A first-generation college student, Billy Caceres, PhD, didn’t start out on the nursing path; his undergraduate senior thesis was on media politics and minority representation. However, after learning how nurses play a crucial role in health promotion, he knew he wanted to become one, specifically a nurse researcher. Caceres wanted to understand how stress impacts the cardiovascular health of vulnerable, sexual minority women. That’s what brought him to Columbia Nursing, where he could deepen his knowledge of lesbian, gay, bisexual, and transgender (LGBT) health. After joining the school in 2017, it wasn’t long before his work on the topic began to receive recognition, most recently at the American Heart Association’s 2018 Scientific Sessions, where he, along with colleagues, received a Best Abstract Award.
Why did you want to become a nurse?
While completing my Bachelor’s degree in Political Science and Communications at New York University (NYU), I worked as a Peer Educator in both the areas of sexual violence prevention and alcohol/other drugs. In this role, I created and facilitated educational workshops for students throughout the campus, developing a passion for health promotion. I knew I wanted to pursue a health-related career, but I wasn’t sure what that would be until I worked as an Office Assistant at the Hartford Institute for Geriatric Nursing (HIGN) also at NYU. During that time, I learned about the role of nurses in improving the health of older adults and how nursing research influenced the development of standards for gerontological nursing practice.
Your first bachelor’s degree was in political science and communications. What made you decide to switch to nursing and do you feel you draw on that educational background in your current work?
Through my work at HIGN, I came to appreciate the importance of nursing research in informing best practices for the care of older adults. Not soon after that experience, I decided to become a nurse and enrolled in an accelerated nursing program upon graduation.
The impact of my background in political science and communications on my nursing career was not very clear at first. However, as I transitioned to clinical practice and then into my PhD program, I realized my research program was driven by a desire to promote social justice, which is directly related to my previous degree.
What were some of your roles and specializations as a nurse?
My first position was on a surgical unit where I cared for patients following a number of surgical procedures—primarily vascular, orthopedic, and plastic surgery. After Hurricane Sandy in 2012, that surgical unit was closed, and I accepted a position in cardiothoracic surgery.
Around the time I started my PhD program, I became a nurse in a post-anesthesia care unit, caring for adult and pediatric patients undergoing a wide variety of surgical procedures. I stayed in that role until starting my postdoctoral fellowship at Columbia Nursing.
What inspired you to obtain a PhD in nursing?
My interest in nursing research was driven in large part from my desire to reduce health disparities and from being exposed to different roles that PhD-prepared nurses could have within and outside of academia. For example, I had the opportunity to work as an intern at the Robert Wood Johnson Foundation, where I helped with initiatives to increase healthcare workforce diversity. In addition, as a nursing student, I was a Research Assistant working on a study focused on estimating the prevalence of elder mistreatment in primary care clinics throughout New York City. For that study, I completed recruitment and data collection for all Spanish-speaking participants.
Why did you come to Columbia Nursing and why is the school special for you?
When I decided to pursue a postdoctoral fellowship, it was clear to me that I needed to be at an institution where I could expand my knowledge of LGBT health, collaborate with interdisciplinary colleagues, and further establish my program of research. Columbia Nursing’s commitment to promoting the health of individuals was a big factor in my decision to come here. I met Drs. Tonda Hughes and Walter Bockting prior to accepting the position and knew that the resources of the Program for the Study of LGBT Health at Columbia University would be essential in establishing my program of research. I have also had the opportunity to collaborate with researchers at the Precision in Symptom Self-Management (PriSSM) Center at Columbia Nursing and at the Center for Behavioral Cardiovascular Health at Columbia University Irving Medical Center. These resources have been instrumental, as I transition to research independence.
What are some focuses of your research agenda? In relation to your agenda, can you elaborate on the research you presented at the American Heart Association’s 2018 Scientific Session?
The focus of my program of research is on understanding how stressors, such as trauma and discrimination, influence the cardiovascular health of vulnerable women, specifically sexual minority women. There are several knowledge gaps in the literature that drive my research agenda, including the lack of studies that have examined the association of stressors and cardiovascular disease risk in sexual minority women.
Therefore, along with colleagues at Columbia Nursing, I recently conducted an analysis of data from the Chicago Health and Life Experiences of Women (CHLEW) study, the longest running study of sexual minority women’s health. We examined the association of lifetime trauma (abuse and neglect) with cardiovascular disease risk (obesity, hypertension, and diabetes) in sexual minority women. We found that sexual minority women who reported more forms of childhood trauma were more likely to report a diagnosis of diabetes. Also, adulthood and lifetime trauma were associated with higher rates of obesity and hypertension in sexual minority women. We presented this work at the American Heart Association’s 2018 Scientific Sessions, where it received a Best Abstract Award from the Council on Cardiovascular and Stroke Nursing. An additional knowledge gap that I hope to address is to examine physiological mechanisms that link stressors to cardiovascular disease risk in sexual minority women. This is the scientific basis for two of my recent grant submissions.
What are your future career aspirations and what do you hope to accomplish?
My long-term goal is to design and test interventions to reduce the impact of stress on the cardiovascular health of vulnerable women. I hope to pursue a research career where I can continue to expand our knowledge in this area and inform the cardiovascular care of vulnerable women. In addition, as a racial/ethnic minority and first-generation college student, I am committed to promoting diversity within nursing. I hope to mentor individuals from under-represented backgrounds who choose to pursue careers in nursing.