Nurse checking blood pressure

Research Roundup

NHLBI Awards Caceres $3M to Study Stigma, Blood Pressure

Assistant Professor of Nursing Billy Caceres, PhD, will receive a $3,084,733 grant from the National Heart, Lung, and Blood Institute of the National Institutes of Health (NHLBI), his first R01 award, for a study looking at how anticipated and vicarious stigma influence blood pressure (BP).

The four-year project, “A Daily Diary Examination of the Influence of Intersectional Stigma on Blood Pressure,” uses a novel approach to examine the relationship between discrimination and cardiovascular disease.

Stigma can include discrimination related to one’s identity, as well as to the effects of systemic racism, sexism, and other types of bias. “There is robust evidence to support stigma as an important social determinant of health,” explains Caceres, noting that exposure to stigma has been linked to hypertension, diabetes, obesity, smoking, and disturbed sleep.

Research to date in this area has focused on the direct experiences of discrimination due to a single stigmatized identity, adds Caceres, an affiliated investigator with both the Center for Sexual and Gender Minority Health Research and the Center for Research on People of Color at Columbia Nursing. “It sort of ignores the fact that people of color can also be women, they can also be gay, they can also have a disability.”

The new study is designed to measure whether the number of stigmatized identities a person has influences the effects of experiencing anticipatory stigma (expecting unfair treatment) and vicarious stigma (witnessing or hearing about discrimination without experiencing it directly). In their daily lives, Caceres notes, people may have more exposure to these indirect but pervasive forms of stigma, with potentially greater health effects.

He and his colleagues will enroll 400 adults diverse in sexual identity, race, ethnicity, and gender, who will have their blood pressure checked twice in the morning and twice at night for seven days. Each morning, they will note their level of anticipated stigma, and at bedtime they will report the amount of vicarious stigma they experienced that day.

Caceres and his colleagues hypothesize that people will have a greater increase in BP when they are reporting higher levels of stigma and that the effect will be stronger in those with a higher number of stigmatized identities.

The study will be a critical step for identifying mechanistic targets for interventions and policies to reverse the adverse effects of stigma on cardiovascular disease risk in stigmatized adults. At the individual level, Caceres notes, “we need interventions that would address both cardiovascular health and discrimination-related stress.” Enrollment will begin in spring 2024.

Columbia Nursing Again Ranks #1 in NIH Research Funding

For the second year in a row, the Columbia University School of Nursing ranked #1 among all U.S. schools of nursing in terms of total research funding from the National Institutes of Health (NIH), with 38 grants totaling nearly $24 million in fiscal year 2023. Those totals compare to 36 grants and about $18.7 million in funding in FY 2022, and 26 grants and $9.5 million in FY 2021, when Columbia Nursing ranked #4 in research funding.

“Our school’s diverse research enterprise, dedicated to advancing health for all, continues to flourish,” says Dean Lorraine Frazier, PhD. “It’s all about the impact of what we do on patients. Our investigators are building the evidence base we need to help patients and communities thrive. We couldn’t be more proud of our scientists and the Columbia Nursing community that helped us reach #1 again.”

The Columbia Nursing research funded by the NIH in FY 2023 included multiple interventions to address racial and ethnic disparities in maternal outcomes, improve asthma control in adolescents and adults, promote viral suppression among people living with HIV, support better care for patients with heart disease, and much more.

Members of the Columbia Nursing faculty also continue to secure funding for their research from a wide variety of other governmental and private sources, including the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, the Patient-Centered Outcomes Research Institute, the Robert Wood Johnson Foundation, and the Betty Irene Moore Foundation.

“Our faculty, postdocs, and PhD students are engaged in an exciting array of projects, locally and globally, with the common goal of promoting health for all across the life span,” observes Elizabeth Corwin, PhD, vice dean of strategic and innovative research. “I continue to be amazed by their creativity and commitment.”

Study Investigates Walking for Maintaining Brain Health

Professor Ulf Bronas, PhD, has begun recruiting people with mild cognitive impairment (MCI) and chronic kidney disease to investigate whether a six-month, home-based walking regimen can help stave off cognitive decline in this high-risk group.

“On average, a patient with chronic kidney disease has a brain that is about 10 years older than a healthy age- and sex-matched individual, and we don’t really know why that is,” Bronas notes.

He initiated the Accelerated Age-Related Cognitive Decline: Impact of Exercise on Executive Function and Neuroplasticity (EXEC) study while at the University of Illinois Chicago. Funded with $2.6 million from the National Institute on Aging, the five-year project will continue at Columbia Nursing for years three to five.

Participants will be assigned to a six-month exercise intervention or health education. The exercise group will receive instruction and coaching on walking and exercising safely, in a way that works for them and is tailored to their needs. The health education group will receive the same information and contact time, but no coaching.

Bronas and his colleagues hypothesize that the exercise group will show improvements in executive function, cognitive subdomains, brain white matter integrity, structure, and functional connectivity compared to the control group after six months.

“We think that walking improves blood flow and perfusion to the brain, which then helps the connectivity in the brain, which then helps to improve cognition,” he explains.

Fewer Nurses Now Serve as State Lawmakers, Study Finds

The number of nurses holding state legislative office in the U.S. has declined significantly over the past decade, investigators from Columbia Nursing reported in a new study.

This 10-year downward trend is concerning and should be a call to action to support all forms of civic engagement among nurses, say study authors Darlene Curley, EdD, a member of the advisory board of Columbia Nursing’s Center for Health Policy and a Maine state legislator from 2002 to 2007, and Patricia Stone, PhD, the Centennial Professor of Health Policy in the Faculty of Nursing and the center’s executive director.

Curley and Stone created a directory of registered nurses holding elected office as of January 15, 2023. Out of 7,382 elected state legislators nationwide, there were 72 nurses in office in 36 states in 2023, compared to 97 nurse legislators in 39 states in 2013. Most of the nurses serving in 2023 are up for re-election in 2024.

The study was published in the January-February 2024 issue of Nursing Outlook.

This article originally appeared in the Spring 2024 issue of Columbia Nursing Magazine.