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:
- Health equity and disparities
- Health promotion
- Infants and families
- Adolescent and emerging adult health and risk behaviors
- Eating disorders
- Injury prevention
- Opioid overdose prevention
- Palliative care and end-of-life care
- Implementation science
- Violence prevention and screening
Principal Investigators of Current Federally Funded Research Projects (as of 9/01/2020)
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.
Research Project Name: School-Based Asthma Therapy (SBAT) to Reduce Disparities in Childhood Asthma: Pragmatic Process and Program Implementation Evaluation
Grant #: NIH R01 HL144652
Duration: 4 years
Overview: This project is a hybrid effectiveness-implementation study where we will conduct a rigorous, comprehensive evaluation of the School-Based Asthma Therapy (SBAT) program clinical and academic outcomes and cost-effectiveness when implemented in a real-world setting. We will also assess the implementation strategies in facilitating further dissemination and implementation of the SBAT program across a variety of schools. Dissemination and implementation research on this integrated, interprofessional, multidimensional SBAT program could serve as a model for programs that aim to improve asthma care and reduce morbidity for high risk children with asthma and has applications for other chronic health conditions.
Research Project Name: Multi-level Influences of Violence Screening in College Health Centers
Grant #: AHRQ R01 HS027154-01
Duration: 2020 – 2024
Overview: The proposed study will use an explanatory sequential mixed-methods (QUAN+qual) design, framed within an organizational expansion of the Theory of Planned Behavior (TPB) and the Consolidated Framework for Implementation Research (CFIR), to collect quantitative and qualitative data from a national sample of college HCPs and female college students. The specific aims are to: (1) (Quant) Explore multivariate associations between individual-, organization-, and state-level variables and college HCPs’ IPV/SV screening intentions and rates, using disaggregated data; (2) (Quant) Examine fixed effects and random effects of individual-, organization-, and state-level variables on college HCPs’ IPV/SV screening rates, using multi-level modeling; (3) (Qual) Obtain in-depth understanding of college HCPs’ beliefs, organizational perceptions, experiences with IPV/SV screening and practice change preferences; and (4) (Qual and Quan) Examine female college students’ attitudes/beliefs and experiences related to IPV/SV screening and disclosure, and compare to HCPs’ perceptions. The study findings will have high impact by elucidating how to effectively implement IPV/SV screening recommendations and informing the development of a multi-level intervention to promote screening in college health centers. Implementing routine IPV/SV screening in college health centers can capitalize on missed opportunities for early detection, referral and treatment.
Research Project Name: Allostatic Load & Epigenetic Mechanisms in Lifecourse Trajectories of Preterm Infants at Age 30
Grant #: NIH/NINR 1 R01 NR018147
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
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)
Training Project Name: URI College of Nursing Advanced Nursing Education Workforce
Grant #: T94HP32906
Duration: 2019 – 2023
Funding Source: U.S. Department of Health and Human Services, Health Resources and Services Administration.
Overview: The purpose of this project is to enhance well-established Academic Clinical Partnerships (ACPs) between the University of RI (URI) College of Nursing (CON) and community health center organizations, that provide a total of 13 Federally Qualified Community Health Centers (FQHCs) as clinical sites for nurse practitioner (NP) students. The project will support academic and practice achievements of students and community-based preceptors in practice with medically underserved individuals negatively impacted by social determinants of health. The project is designed to: (a) provide traineeships to reimburse tuition of a minimum of 14 NP students per year; (b) contribute to the transformation of the primary care workforce by providing intense, longitudinal clinical placements at the ACPs; (c) recruit and educate community-based preceptors to supervise and mentor NP students; and (d) expand the home-based primary health care program to further reduce emergency department and hospital admissions and to offer students the opportunity to work with home-bound, chronically ill individuals.
Training Project Name: Southern Rhode Island Area Health Education Center (AHEC)
Grant #: U77HP23064 (PI: Sarita Warrier, MD, FACP; Brown University)
Duration: 2017 – 2022
Overview: The project’s objectives are to reduce health care inequalities and achieve health equity by increasing the diversity within the nursing workforce while improving individual and community health. URI contributes to these goals through the Pathways to Nursing program, which provides nursing students from underrepresented populations with the resources and support to attain bachelor’s degrees in nursing over five years.
Pathways to Nursing began in 2010 as a partnership between the Southern Rhode Island Area Health Education Center and URI College of Nursing to recruit, support, retain and graduate a diverse group of students. The funding allows the College to offer enhanced services to recruit, retain, and graduate students contributing to a highly qualified and diverse professional nursing workforce. Resources include a mentoring, family orientation, academic scholarships, tutoring, academic skills building, preparation for the board licensing examination, and leadership lecture and development.