Research Roundup Fall 2023
Sharing Expertise to Help Solve Global Problems
In January of this year, Kylie Dougherty, PhD ’23, moved to Ethiopia for a Fulbright- funded project to improve maternal health care in Amhara, 170 miles north of the country’s capital, Addis Ababa. A few months later, due to civil unrest in the region, Dougherty—one of five recent Fulbright Scholars with Columbia Nursing ties, and the University’s first nursing PhD student to receive the prestigious grant—was no longer able to visit Amhara and had to remain in Addis Ababa to continue her work. “It’s been a wild ride,” says Dougherty, who has a background in global health and managed to keep the project going despite the conflict. “You learn to roll with some of those punches.”
Women in Ethiopia face a 1-in-52 chance of dying from a childbirth-related cause, and the country ranks in the highest quintile worldwide for maternal mortality. One of the central reasons for this ongoing tragedy is poor logistics: Ethiopia lacks reliable supply chains for the distribution of medical supplies. As a result, medical professionals are often unaware of their inventories for coping with emergencies that threaten the lives of pregnant women and their babies.
Together with investigators at Emory University and the Ethiopian Ministry of Health, Dougherty concluded that facilitating clinicians’ access to better inventory data could help mitigate the problem. During her eight months in the country as a Fulbrighter, Dougherty gathered data on hospital readiness for obstetric emergencies. Her goal? To design electronic dashboards to provide hospitals with easily digestible visualizations of inventory data.
“We wanted to provide a quick summary,” says Dougherty, “so health care workers can take a quick look and see if their facility is ready or not for different obstetric emergencies, such as sepsis, hypertensive emergency, or prolonged labor, based on their supply inventory.”
Even as the conflict continued in Amhara, Dougherty, with the assistance of a local researcher, was able to organize qualitative interviews with health care workers there to assess their needs. She also met with individuals who tried out prototypes of her visualization dashboards. They found them helpful. “I’ve had the opportunity to present research and network and collaborate with other academics and professionals. This has set up future collaborations,” says Dougherty. “It’s been invaluable.”
U.S. Senator J. William Fulbright proposed the program bearing his name in 1946, to advance knowledge, foster mutual understanding, and improve lives around the globe. Since then, hundreds of thousands of Fulbrighters have had the opportunity to travel to help solve world-spanning problems. Now led by the U.S. Department of State, in partnership with over 160 countries, the Fulbright Program offers funding for educational and cultural exchanges to study or pursue innovative research.
The awards are not limited to students. In fact, four Columbia Nursing faculty members have been granted Fulbright awards in recent years. Earlier in 2023, Maureen George, PhD, who directs Columbia Nursing’s PhD program, received an award for a two-part project in conjunction with the University of the West Indies (UWI).
The first half of George’s project, due to begin in 2024, will involve delivering to faculty at UWI a program called Writing to Improve Nursing Science (WINS) that was developed by Elaine Larson, PhD, Columbia Nursing’s Anna C. Maxwell Professor Emerita. The second part of the project will involve research to promote breastfeeding.
The breastfeeding project is modeled on George’s work improving chronic disease self-management outcomes. In the Caribbean, George will train medical professionals in motivational interviewing and shared decision-making techniques. The resulting data will be used to develop acurriculum whose aim is to increase the number of women who make the decision to breastfeed their children.
George’s achievement builds on the successes of recent Columbia Nursing Fulbright alumni. In 2017, Gregory Alexander, PhD, the Helen Young CUPHSONAA Professor of Nursing, received a Fulbright Scholarship to work as a visiting professor at Macquarie University in Sydney, Australia, for four months. Alexander conducted research into the use of technology to improve care delivery across Australia and New Zealand in what are known there as aged care residential facilities. His research was presented to Australia’s Department of Health and shed light on how aged care issues in Australasia relate to those in the U.S.
A year later, in 2018, Ana Kelly, PhD, an associate professor of nursing, received a Fulbright to spend five months in Malawi. At the Kamuzu College of Nursing, in Lilongwe, Kelly helped local nurses implement evidence-based practices.
The sharing of U.S. knowledge and expertise is central to the Fulbright’s goal of fostering mutual understanding. This is particularly important in advanced practice nursing, “where we are ahead of the rest of the world in many ways,” says Judy Honig, DNP ’05, EdD ’95, the Dorothy M. Rogers Professor and vice dean of academic affairs. Honig was named a Fulbright Specialist this year, a program that offers U.S. academics the opportunity to take part in short exchanges with host institutions.
In November 2023, she will travel to Saxion University of Applied Sciences in the Netherlands. There, she will assist with the introduction of that country’s first professional doctorate, currently being ushered in across numerous disciplines, by drawing on her deep experience designing and implementing Columbia Nursing’s Doctor of Nursing Practice Program.
Honig will share with her Dutch contacts the hurdles she and her Columbia Nursing colleagues overcame in setting up the professional doctoral program. Among the challenges, according to Honig, was finding ways to help research-oriented academics shift gears to educating leaders from a practice-based point of view. “It was hard to break away from that research-focused way of thinking,” says Honig. “I think they’re going to be faced with same thing in the Netherlands. It takes a while for the ethos to change.”
Thanks to the Fulbright, Honig’s impact in the Netherlandswill be felt beyond nursing, in disciplines including energy and sustainability, education, and tourism. “I’m happy to share what we’ve learned on the global front,” says Honig. “Because, increasingly, we’re all one.”
-- Tomas Weber
Combating Nurse Suicide by Leveraging Advances in Technology
The number of nurses who die by suicide has reached an alarming level, with some estimates showing a rate 40% higher than in the general population. Columbia Nursing’s Allison Norful, PhD ’17, hopes to help turn around that grim trend. She recently received almost $1 million to conduct a five-year study of environmental factors in work settings that increase the risk of suicidal behavior among nurses. It’s “critical that we better understand which aspects of a nurse’s personal and professional life may pose a higher risk for poor mental health,” she says, citing modifiable factors like workload and shift type that may affect depression or anxiety. The study, funded by the National Institute of Mental Health, will involve collecting hair and blood samples, which will be examined for cortisol production and DNA methylation.
Norful is also conducting a one-year study, on an intramural pilot grant, to look at factors like sleep, psychiatric issues, stressful events, and work environment characteristics that increase or decrease the probability of nurses taking their own lives. She will determine if wearable sensors, longitudinal surveys, and sleep interventions are potential protective solutions.
“With advancements in precision medicine and laboratory-based technology, we are, for the first time, able to apply novel methods to capture an individual’s physiologic and epigenetic response to environmental stimuli,” Norful says.
New Health Informatics and Data Science Center Launches
In June, Columbia Nursing opened its newest research hub, the Center for Community-Engaged Health Informatics and Data Science (CCHIDS), with Suzanne Bakken, PhD, as its executive director.
The new center, whose goals align with the school’s commitment to social justice and health equity, will integrate the work of Columbia Nursing’s world-class health informatics and data science researchers. “Data is the foundation for nursing practice and the generation of new nursing knowledge through research,” says Bakken, who also holds the endowed Alumni Professorship.
The center’s research portfolio already includes some three dozen research projects, including a national report of nursing home quality measures and information technology and a telemedicine initiative for patients with limited English proficiency. CCHIDS faculty have also developed a suite of informatics and data science resources, such as mobile applications for the prevention and management of HIV/AIDS and heart failure.
The center’s emphasis on community engagement is significant, notes Bakken. “To advance health equity, community engagement is essential across the stages of the research life cycle,” she points out.
This article originally appeared in the Fall 2023 issue of Columbia Nursing Magazine.