Research Studies

The Center for Healthcare Delivery Research and Innovations (HDRI) produces impactful evidence to strengthen health care delivery in the United States and internationally. The interdisciplinary scientists at HDRI have expertise in studying health care policy, organizations, workforce, and quality of care and patient outcomes. One of the main focuses of HDRI is how to optimally utilize health care professionals, particularly the growing nurse practitioner (NP) workforce, and build health care teams to ensure that patients, particularly racial and ethnic minorities, persons living with dementia, and those in underserved areas, have access to timely, high quality, safe health care services.

Federally Funded

Enhancing Nurse Practitioner Primary Care Delivery to Address Social Determinants of Health and Reduce Health Disparities: A Mixed-Methods National Study

Funded by: National Institute of Nursing Research, R01 NR021007 [$3,124,761]

Principal Investigator: Lusine Poghosyan, PhD, RN, FAAN, MPH

Addressing social determinants of health is key to eliminating racial and ethnic health disparities among chronically ill elderly patients. Through a large, national, mixed-methods study, we will examine patients' neighborhoods and primary care practices where they receive care from nurse practitioners to produce evidence to help design future interventions to improve neighborhoods and strengthen primary care practices to ensure optimal care and outcomes for minority patients.

Care for Persons with Dementia in Nurse Practitioner Practices and Racial and Ethnic Health Disparities

Funded by: National Institute on Aging, R01 AG069143 [$3,766,445]

Principal Investigator: Lusine Poghosyan, PhD, RN, FAAN, MPH

The goal of this study is to use a comprehensive mixed-methods approach to assess the impact of NP practice and patients’ community attributes on disparities in outcomes for patients with Alzheimer’s disease and related dementias (AD/ADRD) using advanced multilevel models, geographic information systems, and qualitative methods.

Social Networks in Medical Homes and Impact on Patient Care and Outcomes

Funded by: Agency for Healthcare Research and Quality, R01 HS025937 [$1,870,000]

Principal Investigator: Lusine Poghosyan, PhD, RN, FAAN, MPH

The goal of this study is to produce evidence about the member composition of high-performing primary care teams, how team members communicate, share advice, help, or solve problems to care for patients, and how teamwork affects the quality of care and outcomes of patients with chronic diseases.

Home Based Primary Care for Persons Living with Dementia: Nurse Practitioner Teams and Outcomes

Funded by: National Institute on Aging, R21 AG077384

Principal Investigator: Lusine Poghosyan, PhD, RN, FAAN, MPH and Zainab Osakwe, PhD, NP, RN (Adelphi University)

The goal of this project is to combine analysis of team configurations and social networks in nurse practitioner-led home-based primary care teams with assessment of NP workforce outcomes to identify best practices for teams caring for persons living with dementia.

Comparative and Cost Effectiveness Research Training for Nurse Scientists

Funded by: National Institutes of Health, National Institute of Nursing Research, T32NR014205

Multiple Principal Investigators: Lusine Poghosyan, PhD, RN, FAAN, MPH, and Patricia Stone, PhD, RN, FAAN

Director: Harold Pincus, MD

The goal of this training grant is to provide pre- and post-doctoral nurse scholars with training in comparative and cost-effectiveness research methods and the foundation required to recognize and address the real-world information needs of patients, providers, and policy makers. This is done by examining the comparative and/or cost effectiveness of competing interventions for high-risk and underserved populations across the continuum of care. Funded for a five-year competitive renewal, this training grant It supports two pre-doctoral and three post-doctoral trainees.

Advancement of Research on Nurse Practitioners (ARNP): Setting a Research Agenda

Funded by: Agency for Healthcare Research and Quality, R13 HS027726, [$50,000]

Principal Investigator: Lusine Poghosyan, PhD, RN, FAAN, MPH

The proposed conference will be the first to bring together national and international experts studying the NP workforce and practice to develop a comprehensive research agenda on barriers affecting NPs and evidence-based methods for conducting this research.

Further Psychometric Testing and Validation of the Errors of Care Omission Survey (EoCOS)

Funded by: Agency for Healthcare Research and Quality, R03 HS024758 [$100,000]

Principal Investigator: Lusine Poghosyan, PhD, RN, FAAN, MPH

The goal of this study is to test the validity of a survey tool designed to measure errors of omission in primary care from the perspectives of primary care providers.

Racial and Ethnic Disparities in Chronic Disease Outcomes and Nurse Practitioner Practice

Funded by: National Institute on Minority Health and Health Disparities, R01 MD011514 [$2,558,012]

Principal Investigator: Lusine Poghosyan, PhD, RN, FAAN, MPH

The goal of this study is to understand how to reduce racial and ethnic disparities in outcomes of chronically ill elderly patients receiving care from primary care practices employing nurse practitioners.

Racial and Ethnic Disparities in Chronic Disease Outcomes and Nurse Practitioner Practice AD Supplement

Funded by: National Institute on Minority Health and Health Disparities, R01 MD011514-03S1 [$395,000] 

Principal Investigator: Lusine Poghosyan, PhD, RN, FAAN, MPH

The goal of this supplement is to study primary care practices where AD/ADRD patients receive care from nurse practitioners to produce evidence to identify best practices and ensure high quality care for minority elderly patients with AD/ADRD.

The Impact of Nurse Practitioner Work Environment and Community Characteristics on Acute Care Utilization by Older Adults with Multiple Chronic Conditions

Funded by: Agency for Healthcare Research and Quality, R36 HS029435 [$42,316]

Principal Investigator: Amy McMenamin, RN, PhD candidate

The burden of multiple chronic conditions (MCCs) is amplified by poor community characteristics like low socioeconomic status and poor access to primary care. This study will be the first to investigate whether the relationship between community characteristics and patient outcomes changes at different levels of nurse practitioner (NP) care environment in primary care practices where older adults with MCCs receive care. Findings from this study will guide the design of interventions to improve primary care for older adults with MCCs in practices that employ NPs.

Validation of Primary Care Creativity Tool (PCTC)

Funded by: Agency for Healthcare Research and Quality, R03 HS027502 [$100,000]

Principal Investigator: Yuna Lee, PhD, MPH

Co-Investigator: Lusine Poghosyan, PhD, RN, FAAN, MPH

The goal of this project is to validate a new survey on primary care team creativity, the Primary Care Team Creativity tool, measuring how primary care teams are creative, and generate novel and useful ideas to solve complex primary care challenges.

Practice Environments and Electronic Health Records Use in Primary Care: Reducing Nurse Practitioner Burnout

Funded by: Agency for Healthcare Research and Quality, R36 HS027290, [$42,319]

Principal Investigator: Cilgy Abraham, BSN, RN

Mentor: Lusine Poghosyan, PhD, RN, FAAN, MPH

The study investigates the relationship between NP burnout and practice attributes.

Validation of Nurse Practitioner Primary Care Organizational Climate Questionnaire (NP-PCOCQ)

Funded by: Agency for Healthcare Research and Quality, R03 HS020999 [$100,000]

Principal Investigator: Lusine Poghosyan, PhD, RN, FAAN, MPH

This study is developing the first NP-specific survey tool to measure NP practice environment in primary care practices.

Foundation Funded

Influence of Nurse Practitioner Practice Restrictions on Chronic Disease Health Disparities

Funded by: National Council of State Boards of Nursing [$253,915]

Multiple Principal Investigators: Brooks Carthon, PhD, RN, FAAN and Lusine Poghosyan, PhD, RN, FAAN, MPH

This study focuses on the quality of care for cardiovascular diseases and diabetes and whether NP practice restrictions affect the quality of care and health disparities in these diseases.

Nurse Practitioner Supply, Practice, and Economic Efficiency to Benefit the Underserved and Medicaid Patients

Funded by: National Council of State Boards of Nursing [$256,416]

Principal Investigator: Lusine Poghosyan, PhD, RN, FAAN, MPH

The goal of this study is to assess whether the scope of practice expansions in New York state affects the supply of NPs in underserved areas and the practice environment of NPs within their organizations. The study is also testing the potential cost savings associated with the scope of practice policy change. 

Primary Care Nurse Practitioner Practice Environments and Impact on Quality of Care and NP Outcomes

Funded by: Robert Wood Johnson Foundation, 71250 [$350,000]

Principal Investigator: Lusine Poghosyan, PhD, RN, FAAN, MPH

This study focuses on the impact of the primary care NP practice environment on the quality of care for commercially insured patients.