Currently Funded Research and Training Projects
Supporting Advanced Practice Nursing Students to Improve Access to Primary Care in Medically Underserved Communities
Project Director : Laura Bonanno, PhD, DNP, CRNA
Team Members : Jessica Landry, DNP, FNP-BC and Carly Pigg, MM
Project Dates : July 1, 2016 to June 30, 2020
Funder : Health Resources and Services Administration Scholarships for Disadvantaged Students Program
Abstract : The Scholarships for Disadvantaged Students (SDS) program is designed to increase the diversity in the health professions and nursing workforce by awarding scholarships to students from disadvantaged backgrounds who have financial need including students from racial and ethnic minority groups. The SDS program will provide scholarship awards to full-time second and third year graduate nursing students enrolled in either the nurse anesthesia program or the primary care family nurse practitioner program that are either educationally or economically disadvantaged. The project objectives include: 1) To increase the number of graduates practicing in primary care; 2) To increase the enrollment, retention and graduation of full-time students from disadvantaged backgrounds including students who are members of racial and ethnic minority groups; and 3) To increase the number of graduates working in medically underserved communities (MUCs). The respective program directors will be responsible for informing students of the SDS program and having interested students complete the HRSA Statement of Appointment form and the Commitment form. The available scholarship funds will be equally dispersed among qualified applicants.
Supporting Mental Health During Pregnancy and Beyond
Principal Investigator : Gloria Giarratano, PhD, APRN, CNS, FAAN
Team Members : Mary Alexander, MSW; Michelle More, Psy. D.; Jane Savage, RN, PhD
Project Dates : April 1, 2018 to May 31, 2019
Funder : Louisiana Clinical and Translational Science Center Community Scholars Program
Abstract : Biological and psychosocial changes during pregnancy impact a woman’s emotional well-being and ability to cope with stress, making them vulnerable to depression and anxiety. The negative impact of perinatal depression can be reduced if it is identified early, successfully treated, or prevented from occurring in the first place. These partners aim to build community resilience to perinatal mood disorders by proposing community-based mental health support. To achieve this aim, the partners will conduct focus groups with three groups of community stakeholders, including socially at risk women who have given birth, women currently pregnant, and mental health and childbearing caregivers in order to assess community awareness of the problem and determine community strategies to address the problem.
Health Related Quality of Life Instrument Focusing on Depression, Anxiety and Stress as related to Pulmonary Hypertension
Principal Investigator : Lesley Ann Sakektoo, MD, MPH (Tulane University)
Team Members : Todd Tartavoulle, DNS, APRN, CNS-BC
Project Dates : January 1, 2016 to September 15, 2019
Funder : United Therapeutics
Abstract : These studies are designed to gain better insight into the patient’s perspective of pulmonary arterial hypertension (PAH). The data will ultimately be used to develop patient-reported outcome measures (PROMs) specific to PAH including a feasible, accessible PH-specific Health-Related Quality of Life Instrument (HRQoL). Very importantly, the data will be used to recognize and develop approaches to care in areas of priority importance to patients with PH.
National Cancer Institute Community Oncology Research Program
Principal Investigator : Augusto Ochoa, MD (LSU Health Cancer Center)
Team Members : Lorrie Powel, PhD, RN
Project Dates : July 1, 2015 to June 30, 2020
Funder : National Cancer Institute/ National Institutes of Health
Abstract : The Gulf South-Minority Based-NCI Community Oncology Research Program (GS-MB-NCORP) brings together an integrated clinical trials program from two Minority Based CCOPs and an NCCCP site in the state of Louisiana, supported by well-established and funded Cancer Care Delivery Research (CCDR) and programs in Health Disparities (HD) and Community Based Participatory Research (CBPR). The Minority Based-CCOP established by the LSU School of Medicine in New Orleans (LSUHSC-New Orleans-MBCCOP) and its NCCCP partner, the Mary Bird Perkins Cancer Center-Our Lady of the Lake Hospital (MBP-OLOL) in Baton Rouge, have joined the MBCCOP at the LSU School of Medicine in Shreveport (LSUHSC-Shreveport-MBCCOP) in northwest Louisiana to create the GS-MB-NCORP. This consortium integrates well-established and experienced teams of clinicians and researchers with the aim of expanding access to state-of-the-art cancer clinical trials to the patients we serve, through a network of leading academic and community hospitals. Louisiana has one of the poorest survival rates for cancer patients in the United States, despite not having the highest incidence for all types of the disease. This is particularly true for underserved and minority patients, clearly reflecting a major health disparity. Possible explanations for this disparity range from socio-economic and access to healthcare, to poorly understood genetic and biological differences. The LSU MBCCOPs and the NCCCP at MBP-OLOL have independently worked to increase access to clinical trials for minority and underserved communities, establish outreach and education programs, and expand Cancer Care Delivery Research and Health Disparity studies. In the fall of 2012, we agreed to combine our strengths and experience into the GS-MB-NCORP with the goal of having a more significant impact on cancer associated health disparities by integrating our clinical trials programs and incorporating Cancer Care Delivery and Health Disparity researchers into the clinical trials process. The GS-MB-NCORP’s goals are to increase the participation of minorities and underserved populations in clinical trials, identify barriers to participation, and incorporate the community in the research studies.
: Changing Tides for Nurse Practitioners: Bridging the Gap from Education to Practice through Academic Practice Partnerships
Project Director : Latanja Divens, PhD, DNP, APRN, FNP-BC
Team Members : Jessica Landry, DNP, FNP-BC; Susan Lee, MSN, APRN, FNP-BC; Clair Millet, DNP, APRN, PHCNS-BC; Alison Davis, PhD, RN, CHSE; Annette Hurley-Larmeu, PhD, CCC-A, FAA (LSU Health School of Allied Health); Barbara Doucet, PhD, LOTR (LSU Health School of Allied Health); Lucretia James, MSN, FNP-BC; Jennifer Nickens, MSN, APRN, FNP-C; Carly Pigg, MM; Michele Lowery
Project Dates : July 1, 2017 to June 30, 2019
Funder : Health Resources and Services Administration Advanced Nursing Education Workforce Program
Abstract : The purpose of the Louisiana State University Health (LSU-H) New Orleans, School of Nursing’s (SON) proposal for the program entitled “Changing Tides for Nurse Practitioners: Bridging the Gap from Education to Practice through Academic Practice Partnerships” is to establish and expand academic practice partnerships that will support the Primary Care Nurse Practitioner student’s preparation both academically and clinically to provide medical care and services in and to medically underserved areas and populations (MUA/P) upon completion of graduation and certification. Primary Care Nurse Practitioners are at the forefront of primary care with approximately 50% of PCNPs being employed in the primary care setting with an expected 30% increase by 2020 (Iglehart, 2014). Academic practice partnerships will support and enhance learning in the clinical setting utilizing a new approach to clinical education that will provide immersive learning with real-time experiences. LSU-H SON will utilize two academic practice partners, University Medical Center- New Orleans (UMC) and LSU-H, New Orleans, School of Allied Health (SOAH). Both institutions provide medical services to MUPS in New Orleans and the surrounding areas. The establishment of the academic practice partnerships will also allow for interprofessional education experiences (IPE) that will provide unique opportunities utilizing high fidelity simulation, collaboration and team-based approaches to care. Clinical education will also be enhanced by pre-clinical experiences including simulated cases commonly seen in medically underserved settings, education on common issues in MUPS including vulnerability, diversity and public health in New Orleans. This project will include shared didactic and clinical learning activities for PCNP, Occupational Therapy, and Audiology students, which will enhance competencies to improve the provision of primary care to MUPs. This project will also restructure and enhance current preceptor selection, training and evaluation as well as student and faculty assignments to clinical sites. Rapid cycle quality improvement strategies as well as assigned faculty preceptors will be used to ensure consistent high quality clinical learning experiences, which will enhance graduates’ readiness to practice and ultimately improve access to primary care.
Enhancing Advanced Practice Registered Nursing Education to Improve Readiness for Professional Practice
Principal Investigator : Laura Bonanno, PhD, DNP, CRNA
Team Members : Leanne Fowler, DNP, MBA, APRN, AG/ACNP-BC, CNE
Project Dates : June 1, 2018 to June 30, 2019
Funder : Louisiana Board of Regents Traditional Enhancement Program
Abstract : The Louisiana State University Health New Orleans School of Nursing includes undergraduate and graduate nursing programs. This project supports two advanced practice registered nursing roles in the graduate nursing program: Nurse Anesthesia (NA) and Nurse Practitioner (NP). Certified Registered Nurse Anesthetists (CRNAs) and Nurse Practitioners are critical members of health care teams throughout the United States (US). CRNAs administer approximately 65% of the 40 million anesthetics given in the US each year and serve as the sole providers of anesthesia in more than 70% of rural hospitals in the United States. NPs are increasingly being employed across all care settings in the US as primary providers for patients and key members of healthcare teams with a focus on improving health care quality and reducing costs.
This proposed project involves the purchase of a SonoSite ultrasound unit and a fiberoptic bronchoscopy simulator. This equipment will be used in simulation activities to provide both NA and NP students training in advanced clinical knowledge and skills required for professional practice. The training will allow NA students to gain proficiency in the use of ultrasound for regional anesthesia techniques and invasive line placement as well as advanced training in securing a difficult airway using fiberoptic bronchoscopy. In addition, our NP program will become one of the only NP programs in the US to offer simulated point-of-care ultrasound (POCUS) training. POCUS is a cost-effective, reliable, timely, and easy to use method for enhancing the physical examination of patients, and provides a faster time to diagnosis and treatment when utilized by NPs. This training will allow NA and NP students to practice role specific highly technical skills in a safe and non-threatening environment. We have two primary goals for the project:
- To enhance the existing academic curricula of the Nurse Anesthesia and Nurse Practitioner programs by providing advanced training in the use of ultrasound technology for skilled performance and diagnosis.
- To provide Nurse Anesthesia and Nurse Practitioner students advanced training in the simulated use of fiberoptic bronchoscopy for airway evaluation and management.
Nurse Faculty Loan Program
Project Director : Deborah Garbee, PhD, APRN, ACNS-BC
Team Members : Rick Zimmerman, PhD and Carly Pigg, MM
Project Dates : June 1, 2018 to Open Ended
Funder : Health Resources and Services Administration
Abstract : The purpose of this application is to request funds to secure Nurse Faculty Loan Program (NFLP) funding for doctoral students at the LSU Health New Orleans School of Nursing who desire to pursue a career as a faculty member in a School of Nursing. The NFLP will provide needed financial assistance to students enrolled in the following doctoral programs who are preparing for nurse faculty positions: 1) Doctor of Nursing Practice (DNP) and 2) Doctor of Nursing Science (DNS) program. Nearly all of our DNS students and an increasing proportion of DNP students plan to be faculty in schools of nursing after they complete their degrees. To qualify for our proposed NFLP, students must agree to plan to serve as faculty in accredited schools of nursing for at least four years, as well as take nursing education courses. In addition, Louisiana is a very diverse state, and neither nursing doctoral students nor nursing faculty are currently as diverse as the state. We propose three primary objectives of this program:
- To increase the number of students in our DNS program with training to be nurse educators;
- To increase the proportion of our DNP students who go on to become nursing faculty and are prepared to teach in schools of nursing throughout their careers; and
- To increase the proportion of our DNS and DNP students from under-represented minority groups, to increase the proportion of nursing faculty from these groups.
Smart, portable sleeve for lymphedema treatment
Principal Investigator : Hunter Gilbert, PhD (Louisiana State University)
Team Members : Connie McKnight, RN, MN, OCN, CRA
Project Dates : December 15, 2017 to May 31, 2019
Funder : Leveraging Innovation for Technology Transfer/ Louisiana State University Board of Supervisors
Abstract : The primary goal of this project is to prove the concept of a smart, wearable compression sleeve that provides dynamic compression therapy for the treatment of lymphedema. Lymphedema is a debilitating swelling of the extremities that affects many breast cancer survivors. Compression therapy is a widely successful technique for the management of symptoms, but there are no currently available compression therapy devices that completely satisfy all needs. The objective of this proposal is to design a prototype sleeve for use on the arm that actively senses swelling and treats the symptoms of lymphedema by integrating existing technologies.
Microeconomic intervention to reduce HIV transmission in economically disadvantaged transgender women
Principal Investigator : Rick Zimmerman, PhD, LSU Health School of Nursing; Eric Benotsch, PhD, Virginia Commonwealth University
Team Members : Sheila Grigsby, PhD, RN, MPH, APHN-BC, University of Missouri Saint Louis; Larissa Jennings, PhD, MHS, John Hopkins University
Project Dates : December 1, 2017 to November 30, 2020
Funder : National Institutes of Health/ National Institute of Mental Health
Abstract : The goal of this study is to develop and pilot test an integrated microeconomic (ME) intervention to reduce the risk of HIV transmission among economically disadvantaged male-to-female (MTF) transgender women (TGW). While some psychosocial interventions have been implemented for TGW, most lack rigorous evaluation data and/or economic determinants are largely unaddressed. Despite the high estimated HIV prevalence (>25%) among U.S. TGW (and up to 50% in African-American TGW), they have nevertheless not been targeted in the few available ME initiatives for HIV prevention. Recent studies suggest that there are a variety of factors contributing to HIV vulnerability in TGW, including economic and structural barriers such as experiencing discrimination in employment and housing and the high cost of medical and clinical services required for male-to-female transition, all of which lead to financial instability and reliance on high-risk income generation; and being victims of sexual violence and having much higher incidence of psychiatric symptoms and substance use, all linked to higher HIV prevalence and transmission. It is estimated that TGW are three times as likely as the general population to be unemployed; four times as likely to be unstably housed; and twice as likely to be poor. TGW of color especially experience these disadvantages.
To address high rates of HIV and the related economic disadvantage of TGW (including many TGW of color), this study will use a two group experimental design to develop and longitudinally assess an integrated ME intervention tailored for economically disadvantaged TGW who are also behaviorally at risk for HIV. Microeconomic interventions, defined as very small-scale initiatives to improve the financial status of individuals have been shown in low-income countries to improve protective sexual behaviors, and HIV communication and testing, by combining HIV education and financial training, mentoring, and economic resources.
Consistent with these results, we will finalize and evaluate the intervention via three project aims:
Aim 1: Conduct formative work with TGW and key informants to assess TGW’s current experiences and preferences for each of the possible ME components (including supportive economic services, employment readiness and financial training, gender transition supports, and economics-based HIV education).
Aim 2: Develop an integrated ME intervention for HIV prevention tailored for economically disadvantaged TGW which addresses multiple economic vulnerabilities in two U.S., HIV-prevalent, and resource-poor metropolitan areas (Richmond, VA and the St. Louis MO/IL metro area.)
Aim 3: Using a randomized experimental study design, assess the feasibility and efficacy of the integrated ME for economically disadvantaged U.S. TGW in reducing economic vulnerability and HIV sexual risk-taking.
The ultimate goal of this R34 project is to establish a feasible, acceptable, and scalable microeconomic intervention for HIV reduction in U.S. TGW communities to test within a larger, subsequent RCT.
Nurse Anesthetist Traineeship
Principal Investigator : Laura Bonanno, PhD, DNP, CRNA
Team Members : Carly Pigg, MM
Project Dates : July 1, 2018 to June 30, 2019
Funder : Health Resources and Services Administration
Abstract : The Nurse Anesthetist Traineeship (NAT) Program is designed to meet the needs of licensed registered nurses seeking graduate nursing education in anesthesia (Doctoral level) at Louisiana State University Health Sciences Center School of Nursing (LSUHSC SON). The NAT Program will provide traineeship funding for full-time first, second, and third year nurse anesthesia students to cover a portion of the costs for tuition, fees, books and reasonable living expenses. The project objectives include: 1) Provide nurse anesthesia students with clinical training in rural, medically underserved, and/or HPSA clinical sites; 2) Identify nurse anesthesia students that are from disadvantaged backgrounds and/or are interested in working in rural, medically underserved or HPSAs upon graduation; 3) Have the students sign a HRSA Statement of Appointment form and a Commitment form that indicates whether the student is from a disadvantaged background and whether the student plans to work in a rural, medically underserved or HPSA upon graduation; 4) Disperse Traineeship funds. The project director will be responsible for informing students of the NAT program and having interested students complete the HRSA Statement of Appointment form and Commitment form. The available traineeship funds will be equally dispersed among qualified applicants. Student clinical experiences in the Nurse Anesthesia Program (NAP) include providing care for minority, disadvantaged, underserved, and rural populations. 100% of the 31 nurse anesthesia clinical training sites reside in either rural, medically underserved or HPSAs . All LSUHSC SON nurse anesthesia students receive extensive clinical training in rural, medically underserved and HPSAs. Therefore, the NAT program increases access to nurse anesthesia care for underserved populations .
LSU Advanced Nursing Education Sexual Assault Nurse Examiner Program
Principal Investigator : Jessica Landry, DNP, FNP-BC
Team Members : Nanette Morales, DNP, FNP-BC; Cynthia Armstrong, MN, RN, NEA-BC; Deborah St. Germain, DNP, RN, CEN, CNE; Carly Pigg, MM
Project Dates : September 30, 2018 to September 29, 2021
Funder : Health Resources and Services Administration
Abstract : The purpose of the project is to increase access to certified sexual assault nurse examiners (SANE) for victims in the southeast region of Louisiana encompassing two underserved urban and 10 underserved rural parishes (entities that would be counties in other states). Currently, 1.3 million residents share one certified SANE. In 2016, there were 537 reported rapes in New Orleans. This was a rate of 135.2 rapes per 100,000 residents, which is 2.2 times the national average (City Data, 2018). Metro New Orleans also has a large LGBT population; sexual violence is higher in LGBT than in heterosexual individuals, on average, throughout the US.
The rate of incarceration at 970 per 100,000 is 2nd highest in the state of Louisiana; inmate-on –inmate sexual violence is also generally higher than that in the general population. Of the 10 rural parishes surrounding the New Orleans area, none have SANE services available locally. Instead, when a resident is sexually assaulted, he/she must be transported up to 90 miles to either Jefferson or Orleans Parish (both in the New Orleans area), using the Hospital-based Model. In addition to providing SANE training, we plan to work with rural parishes to increasingly implement the Community-based Model, where SANE practitioners are centralized and travel to local hospitals to complete forensic sexual assault examinations rather than requiring victims to come to them. Funding will be provided for nurses in all aspects of SANE training including didactic coursework, clinical skills training, clinical practice hours, certification, and continuing education. Additional support will be provided for continued professional development and to reduce psychosocial barriers related to retention of SANEs, as well as to encourage activities by project partners to seek funding and adopt practices to sustain the work of the project.
Project goals include :
- Establish relationships with sexual assault response committees in order to implement an infrastructure for training and certification of SANEs in the 12 targeted parishes.
- Provide training for 140 nurses and certification of a minimum of 75 nurses to include didactic courses, simulation, and required clinical hours commensurate with the International Association of Forensic Nurses (IAFN) criteria.
- Support sustainability and retention of the SANE program by providing 24 continuing nursing education hours as well as resources to attend the annual IAFN conference, offer three annual peer review days sponsored by LSUHSC SON, coordinate continuing education sessions and support groups related to self-care, support a regional SANE conference and complete SANE training/certification for three LSUHNO SON faculty.
Investigating the relationship among obesity, early puberty, and sexual behavior in adolescents
Principal Investigator : Julia Tipton, RN, DNS, CPN, CNE
Team Members : Rick Zimmerman, PhD; Gloria Giarratano, PhD, APRN, CNS, FAAN; Melinda Sothern, PhD, CEP
Project Dates : July 1, 2018 to June 30, 2020
Funder : LSU Health School of Nursing Dean’s Seed Grant
Abstract : Childhood overweight and obesity is associated with a myriad of deleterious physiological and psychosocial consequences, including early pubertal development. The link between increased weight status and early puberty among female is well-established. Evidence supports a positive association among earlier sexual maturation and early sexual debut among adolescent females. However, the joint relationships between obesity, early pubertal development, and early sexual debut have received little attention in the literature. The purpose of this descriptive, multivariate and multi-level study is to investigate the interactions between weight status, early puberty and early sexual activity among female adolescents using restricted-use data from the National Longitudinal Study of Adolescent to Adult Health (Add Health). Potential moderating and mediating effects of contextual school and neighborhood variables and genetic predisposition will be examined. Findings will guide the development and testing of a school-based educational intervention aimed at preventing both risky sexual behaviors and obesity among at-risk adolescents.
Securing unbiased real-time evaluations in team training of interprofessional students
Principal Investigator : John Paige, MD
Team Members : Deborah Garbee, PhD, APRN, ACNS-BC; Laura Bonanno, PhD, DNP, CRNA; Qingzhao Yu, PhD; Kathryn Kerdolff, MLIS
Project Dates : July 1, 2019 to June 30, 2021
Funder : International Association of Medical Science Educators
Abstract : Sociometric badges are wearable electronic devices that can measure human activity and engagement using social signals derived from vocal features, body motion, and relative location. They are also equipped with accelerometers, by which researchers can accurately infer fine-grained data such as body positions and the extent and duration of movements. Outside of healthcare, researchers have conducted empirical studies with sociometric badges to understand and predict high-level behavioral constructs such as affect, activity, and creative output. In fact, individuals’ affective state can be determined with 81% accuracy. This potentially makes these badges powerful tools in High Fidelity Simulation (HFS) for measuring the Social Network Analysis (SNA) indicators and, by proxy, the TeamSTEPPS™ competencies.
With our foundational knowledge of teamwork assessment and our enthusiasm for the potential of sociometric badges in this novel context, the specific aim of the proposed work is to use sociometric badges in HFS Operating Room (OR) training sessions to measure the teamwork skills of interprofessional teams of healthcare students .
The goal of the proposed work is to provide evidence that sociometric badges are an effective tool to objectively and reliably measure quantitative indicators of teamwork in HFS with participating interprofessional teams of healthcare students .