Faculty Research: Innovative research sets UT Austin School of Nursing apart
Posted: Nov. 12, 2012
Texas is home to a highly diverse population composed of 46.7 percent non-Hispanic Whites, 36.9 percent Hispanics, 12 percent non-Hispanic Blacks, 3.6 percent Asians, and 0.8 percent American Indians. Many Texans experience significant health disparities including obesity, cardiovascular disease, diabetes, hypertension, cancer, and higher rates of very low birth weight and preterm births. These health disparities may be influenced in part by a high poverty rate (24 percent of children), one of the highest uninsured populations (27.8 percent) in the nation, and language and cultural differences.
Nurse researchers at The University of Texas at Austin School of Nursing address the needs of underserved populations in the state and beyond by conducting National Institutes of Health (NIH)-funded studies that focus on health behaviors and health promotion across the lifespan.
Type 2 diabetes is a major health problem affecting 15 percent of U.S. Hispanics. Dr. Sharon Brown, professor of nursing, began her research in south Texas in 1987 to promote healthier outcomes in Starr County, a border community where fully 50 percent of the Hispanic population over the age of 35 either has diabetes or has a first degree relative with diabetes (a risk factor for developing the disease). With more than $6 millionin funding from the NIH, National Institute of Diabetes and Digestive and Kidney Diseases, Brown designed and tested a culturally specific intervention with instruction on nutrition, self-monitoring of glucose levels, and exercise, incorporating group support to promote behavioral changes. More than 1,000 people have completed her program, which has resulted in a clinically and statistically significant reduction in blood sugar levels (measured with HbA1c). Brown is currently funded by the National Institute of Nursing Research for a meta-analytic study of biobehavioral determinants of health outcomes in Type 2 diabetes.
Dr. Alexandra Garcia, associate professor, is testing a culturally specific home-based intervention designed to improve diabetes symptom recognition and self-management among Mexican Americans who live in central Texas. The study is funded by the NIH, National Institute of Diabetes and Digestive and Kidney Diseases. This innovative intervention is tailored to address the participants’ self-identified symptoms, which do not always coincide with the classic symptoms identified by health-care providers and are often not in standardized clinical guidelines. Garcia’s intervention has resulted in significant improvements in participants’ cholesterol levels, blood pressure, diabetes knowledge, self-efficacy (or confidence) to manage diabetes, sense of empowerment, readiness to engage in diabetes self-management behaviors, and quality of life.
Of the 24 million Americans who have asthma, 9 million are children under 18 years of age. Dr. Eileen Kintner, associate professor, has designed an asthma educational intervention that fits into the regular academic health curricula. Her study, funded by the NIH, National Institute of Nursing Research, focuses primarily on medically underserved fifth grade students in urban school settings who have asthma. The intervention is provided in 10 classes that focus on what causes asthma episodes and how to get help during an episode. Students work on spelling words, math problems, reading assignments and other learning activities to describe what it’s like to live with asthma. They also practice how to tell someone when they’re having an asthma episode. The children have greater acceptance of their asthma and better health outcomes as a result.
For the past 13 years, Dr. Sharon Horner, professor and associate dean for research, has been testing and refining an educational intervention designed to improve rural children’s and their parents’ asthma self-management in a series of studies funded for a total of $3.6 million from the NIH, National Institute of Nursing Research and National Institute of Heart, Lung and Blood. Most studies of asthma self-management with children have been conducted with urban populations, and Horner is one of the few researchers to study the effects of asthma self-management education with Mexican Americans. All materials for the study are presented in English and Spanish versions to match the participants’ language needs. The intervention has resulted in significant improvements in family asthma management, children’s skill at using an inhaler, and reductions in days with asthma symptoms and limitations.
Dr. Lynn Rew, professor, is currently testing the feasibility of a brief intervention to enhance psychological capital in homeless young women. This intervention, funded by the National Institute of Nursing Research, focuses on a population of youth that is highly vulnerable to adverse physical and psychological outcomes. The brief intervention consists of group activities that help these women set realistic and attainable goals to improve their quality of life. This study is a component of Rew’s program of research that addresses the health behaviors of adolescents, for which she has received more than 5 million dollars in continuous funding since 1999 from the National Institutes of Health.
Dr. Alexa Stuifbergen, dean of the School of Nursing, was among the first researchers to study health promotion in persons with chronic and disabling conditions. With continuous support totaling more than $9.6 million from the NIH, National Institute of Nursing Research and the National Institute for Child Health and Human Development from 1993 to the present, she has developed, tested and cross-validated a model of health promotion and quality of life in persons with chronic and disabling conditions — specifically chronic neurological conditions. Stuifbergen and her colleagues developed a wellness intervention for women with multiple sclerosis (MS) that significantly improved health behaviors (e.g. exercise and stress management) and improved pain and mental health. Her wellness interventions have been adapted for use with other groups including women with fibromyalgia, HIV and cancer survivors. Stuifbergen has most recently completed a study of a computer-assisted cognitive rehabilitation intervention for persons with MS.
Dr. Tracie Harrison, associate professor worked with The Administration on Aging as a 2011–2012 Health and Aging Policy Fellow through the Atlantic Philanthropies to enhance policies that affect older Americans with disabilities. Findings from her earlier studies suggest that the lifestyles of women with disabilities are uniquely shaped to support their identity as women within the context of having impairments. Over the life course, they are often left to accommodate seemingly unpredictable impairment-related dilemmas by using trial-and-error, culturally predisposed problem solving while relying on socially predetermined resources. She is currently completing a qualitative study funded by the NIH, National Institute of Nursing Research, with Mexican American and white women with disabilities to discern the cultural influences of aging with disabilities. The ultimate goal of Harrison’s research is to develop a model of healthy aging for women with disabilities that can be used to understand changes that affect them across their life spans.
Dr. Heather Becker, research scientist at the School of Nursing, recognized that individuals with chronic and disabling conditions may find themselves managing other health conditions as they age (such as osteoporosis, cardiovascular disease, or cancer). Becker’s most recent study, funded by the National Cancer Institute, explored health promotion for cancer survivors who had a pre-existing disabling condition, such as polio or Multiple Sclerosis. About half of the 145 people in the sample — primarily breast cancer survivors — had been diagnosed at least 10 years previously. They described various challenges they encountered in managing their cancer in addition to their prior disabling condition. Becker found that the social support received from others and self-efficacy for health promoting behaviors were most strongly related to how often people engaged in health promotion in areas such as nutrition, stress management, physical activity, spiritual growth, interpersonal relationships and health responsibility. Using feedback from study participants, Becker also developed and pilot tested an online health promotion intervention for cancer survivors with pre-existing conditions.
Dr. Terry Jones has more than 25 years of experience in nursing, including leadership positions in nursing administration, quality and operations. She completed a three-year clinical science training program in the North and Central Texas Clinical and Translational Science Initiative, during which she received a $50,000 pilot award to study “Nursing Interventions Using Real Time Location Systems and Wi-Fi Technology.” Jones was appointed assistant professor in 2010 and received the competitive intramural 2011 Summer Research Assignment (SRA) award from The University of Texas at Austin, which allowed her to complete the analysis of data collected that same year as part of the study “Implicit Rationing of Nursing Time and Care,” funded by an Ed and Molly Smith Centennial Fellowship award. She has recently received a competitive extramural research award ($5,000) from the Academy of Medical Surgical Nurses.
Dr. Cherie Simpson established the reputation of a serious, talented nursing scholar during her time as a doctoral student at the School of Nursing. She received a three-year pre-doctoral fellowship from the NIH for her proposal “Sleep: Effect on Dementia Caregiver Mastery, Perceived Stress, and Depression.” Appointed assistant professor, Simpson is currently conducting a pilot study assessing sleep in caregivers of persons with dementia with the support of a competitive 2012 Summer Research Assignment from The University of Texas at Austin. She will use the data to refine a caregiver sleep intervention specifically for use with caregivers of persons with dementia.