School of Nursing Unveils New Research Themes to Advance its Mission for Health Equity

July 2020Milenko Martinovich

Consistently ranked among the nation’s top nursing schools in National Institutes of Health funding, the UCSF School of Nursing is committed to enhancing its research strength and leverage its expertise to advance health and health equity.

The School has unveiled five research themes that serve as the focus of its research mission. The themes will facilitate and promote interdisciplinary collaboration across the university, and align with the needs of California and beyond. Together, faculty will work to advance these five research areas, while training predoctoral and postdoctoral researchers to take innovations to the next level.

“We have to be responsive and forward-thinking and responsive,” said Julene Johnson, the School’s associate dean of research. “As science changes, we need to be able to pivot quickly on emerging topics, in addition to building on the long-standing strengths of the School.”

Health Equity

Barriers to health equity – including social, economic, demographic and structural – must be overcome so all populations have access and opportunity to be healthy. Small-scale interventions can provide relief, but engineering broad social and political reform to erase health inequities is the ultimate goal. 

Faculty, students and alumni at the School of Nursing are leading the charge for a more equitable future. The School established the Sally Bates Endowed Chair in Health Disparities, which is dedicated to aiding underserved and minority populations overcome health inequities. Associate Dean Catherine Waters, who holds the Bates Chair, has leveraged her past success as a San Francisco Health Commissioner to steer research toward providing tangible solutions for those in need. Her work has aided Asian-American and Latinx communities suffering from chronic illnesses like diabetes, provided guidance to reduce tobacco-related health disparities among African Americans and examined depression and psychological distress in Arab immigrants. 

Howard Pinderhughes School of Nursing professor Howard Pinderhughes has been instrumental in UCSF’s intention to become an “anchor institution,” to support underserved communities by hiring, buying and investing locally. Pinderhughes first pitched the idea in 2015 and since then the plan has been approved by UCSF leadership, including the executive vice chancellor and provost, and is moving forward swiftly. 

Other faculty working to help our communities achieve health equity include:

  • Associate professor Monica McLemore is a leading scholar on reproductive justice. Her research spans the reproductive spectrum and combines nursing, public health and policy research perspectives to offer effective interventions. 
  • Professor Janet Shim centers her work on social inequalities in health, including science, technology and medicine. Her current NIH-funded study explores how to develop approaches that will achieve “greater inclusion of historically marginalized populations in biomedical research.” 
  • Associate professor Glenn-Milo Santos examines substance use and sexual risk behaviors of vulnerable populations, including transgender and HIV-positive individuals, to develop pharmacologic and behavioral interventions. The NIH has honored Santos with the Drug Abuse Dissertation Research Award and Early Independence Award in recent years.
  • Professor Carol Dawson-Rose is an authority on HIV/AIDS prevention and treating patients with HIV/AIDS in medical settings. Her work has impacted patients both here in the U.S. and Africa.

Community and Population Health

Why do certain populations suffer negative health outcomes? 

Faculty are working to identify the social, economic, biological and environmental issues that impact the health of vulnerable populations, with an emphasis on diverse and high-risk communities. The School partners with public and private organizations and academic institutions to devise sustainable solutions that increase communities’ chances for having more positive health outcomes. 

Projects under way include:

  • The School partners with the California Department of Social Services to evaluate a state program designed to support positive health outcomes for pregnant Jerry John Nutor and parenting people, families and infants born into poverty.
  • The nursing schools at UCSF, UC Davis and UCLA partnered to launch new remote-access training that will prepare 300 psychiatric mental health nurse practitioners over five years, nearly doubling the pipeline of specialized mental health providers. It is the first remote learning, post-master’s certificate of its kind in California. Classes begin January 2021. 
  • Assistant professor Jerry John Nutor was recently selected as one of UCSF’s Population Health and Health Equity Scholars, who receive funding for ongoing local, national and global projects. Nutor’s current project examines HIV-positive mothers in Uganda, who stop using antiretroviral treatments after childbirth. He is examining the barriers that affect retention in HIV care to create interventions to change behavior.
  • Professor Abbey Alkon is helping to reduce the risk of adverse health problems in children associated with pesticide exposure. She is examining 100 child care centers serving socio-economically and ethnically diverse preschool-age children in four California counties.

Aging and Life Course

In just 14 years, the United States will reach a historic milestone, according to the U.S. Census Bureau: Older adults will outnumber children for the first time in the nation’s history.

Americans are living longer and the School of Nursing, notably its Institute for Health & Aging (IHA), has been at the forefront of research, education and public service in this arena. Faculty research on Alzheimer’s has guided city and state policy. Faculty-led studies showing cost savings in Medicaid have led to enhanced services for people on disability.

Graduate students and postdoctoral scholars have opportunities to collaborate with IHA faculty on aging research with a focus on social policy and social justice, law, and public service.

Van Park Faculty are continuing their innovative work, which includes:

  • Associate professor Van Park recently received a $3.3 million grant from the NIH National Institute on Aging to engage, educate and recruit 10,000 Asian Americans and Pacific Islanders into a potential participant registry for Alzheimer’s and aging research.
  • Associate professor Elena Portacolone’s work has focused on devising strategies to include Latinx and African American individuals in dementia research.
  • Assistant professor Jarmin Yeh is collaborating with the California Department of Public Health on two projects on Alzheimer’s disease, including the social and economic impacts of caregiving for these individuals.

Symptom Science

Sixty percent of U.S. adults have a chronic disease, and 40 percent have two or more chronic diseases, according to Centers for Disease Control and Prevention. Chronic diseases like diabetes and heart disease are the leading cause of death and disability, and a driving force behind the nation’s $3.5 trillion in annual health care costs.

By examining the symptoms of chronic diseases, like pain and fatigue, School of Nursing researchers and postdocs are creating tailored treatment plans to minimize or prevent these debilitating physical and mental effects. They are also developing a symptom management model that takes into account psychological, demographic and environmental factors to improve quality of life for those living with chronic diseases.

  • Professor Christine Miaskowski is conducting three NIH-funded projects involving individuals with cancer, cancer survivors and on biobehavioral research Christine Miaskowski training in symptom science.
  • Professor Sandra Weiss’s work examines the context, symptoms and treatment of depression in women.
  • Associate professor Anne Lown is investigating the use of acupressure to reduce treatment-related symptoms in children with cancer.

In addition, the School is training future nurse scientists through its Biobehavioral Research Program in Symptom Science, which is funded by the NIH. Each year, the School trains five predoctoral students and three postdoctoral fellows in research that integrates biomarkers, social determinants and the individual’s symptom experience. Through such integrative studies, there is increased potential to develop more comprehensive knowledge of the mechanisms’ underlying symptoms, unique predictors of diverse symptom profiles, and precision-based approaches to symptom management. 

Digital Health, 'Omics & Data Science 

As precision health gains popularity, the role of 'omics in nursing science — genomics, microbiomics and metabolomics, to name a few — grows in importance. Leveraging genetic and environmental data to construct individualized prevention and treatment plans — the heart of precision health — is difficult without a mastery of 'omics.

The School of Nursing’s Genomics Laboratory is an active hub of 'omics research. The Lab is home to tens of thousands of specimens that are used in various research projects. Researchers studying diabetes, cancer, reproductive care, and health impacts on LGBTQ communities have all leveraged the Lab’s resources to conduct research and develop effective solutions that directly affect underserved populations. In tandem with biomarkers work, projects in the lab integrate data from wearables and other digital health tools to investigate the combination of heritable and behavioral contributors to health.

Elena Flowers The Lab also offers predoctoral students and postdoctoral fellows opportunities to collaborate on genomics-related study design methods and training development as well as feedback on dissertations.

Projects that leverage 'omics and digital health include:

  • Assistant professor Kord Kober is investigating chemotherapy-related fatigue in individuals with cancer by examining genetic and epigenetic differences between groups suffering high and low fatigue. Studying the genetic mechanisms involved may lead to a more effective therapeutic intervention.  
  • Professor Barbara Koenig is leading an effort to advance equity in genomic medicine through the Program in Prenatal and Pediatric Genomic Sequencing. The NIH-funded program will provide state-of-the-art genomic assessments to families with children with potential prenatal or pediatric genetic disorders. 
  • Associate professor Elena Flowers studies biomarkers that characterize the intersection of heritable and behavioral contributors to risk for type 2 diabetes in racial minority groups.

Preparing future nurses to master 'omics means starting early. Flowers, who authored a 2019 article on how an updated curriculum emphasizing genomics will better prepare advanced practice nurses in the age of precision health, developed the curriculum for a new School of Nursing course that launched in 2017 that focuses on the practical outcomes of genomics advances and its pertinence to nursing practice.

Flowers serves on UCSF’s Institute for Human Genetics Education Committee that is working to assess and fulfill the educational needs of faculty and trainees at the university, with the ultimate goal of ensuring that people have resources they need to conduct research and use genetics and genomics technologies effectively in clinical practice.