Young person holding hands with elderly man.

National Institute on Aging Awards $3.6 Million Grant to Columbia Nursing to Study Racial and Ethnic Health Disparities in People with Dementia

October 22, 2020

The National Institute on Aging (NIA) has awarded a five-year, $3.6 million research grant to Columbia Nursing faculty member Lusine Poghosyan, Ph.D., for a study on the care of persons with dementia in nurse practitioner practices and on racial and ethnic health disparities. The research will run from September 15, 2020, until May 21, 2025.  

The research will focus on communities and primary care practices where persons with dementia (PWD) receive care from nurse practitioners. Its objective is to produce evidence that will help design future systems and community interventions to ensure optimal care for minority elderly PWD. 

“The number of nurse practitioners is growing, and they are capable of delivering high-quality care to community-dwelling dementia patients, to help them live at home,” says Poghosyan. “Our study will show for the first time how to improve the clinics where nurse practitioners take care of dementia patients and assure that all patients, regardless of race and ethnicity, receive high-quality care”. 

“Racial and ethnic health disparities are among the most persistent challenges facing our health care system, and eliminating them is a national priority,” Poghosyan adds. “Assuring high-quality, safe care for dementia patients will also reduce the burden on family caregivers.” 

Assuring the Best Care for a Growing Patient Population 

More than 5.7 million Americans are living with Alzheimer’s disease and related dementias; this number is expected to double by 2030 and triple by 2050. Racial and ethnic minorities suffer from such conditions disproportionality. Minority persons with dementia often lack high-quality continuous primary care and have poor outcomes, such as high rates of hospitalization and emergency department use.  

Policymakers caution that health disparities will widen as we face a shortage of primary care physicians. Nurse practitioners, the fastest growing primary care workforce, are mitigating these challenges. Yet little is known about how to optimize primary care practices employing nurse practitioners, which often lack the organization and structure needed to ensure continuity of care and better outcomes for minority PWD. And there’s little guidance on how to improve community resources to help.  

The current absence of such data underscores the rationale behind Columbia Nursing’s recent establishment of the Center for Research on People of Color (CRPC). The CRPC grew out of society’s growing demands of health equity and justice; it will offer multidisciplinary resources for research and educational programming designed to address injustices in health care that disproportionately affect communities of color — like Poghosyan’s study.

“Over the next five years, we will be engaged in collecting new data from nurse practitioners themselves, as well as data from Medicare, to produce much-needed evidence,” Poghosyan explains. “We will also interview nurse practitioners to understand the challenges they face in delivering care to dementia patients, particularly to minorities, and how to better eliminate clinic and community barriers. Our mixed-method national study will fill this gap.” 

About Lusine Poghosyan 

Lusine Poghosyan, Ph.D., M.P.H., R.N., F.A.A.N., is the Stone Foundation and Elise D. Fish Professor of Nursing at Columbia University School of Nursing. She is also the chair of the Primary Care Expert Panel at the American Academy of Nursing, and a Fellow of the American Academy of Nursing and the New York Academy of Medicine. 

Poghosyan is nationally and internationally recognized as a health services researcher with expertise in studying primary care organizations, workforce issues, teamwork, and quality of patient care, especially regarding care of chronic diseases. Her research produces evidence about how to optimally utilize nurse practitioners as primary care providers and build primary care teams to assure that patients, particularly racial and ethnic minorities and those living in underserved areas, have access to timely, high-quality, safe primary care. 

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