Research

Faculty in the URI College of Nursing are leading innovative research initiatives, generating new knowledge and producing transformative scholarship. CON faculty lead and/or participate in research projects in a wide variety of focal areas. Some key areas of research focus are described below. Principal investigators (PIs) with current federally funded projects are listed. A number of faculty are also co-investigators on other research projects (not listed).

Pre-doctoral and post-doctoral applicants are encouraged to review faculty members’ individual bios and/or schedule appointments to speak directly with potential research mentors.

Areas of Research Focus

CON faculty are engaged in a variety of funded research projects and research-related activities. Areas of research focus include:

Adolescent and emerging adult health and risk behaviors
Aging
Cancer health equity
Chronic disease and health promotion/prevention
Complementary and integrative health
Global women’s health
Health equity and disparities
Implementation science
Infants and families
LGBTQIA+ health
Opioid Use Disorder
Palliative care and end-of-life care
Violence prevention and screening

Principal Investigators of Current Federally Funded Research Projects (as of 9/01/2020)

PI: Susan DeSanto-Madeya, PhD, MSN-CNS, BSN-RN, FPCN, FAAN

Research Project Name: Structural Racism and Engagement of Family Caregivers in Serious Illness Care
Grant #: NIH R01
Overview: Serious illness is a condition that carries a high risk of mortality and either negatively impacts a person’s daily function or excessively strains their family caregivers. Serious illness affects an estimated 12 million US adults. Structural inequity and racial/ethnic residential segregation may affect serious illness outcomes by 1. limiting access to palliative care, the specialty focused on improving quality of life for persons with serious illness and their families and 2. limiting the capacity of family caregivers to engage with the healthcare system. Family caregivers are critical for this population because they assist with complex decision making, care coordination and patient advocacy. Structural inequity refers to the totality of ways in which societies foster racial discrimination through mutually reinforcing systems (such as housing, education, employment, and healthcare) that ultimately affect health outcomes. Such institutions include healthcare systems, whose internal cultures may affect care delivery and patient outcomes differentially by race and ethnicity. Few studies have attempted to highlight racism’s impact on family caregivers. To address this gap, we propose a population-based, multi-level, mixed-methods study within and across the state of Massachusetts, a diverse state with large limited-resource communities and a population that includes ~30% persons of color (POC). Focusing on a single state allows for in-depth investigation across communities that vary in racial composition and resources, as well as across hospital systems that vary in terms of size, profit status and academic affiliation. In Aim 1 we propose a quantitative analysis that will describe neighborhood-level burden of serious illness, access to hospital-based palliative care, availability of caregiver resources, and their impact on individual-level health outcomes. Data from the All Payer Claims Database will characterize neighborhood-level rates of serious illness and access to palliative care (travel time), and individual-level health care utilization (hospitalization, palliative care use, length of stay, ICU stay) and health outcomes (in-hospital death). Mediation analysis with linked data on neighborhood-level caregiver-related resources from the American Community Survey will identify the effect of neighborhood-level caregiver resources on outcomes. We hypothesize that poorer access to care, measured as longer travel time to hospitals, will more negatively affect POC from neighborhoods with fewer caregiver resources. In Aim 2 we will conduct qualitative case studies of hospitals to characterize how hospital cultures support or constrain caregiver engagement for persons with serious illness from different POC communities. We will conduct n=8 in-depth case studies to characterize institutional cultures of caregiver engagement. In Aim 3 we convene community, content, and policy experts to synthesize quantitative and qualitative results to produce culturally appropriate hospital recommendations and actionable policy solutions to improve equity in caregiver engagement for serious illness. Disentangling the relationships between segregation, neighborhood deprivation, and healthcare utilization in serious illness will help us show that inequity, not mistrust, is a primary barrier to equitable care and health outcomes.

Learn more about equity in caregiving here.

PI: Amy D’Agata, PhD, RN.

Research Project Name: Allostatic Load & Epigenetic Mechanisms in Lifecourse Trajectories of Preterm Infants at Age 30
Grant #: NIH/NINR 1 R01 NR018147
Duration: 2019-2024
Overview: Among the most intense experiences of adversity for infants is premature birth. Annually, 1 in 10 (450,000 in the U.S., 15 million worldwide) infants are born prematurely. Yet, studies of premature infants at adulthood are few compared to those at younger ages and most focus on the smallest 20% of premature infants. We do know that their transition to adulthood is challenging, and often hampered by cognitive, physical and mental health, motor and independence difficulties. With an interdisciplinary team, this longitudinal study is the 10th wave of a Rhode Island born cohort of infants representing a wide range of neonatal morbidity, birth weight, and socioeconomic status who are now in their early 30s. The study aims include: complex modeling of adult outcomes of health, function, work, and social competence; examination of allostatic load with metabolic, cardiovascular, neuroendocrine and inflammatory biomarkers; and epigenome-wide DNA methylation and estimates of age acceleration (Horvath’s epigenetic clock). The project brings a lifecourse perspective to determine how prematurity and environmental stress effects preterm-to adult health. To our knowledge, this would be the only U.S. study of premature infants to age 30-33y. Thus, there is limited research-based evidence to inform the timing and content for interventions despite millions of preterm survivors.

Principal Investigators with Current Foundation-funded Research Grants

PI: Susan DeSanto-Madeya, PhD, APRN-CNS, FAAN

Research Project Name: Photovoice: An Intervention for Aligning Goals of Care within Seriously Ill African-American Dyads
Grant: Hillman Foundation
Duration: Jan. 1, 2021 – Dec. 31, 2021
Overview: African-American seriously ill adults experience significant disparities in care, are less likely to receive palliative care services and are more likely to be hospitalized unnecessarily. This project seeks to examine attitudes towards palliative care among African-American adults with serious illnesses and their caregivers. The project uses Photovoice as part of an intervention to assist these seriously ill adults and their caregivers to align their treatment goals and examine palliative care options.

PI: Jungeun Lee, PhD, RN

Research Project Name: Fatigue, sleep disturbance, and quality of life for older adults living with HIV
Funder / Grant #: Rhode Island Foundation / #5205_20200602
Duration: 04/01/2020 – 09/30/2021
Overview: HIV requires continuing treatment and care, which is especially critical among older adults who tend to have co-morbidities and impaired health-related quality of life (HRQOL). Older people living with HIV (PLWH) often experience adverse symptoms that are associated with impairments in medication adherence, physical activity, cognitive function, psychological health, and HRQOL. This study proposes a much-needed approach to a considerable issue of public health given the rising numbers of older PLWH. The findings from this study will inform the development and testing of personalized programs to reduce symptom burden and improve HRQOL for older PLWH. The long-term goal of this study is to improve HRQOL and decrease morbidity associated with HIV and aging.

Principal Investigators of Current Federally Funded Training Projects (as of 9/01/2020)

College of Nursing