Heroes Award in the nursing category. Janet Haas ’07 served as the 2018 president of the Association for Professionals in Infection Control and Epidemiology.
William Roberts ’05 received the Columbia
Nursing 2018 Distinguished Alumni Award for Nursing Administration.
professor at Emory Nursing.
Charlotte Cabello ’78 ’06 was welcomed
Sharron Close ’01 ’03 ’11 started a clinic
Patient Care, Yvonne L. Munn Center for Nursing Research.
Allison Norful ’17 and Jasmine Travers ’16 are founding chairs of the Eastern Nursing Research Society’s Health Services Research Interest Group.
Sarah Collins Rosetti ’09 was named a Fellow of the American College of Medical Informatics. Sarah also received a Leadership Award from the American Medical Informatics Association. Rebecca Schnall ’09 was inducted into the American Academy of Nursing in 2018. Carolyn Sun ’15 was elected to the Eastern
Allison Norful ’17 received a 2018 Heilbrunn
Nursing Research Society (ENRS) Nominating Committee. She was selected from among five candidates, and the election had the highest voter turnout in ENRS election history.
Nurse Scholar Award from Rockefeller University’s Heilbrunn Family Center for Research Nursing. She also received a 2018 Postdoctoral Scholarship from the Academy Health Interdisciplinary Research Group on Nursing Issues.
Psychiatric Mental Health
Andrew Phillips ’08 ’12 was appointed faculty nurse scientist at Massachusetts General Hospital by the hospital’s Institute for
Jeannemarie Baker ’90 received the Columbia Nursing 2018 Neighbors Humanitarian Distinguished Alumni Award.
Kasey Jackman ’05 ’10 ’17 received
the Dissertation Excellence Award from Columbia University School of Nursing.
2018-2019
In Memoriam Laura DeWeese Donohoe ’68 passed away in
Feb. 2017 at Portsmouth Regional Hospital, in New Hampshire. A graduate of Smith College and Columbia Nursing, Laura was a devoted caregiver throughout her life. She worked as pediatric nurse at Portsmouth Regional Hospital for 30 years. Prior to that, she lived in New York City working as a nurse in the burn unit at Harlem Hospital; in the kidney transplant unit at St. Luke’s Hospital; and at Trinity School in Manhattan. Laura was an active member of the National
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Columbia Nursing Spring 2019
Society of the Colonial Dames of America (NSCDA) and was devoted to the MoffattLadd House & Garden, a historic museum owned and operated by the New Hampshire Chapter of the NSCDA. Geraldine Allerman Golden ’57 passed away on
Oct. 31, 2018, at the age of 84. She graduated from Columbia Nursing with a BS in nursing and went on to obtain both her master’s and EdD in nursing education at Teachers College. She began her nursing career at St. Joseph’s
Hospital in Paterson, New Jersey, followed by nursing at NewYork-Presbyterian/ Columbia University Medical Center, and later held positions in administration at St. Luke’s/Roosevelt Hospital (Mount Sinai) in New York City. She spent the latter part of her career as a nurse educator at both the undergraduate and graduate levels at Pace University, Mercy College, and the State University of New York at Binghamton, and ended her career at University of Medicine and Dentistry of New Jersey.
Doris Macdonald Hansmann ’43 passed away
on May 16, 2018, in the company of loved ones at her home in Ridgewood, New Jersey, at the age of 97. She lived a life of kindness and service, devoted to her family, friends, and community. In 1943, Dorie graduated with a combined BA/BSN from Elmira College and Columbia University School of Nursing as president of her class. Later that same year, she married Ralph E. Hansmann, the love of her life. Service and citizenship were important to Doris. She was a founding member of Children’s Aid and Family Services in the 1950s and served the growing organization in many ways. As chair of the Columbia Nursing Capital Campaign, she helped raise over a million dollars for the school. Elizabeth Mathil Lauver ’56 passed away on
Jan. 17, 2019, at Homestead Village in Lancaster, Pennsylvania, at the age of 85. Betty obtained her Bachelor of Science in Nursing from Columbia Nursing and then worked in the private-duty sector in New York. She, her husband, and daughters also spent many summers in Oakland, Maine, at the New England Music Camp, where her husband Karl was the head counselor and Betty was a nurse. Betty was a member of the Westhampton Presbyterian Church while she lived in New York. Karl and Betty enjoyed traveling cross-country in their RV and their summers in Maine. Betty moved to Lancaster in the early 2000s, where she volunteered for Women & Babies Hospital. Melva Brown Neff ’62 passed away on Dec.
23, 2017, in Syracuse, New York, at the age of 78. She graduated from King’s College in 1959 and Columbia Nursing in 1962. Melva had a nursing career that spanned 48 years. She began her career caring for newborns as an ICU Nurse in New York City and later moved to Utica, New York, where she became a nurse manager at St. Luke’s Hospital. While there, she met Fred. They married in 1966 and had three children. She then became a nursing instructor, first at Mohawk Valley Community College, then at West Chester
Other Losses in Our Community Geraldine Golden Allerman ’57 Suzanne Lillicrapp Anderson ’59 Angelica Sarmiento Bailey ’99 Karen Baldwin ’79 Lois Ramhurst Ballmann ’59 Elizabeth Schoonmaker Booth ’42 Helen McCormick Callahan ’46 Margaret Grace Coligan ’64 Ella Martens Craft ’42 Mary Felsing Crawford ’54 Rebecca Shoemaker Dallavo ’44 Isabel Hoet Dannenberg ’51 Helen Searls DeGroot ’56 Janet Duncan Dolan ’65 Laura DeWeese Donohoe ’68 Barbara Gorgay Downey ’72 Eunice Hering Feininger ’47 Mary Roseberry Fetig ’46 Gay Currie Fox ’46 Carolyn Werner Gibson ’53 Marcia Tucker Gleasman ’63 Geraldine Allerman Golden ’57 Doris MacDonald Hansmann ’43 Mary Towers Harris ’49 Jessie Nye Havice ’49 Nancy Bartlett Horne ’52 Christina Housman ’56 M. Dorothy Jacobsen ’48 Bette Fearon Johnson ’48 Judy Andersen Kamm ’70
State College, and later at Onondaga Community College. She also became one of the first nurses hired by Hospice of Central New York. Her interest in quality care of the elderly led Melva to become director of education for the Syracuse Home Association, an infection control nurse at James Square, and ultimately infection control practitioner at the Loretto Health and Rehabilitation Center. She subsequently became a consultant for nursing facilities in the region. Marion Howald Swarthout ’42 passed away on Nov. 19, 2018, peacefully in her home in
Frances Koslowski Kobylarz ’56 Patience Hornney Kostrzewsky ’49 Linda Lacasse ’92 Edith Flanders Lambert ’63 Elizabeth Mathil Lauver ’56 Ruth Lindner Leistensnider ’56 Margaret Smith McGovern ’58 Carol Mizock ’75 Jo-Anne Casamento Morgan ’70 Marjorie Johnston Murray ’50 Mary Payne Nangeroni ’46 Melva Brown Neff ’62 Rachel Parios Parios ’76 Elizabeth Morgan Porter ’47 Elizabeth Post ’44 Lucille Levin Reed ’49 Antonio Ripoll ’99 Ruth Oliver Ryan ’54 Pamela Outsh Schwab ’70 Emily DiYulio Scinto ’51 Ruth Hirsch Silverman ’45 Marilyn Miller Stiefvater ‘54 Paula Stolz ’69 Marion Howald Swarthout ’42 Marjorie Hutchins Taylor ’56 Delight Mocas Tillotson ’52 Judith Solcum Van Derburgh ’50 Nancy Scheirt Wasileski ’67 Jean Bensinger Wetzel ’46
Laguna Woods, California. Born to Swiss parents, Ernest and Louise Howald, she treasured her Swiss heritage, and passed it on to her children and grandchildren. Marion graduated from Columbia Nursing in 1942, and served as a first lieutenant in the U.S. Army Nurse Corps at Fort Jay, New York, from 1943–44. In 1944 she met her beloved husband, Walter M. Swarthout, also an Army lieutenant. They married in 1944 and were a loving example until his death on March 20, 1990. Marion worked as a registered surgical nurse at Pacoima Lutheran, Serra Memorial, and Northridge Hospitals from 1963–86.
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A GLIMPSE OF SOME ALUMNI EVENTS
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1: Dottie Simpson Dorion ’57, Dean Lorraine Frazier, and Ken Forde at the welcome reception for Dean Frazier in November 2018. 2: Midge Harrison Fleming ’69, Angela Clarke Duff ’70, Dolores Fernandez ’56, and Dottie Simpson Dorion ’57 at the welcome reception for the dean in November 2018. 3: Ally Picard, Linh Tran, and Connie Yip ’11 ’13 at the Psychiatric Mental Health alumni and student networking event held in October 2018, hosted by Susan Furlaud ’09 ’12. 4: Alumni and students at the Nurse Midwifery and student networking brunch in September 2018. 5: David Schwedes ’18 moderated an alumni panel titled Men in Nursing, in September 2018, featuring: Kent Haina ’14 ’18; Kevin Browne ’92; Kenrick Cato ’08 ’14, associate research scientist; Francisco Diaz ’03 ’05; and Paul Coyne ’13 ’15 ’16. 6: Joan McCormick ’61, Lois Mueller Gazier ’57, Tim Lehey ’85, Dean Lorraine Frazier, and Olga Brown Vanderpool ’70 at the welcome reception for Dean Frazier in November 2018.
7: Dean Lorraine Frazier and Daniel Billings ’15 ’16 ’18 at the welcome reception for the dean in November 2018. 8: Carolyn Fu; Carolyn Sun ’15, 10 associate research scientist; and Catherine Cohen ’12 ’16 at the Serving Those Who Serve Our Country: Healthcare Priorities for the VA, Public Health, and Tri- Services event jointly hosted by Columbia Nursing’s Alumni Association and Center for Health Policy in October 2018. 9: Alumni and students at the Nurse Anesthesia networking reception that took place during National CRNA Week in January. 10: Kathleen Aitken ’73 ’95 ’97, Dean Lorraine Frazier, and Laura Zeidenstein ’05, associate professor, at the Nurse Midwifery alumni and student networking brunch in September 2018.
To view more pictures and event information, visit nursing.columbia.edu/alumni
Bobbie Berkowitz Delegation to Guatemala Save the date: November 4–13, 2019 You’re invited to attend a nursing delegation to Guatemala (Antigua, Atitlán, and Guatemala City) with Bobbie Berkowitz, former dean of Columbia Nursing. Enjoy the unique culture and traditions of Guatemala while you spend time with the locals and meet fellow nursing professionals. To register or for more information, call 888-747-7501 or visit nandajourneys.com.
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Selected Faculty
Publications
JÖRG ME YER
Our faculty’s research continues to create new knowledge that advances health care. Listed are selected articles published by leading peer-reviewed publications. Adriana Arcia, PhD, assistant professor; Jacqueline Merrill ’98 ’06, PhD, professor; and Suzanne Bakken, PhD, Alumni Professor of Nursing and professor of biomedical informatics,
were the authors of a book chapter titled, “Consumer Engagement and Empowerment Through Visualization of ConsumerGenerated Health Data,” published in Consumer Informatics and Digital Health: Solutions for Health and Health Care.
Suzanne Bakken, PhD, Alumni Professor of Nursing and professor of biomedical informatics, and Rebecca Schnall ’09, PhD, Mary Dickey Lindsay Associate Professor of Disease Prevention and Health Promotion, were among
the authors of “Behavioral Interventions Using Consumer Information Technology as Tools to Advance Health Equity,” published in the American Journal of Public Health. Jean-Marie Bruzzese, PhD, associate professor,
Dawon Baik, PhD, postdoctoral research fellow,
was among the authors of “Examining Interprofessional Team Interventions Designed to Improve Nursing and Team Outcomes in Practice: A Descriptive and Methodological Review,” published in the Journal of Interprofessional Care, and “Using the Palliative Performance Scale to Estimate Survival for Patients at the End of Life: A Systematic Review of the Literature,” published in the Journal of Palliative Medicine. Dawon Baik, PhD, postdoctoral research fellow, and Haomiao Jia, PhD, associate professor, were
among the authors of “Measuring Health Status and Symptom Burden Using a WebBased mHealth Application in Patients with Heart Failure,” published in the European Journal of Cardiovascular Nursing.
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was among the authors of “Comprehensive Community-Based Intervention and Asthma Outcomes in African American Adolescents,” published in Pediatrics, and “The Preliminary Impact of a Sleep Improvement Program on Sleep, Mood, and Anxiety Symptoms in College Students: A Pilot Study,” published in the Journal of American College Health. Jean-Marie Bruzzese, PhD, associate professor; Maureen George, PhD, associate professor; and Jianfang Liu, PhD, assistant professor, were
among the authors of “Health Literacy and Asthma Among Hispanic and AfricanAmerican Urban Adolescents with Undiagnosed Asthma,” published in Annals of Allergy, Asthma and Immunology. Jean-Marie Bruzzese, PhD, associate professor; Rita Marie John ’05, DNP, special lecturer;
and Jade Sekeres ’17, MS, DNP student, were among the authors of “An Adolescent Male with a Nonhealing Leg Ulcer: A Case of Granulomatosis with Polyangiitis,” published in The Nurse Practitioner. Jean-Marie Bruzzese, PhD, associate professor, and Lusine Poghosyan, PhD, associate professor,
were among the authors of “Individual and Neighborhood Factors Associated with Undiagnosed Asthma in a Large Cohort of Urban Adolescents,” published in Journal of Urban Health. Billy Caceres, PhD, postdoctoral research fellow; Kathleen Hickey, EdD, professor; and Tonda Hughes, PhD, Henrik H. Bendixen Professor of International Nursing, were among the authors
of “Cardiovascular Disease Disparities in Sexual Minority Adults: An Examination of the Behavioral Risk Factor Surveillance System (2014–2016),” published in the American Journal of Health Promotion. Hwayoung Cho ’17, PhD, postdoctoral research scientist; Jacqueline Merrill ’98 ’06, PhD, professor; and Rebecca Schnall ’09, PhD, Mary Dickey Lindsay Associate Professor of Disease Prevention and Health Promotion, were among the authors of
“A Multi-Level Usability Evaluation of Mobile Health Applications: A Case Study,” published in the Journal of Biomedical Informatics. Hwayoung Cho ’17, PhD, postdoctoral research scientist, and Rebecca Schnall ’09, PhD, Mary Dickey Lindsay Associate Professor of Disease
Prevention and Health Promotion, were among the authors of “A Mobile Health Intervention for HIV Prevention Among Racially and Ethnically Diverse Young Men: Usability Evaluation,” published in JMIR mHealth uHealth. Hwayoung Cho ’17, PhD, postdoctoral research scientist; Rebecca Schnall ’09, PhD, Mary Dickey Lindsay Associate Professor of Disease Prevention and Health Promotion; Dawon Baik, PhD, postdoctoral research fellow; Tiffany Porras, MPH, research coordinator; and Melissa Beauchemin ’06 ’10, PhD student,
were authors of “Understanding the Predisposing, Enabling, and Reinforcing Factors Influencing the Use of a Mobile-Based HIV Management App: A Real-World Usability Evaluation,” published in the International Journal of Medical Informatics. Maureen George, PhD, associate professor; Haomiao Jia, PhD, associate professor; Allison Norful ’17, PhD, associate research scientist; Lusine Poghosyan, PhD, associate professor; and Jean-Marie Bruzzese, PhD, associate professor, were among the authors of
“Shared Decision-Making in the BREATHE Asthma Intervention Trial: A Research Protocol,” published in the Journal of Advanced Nursing. Caroline Handschuh ’19; Allison LaCross ’11 ’12 ’14, DNP, assistant professor; and Arlene Smaldone ’03, PhD, professor and assistant dean of scholarship and research, were the
authors of “Is Sexting Associated with Sexual Behaviors During Adolescence? A Systematic Literature Review and Meta-Analysis,” published in the Journal of Midwifery and Women’s Health. Amanda Hessels, PhD, assistant professor, was
among the authors of “Impact of Patient Safety Culture on Missed Nursing Care and Adverse Patient Events,” published in the Journal of Nursing Care Quality. Tonda Hughes, PhD, Henrik H. Bendixen Professor of International Nursing, was among the authors
of “Sexual Orientation Disparities in Pregnancy and Infant Outcomes,” published in
Maternal and Child Health Journal; “Qualitative Study of Depression Literacy Among Korean American Parents of Adolescents,” published in the Journal of Psychosocial Nursing and Mental Health Services; “Severity of Alcohol, Tobacco, and Drug Use Disorders Among Sexual Minority Individuals and Their ‘Not Sure’ Counterparts,” published in LGBT Health; “Women’s Self-Perceived Similarity to Their Mother and Associations with Patterns of Alcohol Misuse over 20 Years,” published in Alcohol and Alcoholism; “Health Professional Training and Capacity Strengthening Through International Academic Partnerships: The First Five Years of the Human Resources for Health Program in Rwanda,” published in International Journal of Health Policy and Management; “Sexual Identity of Drinking Companions, Drinking Motives, and Drinking Behaviors Among Young Sexual Minority Women: An Analysis of Daily Data,” published in Psychology of Addictive Behaviors; and “Health Care-Related Correlates of Cervical Cancer Screening Among Sexual Minority Women: An Integrative Review,” published in Journal of Midwifery and Women’s Health. Tonda Hughes, PhD, Henrik H. Bendixen Professor of International Nursing, and Walter Bockting, PhD, professor and co-director, LGBT Health Initiative, Division of Gender, Sexuality, and Health,
were among the authors of “Mental Health Promotion for Gender Minority Adolescents,” published in the Journal of Psychosocial Nursing and Mental Health Services. Tonda Hughes, PhD, Henrik H. Bendixen Professor of International Nursing, and Cindy Veldhuis, PhD, postdoctoral research fellow, were among the
authors of “Depression and Victimization in a Community Sample of Bisexual and Lesbian Women: An Intersectional Approach,” published in Archives of Sexual Behavior. Kasey Jackman ’05 ’10 ’17, PhD, postdoctoral research fellow; Judy Honig ’05, DNP, Dorothy M. Rogers Professor of Nursing and senior associate dean of academic affairs and dean of students; and Walter Bockting, PhD, professor and co-director, LGBT Health Initiative, Division of Gender,
Sexuality, and Health, were among the authors of “Stigma, Gender Dysphoria, and Nonsuicidal Self-Injury in a Community Sample of Transgender Individuals,” published in Psychiatry Research. They were also among the authors of “Experiences of Transmasculine Spectrum People Who Report Nonsuicidal Self-Injury: A Qualitative Investigation,” published in the Journal of Counseling Psychology. Kasey Jackman ’05 ’10 ’17, PhD, postdoctoral research fellow, and Tonda Hughes, PhD, Henrik H. Bendixen Professor of International Nursing, were among the authors of “Sexual
and Gender Minority Health Research in Nursing,” published in Nursing Outlook. Brenda Janotha ’08, DNP, assistant professor,
was among the authors of “Improving Herpes Zoster Vaccine Rates: The Impact of a Targeted Educational Program,” published in the Journal of the American Association of Nurse Practitioners. Rita Marie John ’05, DNP, special lecturer,
co-authored “Mind & Body Practices in the Treatment of Adolescent Anxiety,” published in The Nurse Practitioner; “Disruptive Mood Dysregulation Disorder,” published in The Journal for Nurse Practitioners; “The Pediatric Primary Care Management of Myasthenia Gravis,” published in The Journal for Nurse Practitioners; “The Primary Care Management for Youth Experiencing Incarceration,” published in The Journal for Nurse Practitioners; and “Diagnosis and Primary Care Management of Focal Segmental Glomerulosclerosis in Children,” published in The Nurse Practitioner. Theresa Koleck, PhD, associate research scientist, was among the authors of
“Exploratory Study of Associations Between DNA Repair and Oxidative Stress Gene Polymorphisms and Cognitive Problems Reported by Postmenopausal Women With and Without Breast Cancer,” published in Biological Research for Nursing. Theresa Koleck, PhD, associate research scientist; Niurka Suero-Tejeda, MS, project manager;
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Selected Faculty Publications and Suzanne Bakken, PhD, Alumni Professor of Nursing and professor of biomedical informatics, were the authors of “The Influence of
Rebecca Schnall ’09, PhD, Mary Dickey Lindsay Associate Professor of Disease Prevention and Health Promotion, was among the authors of
Education to Support HIV Self-Management in Limited-Resource Settings,” published in Journal of Nursing Scholarship.
Latino Symptom Experience on Participation in Usual Activities and Satisfaction with Participation in Social Roles,” published in Hispanic Health Care International.
“Adaptation of a Group-Based HIV RISK Reduction Intervention to a Mobile App for Young Sexual Minority Men,” published in AIDS Education and Prevention.
Patricia Stone, PhD, Centennial Professor of Health Policy, was among the authors of
Maichou Lor, PhD, postdoctoral research fellow,
Rebecca Schnall ’09, PhD, Mary Dickey Lindsay Associate Professor of Disease Prevention and Health Promotion; Hwayoung Cho ’17, PhD, postdoctoral research scientist; and Natalie Voigt, PhD student, were authors of
was author of “Color-Encoding Visualizations as a Tool to Assist a Nonliterate Population in Completing Health Survey Responses,” published in Informatics for Health and Social Care. She was also among the authors of “Navigating Challenges of Medical Interpreting Standards and Expectations of Patients and Health Care Professionals: The Interpreter Perspective,” published in Qualitative Health Research. Maichou Lor, PhD, postdoctoral research fellow; Theresa Koleck, PhD, associate research scientist; and Suzanne Bakken, PhD, Alumni Professor of Nursing and professor of biomedical informatics, were among the authors of
“Association Between Health Literacy and Medication Adherence Among Hispanics with Hypertension,” published in Journal of Racial and Ethnic Health Disparities. Lusine Poghosyan, PhD, associate professor; Jianfang Liu, PhD, assistant professor; and Allison Norful ’17, PhD, associate research scientist, were
among the authors of “Nurse Practitioner Practice Environments in Primary Care and Quality of Care for Chronic Diseases,” published in Medical Care. Nancy Reame, PhD, Mary Dickey Lindsay Professor Emerita of Disease Prevention and Health Promotion, was among the authors
of “Postmenopausal Hormone Treatment Alters Neural Pathways but Does Not Improve Verbal Cognitive Function,” published in Menopause. Jeanne Rubsam ’93, MS, assistant professor,
was among the authors of “High Volume Crystalloid Resuscitation Adversely Affects Pediatric Trauma Patients,” published in the Journal of Pediatric Surgery.
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“Hospital Staffing and Healthcare Associated Infections: A Systematic Review of the Literature,” published in Joint Commission Journal on Quality and Patient Safety. Patricia Stone, PhD, Centennial Professor of Health Policy, and Andrew Dick, PhD, assistant clinical professor, were among the authors of
“Supervised Physical Activity and Improved Functional Capacity Among Adults Living with HIV: A Systematic Review,” published in the Journal of the Association of Nurses in AIDS Care.
“Nursing Home Adoption of the National Healthcare Safety Network Long-Term Care Facility Component,” published in the American Journal of Infection Control.
Arlene Smaldone ’03, PhD, professor and assistant dean of scholarship and research, was
Maxim Topaz, PhD, Elizabeth Standish Gill Associate Professor of Nursing, was among the
among the authors of “A Visual Analytics Approach for Pattern-Recognition in Patient-Generated Data,” published in the Journal of the American Medical Informatics Association, and “A Protocol for a Pilot Randomized Controlled Trial to Assess the Feasibility and Effect of a Cognitive Behavioral Intervention on Quality of Life for Patients on Hemodialysis,” published in Contemporary Clinical Trials.
authors of “Medical Malpractice Trends: Errors in Automated Speech Recognition,” published in the Journal of Medical Systems; “Improving Patient Prioritization During Hospital-Homecare Transition: A Pilot Study of a Clinical Decision Support Tool,” published in Research in Nursing & Health; and “Nurses ‘Seeing Forest for the Trees’ in the Age of Machine Learning: Using Nursing Knowledge to Improve Relevance and Performance,” published in Computers, Informatics, Nursing.
Laura Starbird, PhD, postdoctoral research fellow, was among the authors of “A System-
atic Review of Interventions to Minimize Transportation Barriers Among People with Chronic Diseases,” published in the Journal of Community Health, and “Care2Cure: A Randomized Controlled Trial Protocol for Evaluating Nurse Case Management to Improve the Hepatitis C Care Continuum Within HIV Primary Care,” published in Research in Nursing and Health.
Cindy Veldhuis, PhD, postdoctoral research fellow, and Tonda Hughes, PhD, Henrik H. Bendixen Professor of International Nursing, were
Samantha Stonbraker ’13 ’16, PhD, associate research scientist; Suzanne Bakken, PhD, Alumni Professor of Nursing and professor of biomedical informatics; and Rebecca Schnall ’09, PhD, Mary Dickey Lindsay Associate Professor of Disease Prevention and Health Promotion, were among
Kyungmi Woo ’18, PhD, postdoctoral research fellow, and Jingjing Shang, PhD, associate professor, were among the authors of
the authors of “Priority Topics for Health
among the authors of “Mapping the Landscape of Support and Safety Among Sexual Minority Women and Gender Non-Conforming Individuals: Perceptions After the 2016 US Presidential Election,” published in Sexuality Research and Social Policy.
“Patient Factors Associated with the Initiation of Telehealth Services Among Heart Failure Patients at Home,” published in Home Health Care Services Quarterly.
JÖRG ME YER
“ Columbia Nursing’s Annual Fund enabled me to pursue nursing after earlier careers as an opera singer and then as a licensed massage therapist specializing in injury rehabilitation and trauma. As a nontraditional older student, I am enormously grateful for my Annual Fund scholarship that allowed me to change professions and return to school to do something totally new and deeply meaningful.” “— Jennifer Furst ’17, DNP
Make your gift to the Annual Fund today!
HELP BUILD THE
FUTURE OF NURSING Scholarship Fund
Dean’s Discretionary Fund
Building Fund
Global Fellows Fund
To make your tax-deductible contribution, send a check payable to Columbia University School of Nursing or donate online at nursing.columbia.edu/giving.
For more information, contact Janine Handfus, associate director, Annual Fund, at 212-305-0079 or jh2526@columbia.edu.
Innovations in Simulation Fund
560 West 168th Street, MC 6 New York, NY 10032
COLUMBIA NURSING ON THE ROAD:
MEET DEAN FRAZIER Mark your calendars for Meet the Dean events featuring Lorraine Frazier.
Portland, ME Sunday, September 29, 2019
Boston, MA Thursday, April 9, 2020
San Francisco, CA Thursday, November 14, 2019
Savannah, GA Saturday, April 18, 2020
Santa Monica, CA Saturday, November 16, 2019
Raleigh, NC Fall 2020
New Canaan, CT Saturday, March 7, 2020
FOR INFORMATION:
nursingalumni@columbia.edu
