UC Davis Student-Faculty Partnership for Service on Oral Health
Principal Investigators:
Gerald Kayingo
Funder: NCCPA Health Foundation
Award: $3,500
Period: Jan. 1, 2016, to Dec. 31, 2017
The project has two aims. The first is an educational aim to develop an integrated interprofessional service-learning module on oral health. The second focuses on the community, hoping hopes to improve access to oral health and diabetes education in underserved communities in Sacramento through a network of student-run clinics.

ADAPTS: Action on Diabetes Awareness and Periodontal Treatment in Sacramento
Principal Investigators:
Gerald Kayingo
Funder: Physician Assistant Foundation
Award: $10,000
Period: Jan. 1, 2016, to Dec. 31, 2017
The project aims to improve access to diabetes education and oral-health services in Sacramento’s underserved communities through a network of student-run clinics. In this student-and-community partnership, School of Nursing researchers propose an innovative approach to health education that will be interprofessional, patient-centered, culturally sensitive and sustainable. A train-the-trainer and peer- to-peer health education program will be developed and implemented.

DESPIERTA: Developing Educational Strengths, Promoting Individual Responsible Teen Awareness
Principal Investigator: Mary Lou de Leon Siantz
Funder: Research Program on Migration and Health
Award: $39,590
Period: Sep. 1, 2014, to Oct. 31, 2017
The purpose of this exploratory project is to investigate the migration experience and its impact on the depression and pregnancy rates among the 14 to 18-years-old migrant adolescent girls of Mexico and Mexican migrant adolescent girls in the U.S. This project proposes a qualitative and quantitative approach to explore and compare risk for depression, pregnancy and access to care between those who migrate to the San Joaquin Valley of California, and those who do not migrate from Jalisco, Mexico. Mary Lou De Leon Siantz’ specific goals are to determine the rates and severity of depression, as well as pregnancy rates, in Mexican migrant adolescent girls, compare the rates in non-migrant girls in Jalisco and inform binational health policies.

Director of Nursing Guidelines for Delegation in Nursing Homes: Guideline Development and Pilot Testing
Principal Investigator: Elena O. Siegel
School of Nursing Co-Investigator: Debra Bakerjian
Funder: National Council of State Boards of Nursing
Award: $299,956
Period: Feb. 1, 2015, to July 31, 2017
The purpose of this study is to develop and test Directors of Nursing Delegation Guidelines as a resource for the implementation and oversight of nursing home delegation practices in accordance with state regulations. The Guidelines will provide a much-needed resource for nursing directors to effectively operationalize state board of nursing regulatory provisions for all types of delegation carried out in their clinical practice setting. The long-term goal of this project is to advance the translation of all types of delegation regulations into safe and effective nursing practice.

Social Capital and Latina Caregiver Well-being Study:  Intervention and Feasibility Testing
Principal Investigator
: Ester Carolina Apesoa-Varano
Other UC Davis collaborators: Ladson Hinton, Debora A. Paterniti
Funder: UC Davis Behavioral Health Center of Excellence
Award: $200,000
Period: April 1, 2015, to Sept. 30, 2017
The mental health needs of Latina caregivers of family with dementia pose a significant public health challenge, given the unprecedented aging and projected growth of Latinos in the U.S. The aims of this study are to develop a socio-culturally informed non-kin intervention model for reducing emotional distress and burden in Latina caregivers. Researchers will then refine that model by gathering recommendations from community organizations, Latina caregivers of family with dementia, and kin and non-kin of Latina dementia caregivers. Finally they will pilot test the refined intervention with Latina dementia caregivers.

Exploring the Roles of Nursing Home Administrators and Organizations in Nursing Home Quality: A Pilot Study to Establish Feasibility of Approach
Principal Investigator
Elena O. Siegel
Funder: National Association of Long-Term Care Administrator Boards
Award: $26,615
Period: May 1, 2015, to August 31, 2017
This exploratory descriptive study establishes feasibility of an approach to examine nursing home administrator functioning and performance across multifacility provider organizations and the impact on nursing home quality. Siegel will examine ways in which the licensed administrator position looks different from one setting to the next, in terms of individual and organizational factors, and how these differences are associated with nursing home quality.

Mapping and Integration of the Pain Management Core Competencies
Principal Investigator: Heather M. Young
Other UC Davis collaborators: Scott Fishman
Funder: Mayday Fund
Award: $85,250
Period: May 1, 2014, to December 31, 2017
This grant supplements other research being conducted by Heather M. Young and Scott Fishman to launch a high-impact education module for students from multiple professions to learn team-based, person-centered chronic pain care. This funding enables researchers to conduct an interprofessional consensus summit as the critical first step in the development of an interprofessional educational simulation tool based on the pain competencies. It also enables the research team to assemble leaders from multiple professions, including medicine, nursing and pharmacy, to map how the pain management competencies overlap with existing competencies within each individual profession.

Early Palliative Care: Views and Help-Seeking in Mexican-Heritage Older Adults with Serious Chronic Illnesses
Principal Investigator:
 Ester Carolina Apesoa-Varano
Other UC Davis collaborators:
 UC Davis Center for Musculoskeletal Health
Award: $10,000
Period: Nov 30, 2016, to December 1, 2017
This study focuses on Mexican-heritage older adults’ experience of serious co-morbid illness in understanding of early palliative care (EPC), as well as how EPC engagement can be facilitated based on this group’s illness experience and palliation views. Building on the illness behavior model, the qualitative study combines grounded and social constructionists’ approaches to gather formative data that will allow the researchers to identify the barriers to and facilitators of engaging in EPC in this underserved population. Thus, this study does not focus on the biomedical aspects of disease, but rather on the sociological and cultural dimensions of how illness is experienced and anticipated in the lay context (e.g. home) in order to understand how and when individuals may begin to consider early palliation as an alternative mode of care.

On Point: Shared Decision Making at the Point of Need in Cancer Care
Principal Investigator:
Katherine Kim
Other UC Davis collaborators: Richard J. Bold, Nicholas Rolphe Anderson
Funder: Boston University Center for Future Technologies in Cancer Care
Award: $265,550
Period: July 1, 2016, to June 30, 2017
For individuals with cancer, decisions regarding care management throughout the treatment phase are numerous. While shared decision-making aids for screening, prevention and selection of early treatment options are available, there is a lack of knowledge about how shared care management tools might support adherence to and outcomes of the treatments once selected. The proposed On Point technology is a mobile application that is interoperable with an electronic health record that enables shared care management and optimizes individuals’ adherence with their own plans of care during active therapy. In this project, the researchers will develop On Point from an existing prototype they created and assess feasibility of implementing the system with “precision” clinic visits that are fitted to individual needs.

Teamwork in the Hospital: Gendered and Racialized Epistemologies at the Bedside
Principal Investigator:
Ester Carolina Apesoa-Varano
Other UC Davis collaborators: Vicki Smith, Ming-Cheng Lo
Funder: UC Davis Feminist Research Institute
Award: $10,000
Period: July 1, 2016, to June 30, 2017
The overall goal is to examine how gendered and racialized/ethnicized epistemologies of care are enacted at the bedside and seek to understand how larger gendered and racialized organizational and cultural dynamics are related to the micro-level interactions of practitioners in a care team. This project involves a feminist methodological approach that integrates interviews, ethnography and participant self-narratives as central to understanding the experiences of hospital practitioners under the teamwork model.

Alcohol-related Care and Outcomes for Outpatients with HIV in a National VA Cohort
Sheryl Catz
Funder: National Institute on Alcohol Abuse and Alcoholism (Subaward from Group Health Research Institute)
Award: $32,500
Period: Feb. 15, 2015, to Jan. 31, 2017
Unhealthy alcohol use is common among HIV-positive patients and associated with poorer adherence to antiretroviral therapy, increased HIV disease progression and poorer survival. This study makes use of Veterans Affairs (VA) Healthcare System data to describe and compare receipt of route brief intervention among outpatients with unhealthy alcohol use and evaluate whether changes in alcohol screening scores are associated with changes in medication adherence, markers of disease progression and mortality risk.

Usability and Acceptance of Personal Health Network Technology for R.N.-led Cancer Care Coordination
Principal Investigator: Janice Bell
Funder: Oncology Nursing Society
Award: $25,000
Period: Jan. 1, 2015, to Dec. 31, 2016 
This is a pilot study to assess and refine a novel personal health network technology for cancer-care coordination in preparation for a large-scale randomized controlled trial. Researchers describe and identify socio-demographic and job-related predictors of technology acceptance and use among oncology nurses, evaluate implementation of evidence-based chemotherapy symptom management algorithms configured in the network and evaluate the ease-of-use and acceptance of the personal health network for chemotherapy care coordination.

Interprofessional Pain Management Competency Program
Co-Principal Investigator:
Heather Young
Other UC Davis collaborators: Scott Fishman
Funder: Mayday Fund
Award: $378,481
Period: April 1, 2011, to December 31, 2016 
The overall goal of the interprofessional pain management competency program is to identify core pain competencies for prelicensure learners from diverse health care professions that will ultimately change how clinicians respond to pain. Creating and distributing standardized, consensus-based competencies in pain management that can be used by educational institutions worldwide, across the spectrum of health-care practitioners will serve as a foundational step in improving the culture and content of care for adults and children with acute and chronic pain or pain at the end of life. The core pain management competencies will also be mapped with existing competencies within individual professions, including medicine and nursing. This funding also supports the development of an interprofessional learning module based on the pain competencies.

An Education and Practice Collaboration to Relieve Pain and Suffering
Principal Investigator: Heather Young
Investigators: Deborah WardVirginia Hass
Other UC Davis collaboratorsScott Fishman, Mark Servis, JoAnne Natale
Funder: Macy Foundation
Award: $340,281
Period: June 1, 2014, to August 31, 2016
The primary purpose of this project is to collaboratively develop and test a specialized interprofessional training experience for health-professional school students of prelicensure health professional schools with a focus on the practice of relieving pain. Researchers envision that the module will serve as a model for development of additional interprofessional education activities for other clinical areas beyond pain management. The research team conducts a formative evaluation to improve the program concurrently and summative evaluation to assess terminal outcomes. The evaluation will include an assessment of learners’ ability to demonstrate competency in focal areas of pain management, as well as interprofessional, person-centered communication.

Use of mHealth to Support Nurse-directed Care Coordination for Chemotherapy Patients: Improving Health, Health Care Delivery and Health Care Utilization
Principal Investigator: Jill Joseph
School of Nursing Co-Investigators: Janice Bell, Katherine Kim
Funder: McKesson Foundation Mobilizing for Health
Award: $199,854
Period: Feb. 26, 2014,  to Sep. 30, 2016
School of Nursing researchers, in partnership with the UC Davis Comprehensive Cancer Center, launched a pilot project in which nurses utilize health information technology and mobile phone technology to coordinate and improve selected aspects of cancer care among patients with recurrent cancer in California’s rural Central Valley. The overall goal of this pilot project is to obtain critically important preliminary information regarding the feasibility, acceptability, and potential health and economic benefits of a technology-supported care coordination project in a highly disadvantaged group of patients with recurrent cancer.

Mapping and Integration of the Pain Management Core Competencies
Principal Investigator: Heather Young
Other UC Davis collaborators: Scott Fishman
Funder: Milbank Foundation for Rehabilitation
Award: $62,500
Period: July 1, 2014, to September 30, 2016
This grant supplements other research being conducted by Heather Young and Scott Fishman to launch a high-impact education module for students from multiple professions to learn team-based, person-centered chronic pain care. This funding enables researchers to conduct an interprofessional consensus summit as the critical first step in the development of an interprofessional educational simulation tool based on the pain competencies. It also enables the research team to assemble leaders from multiple professions, including medicine, nursing and pharmacy, to map how the pain management competencies overlap with existing competencies within each individual profession.

Internet-based Medication Adherence Program for Nicotine Dependence Treatment
Sheryl Catz
Funder: National Institute on Drug Abuse (Subaward from Group Health Research Institute)
Award: $45,634
Period: April 1, 2014, to Aug. 31, 2016
The purpose of this study is to develop and evaluate the feasibility and acceptability of a mobile Web tool to enhance medication adherence among smokers using varenicline.

Health Coaching Accelerator
Principal Investigators
: Katherine Kim
Funder: Merced County Workforce Investment Board
Award: $60,862
Period: Jan. 18, 2016, to May 30, 2016
The project provides for medical assistant health coach training for team-based chronic care management in Merced County. Kim provides training in health coaching for medical assistants and site preceptors who assist community health center patients with diabetes and hypertension. This training enhances career development opportunities through skill development for low-wage medical assistants and other health workers.

Boston University Continuation of Collaborative Care Coordination
Principal Investigator: Katherine Kim
Funder: Boston University
Award: $76,681
Period: July 1, 2015, to June 30, 2016
School of Nursing researchers conduct a randomized intervention pilot for people with cancer to compare nurse-led care coordination incorporating mobile health to nurse-led care coordination without any mobile health enhancements. All participating cancer patients will receive evidence-based care coordination. Working with a private partner, Tiatros, the team will adapt and implement their mHealth platform incorporating HIPAA-compliant and cloud-based secure health-relevant social networking, as well as supporting real-time and ongoing patient symptom reporting.

Improving Dementia Care through MUSIC & MEMORY℠
Principal Investigators:
Debra Bakerjian
Funder: California Association of Health Facilities
Award: $421,263
Period: Aug. 15, 2015, to June 30, 2018
The scope of services for this work covers two distinct components. The first is the California Association of Health Facilities (CAHF) quality improvement research effort to improve dementia care through the use of Music and Memory℠. School of Nursing researchers consult with CAHF on development of criteria for facility selection and data collection processes for this quality improvement project. UC Davis is responsible for independently evaluating the outcomes data from that quality improvement project. The second component of the project is the development and testing of a Quality Assurance and Performance Improvement intervention. The School of Nursing team is responsible for the design, implementation, data collection and data analysis for this segment of work.

Oral Health for Life: Promoting Oral Health Among Tobacco Quitline Callers
Sheryl Catz
Funder: National Institute of Dental and Craniofacial Research (Subaward from Group Health Research Institute)
Period: Aug. 1, 2014, to June 30, 2018
The purpose of this project is to conduct a randomized clinical trial to evaluate the effectiveness of an integrated oral health promotion, tobacco cessation counseling program delivered through tobacco quitlines. The trial tests the effectiveness of a multimodal behavioral intervention — the Oral Health 4 Life program — targeted to smokers who are ready to quit smoking and seeking services through state tobacco quitlines.

Psychotropic Medication Use Among U.S. Children and Youth: National Trends, Disparities and Related Expenditures
Principal Investigator
: Janice Bell
Funder: U.S. Health Resources and Services Administration, Maternal and Child Research Program
Award: $95,960
Period: April 1, 2014, to March 31, 2016
The use of psychotropic medications as treatment for children and youth with mental health problems increased dramatically through the 1990s, doubling and in some cases tripling. Most related trend papers are out-of-date and limited in scope. This goal of this study is to examine trends, expenditures, disparities and health care quality associated with psychotropic medication use from 2002 through 2011. The findings will support clinicians, public health professionals, researchers and policy makers by informing recommendations, identifying interventions and providing current national estimates from which future trend studies can be extended.

Customized Training for Health Coaching
Principal Investigator: Katherine Kim
School of Nursing Co-Investigator: Janice Bell
Funder: Golden Valley Health Centers 
Award: $103,976
Period: June 1, 2014, to May 31, 2016
The goal of this project is to implement health coaching by medical assistants for diverse patients with diabetes and hypertension in six community clinic sites in California’s agricultural Central Valley. School of Nursing researchers draw upon evidence-based programs in nurse-led care coordination and chronic disease health coaching to develop a hybrid training person, both in-person and remote, didactic and on-the-job training program for 22 medical assistants and nurse care coordinators. The health coaching activities are integrated in a tailored fashion for the site-level organization and care team workflow. Evaluation includes impact on utilization and health outcomes, patient and clinician satisfaction and an assessment of learning effectiveness for trainees.

Alameda County Care Alliance Community Care Navigator Enhanced Training Curriculum (subaward)
Principal Investigator: Katherine Kim
Funder: The San Francisco Foundation/Alameda County Care Alliance
Award: $15,000
Period: May 15, 2015, to April 30, 2016
Katherine Kim leads a team to develop an enhanced curriculum for the faith-based community care navigators in advanced illness management. This enhanced community care navigator training program builds on the foundational Alameda County Care Alliance (ACCA) Community Care Training to build skills in health coaching and healthcare system navigation. Together with the ACCA, UC Davis will train six navigators from five churches of the health ministry. This will be a highly interactive and resource-rich training which will give the community care navigators support to help care for people living with advanced illness in the community. UC Davis will also be performing on-the-job assessments and providing feedback for each community care navigator.

A Social/Mobile Platform for Optimizing Health Services for Complex Chronic-Care Management
Principal Investigator
: Katherine Kim
Funder: Center for Information Technology Research in the Interest of Society (CITRIS)
Award: $59,983
Period: July 1, 2015, to June 30, 2016
Using participatory design methods, the project team will develop a working prototype of a mobile platform for effective care coordination for individuals with cardiovascular disease. A group of stakeholder advisers, including physicians, nurses, patients, case managers and other members of the patient-care team, will be recruited to inform the design of the prototype. The prototype will have the capacity to incorporate clinical and patient-generated data, share data with electronic health record systems, enable communication and collaboration between patients and care teams and incorporate privacy-preserving features. The prototype will consist of a fully functional front-end pre-populated with content to allow participants to dynamically explore the system, while allowing researchers to capture feedback and observe the system’s usefulness and usability.

Novel Personal Health Network Technology to Enhance Nurse-directed Early Palliative Care for Cancer Patients: A Pilot Study to Establish a Randomized Clinical Trial
Principal Investigator:
Janice Bell
Co-Principal Investigator: Katherine Kim
School of Nursing Co-Investigators: Jill Joseph, Ester Carolina Apesoa-Varano, Sheryl Catz
Other UC Davis collaborators: David Copenhaver, Richard Bold
Funder: UC Davis Center for Healthcare Policy and Research, UC Davis Clinical and Translational Science Center, UC Davis School of Medicine, UC Davis School of Nursing
Award: $50,000
Period: June 1, 2014, to Dec. 31, 2015
Palliative care — defined as patient- and family-centered care that optimizes quality of life by anticipating, preventing and treating suffering — encompasses both care coordination and symptom management, assisting and supporting patients throughout the continuum of illness. This project leverages ongoing work to collect preliminary data to support future grant application to the Patient-Centered Outcomes Research Institute (PCORI) to determine if the provision of nurse-directed, technology-enabled palliative care can improve outcomes relevant to cancer patients, their family members and caregivers, and their providers when compared to usual care. The study includes surveys to describe the experiences of cancer patients receiving usual care services in UC Davis Comprehensive Cancer Care Center and qualitative interviews to identify patient-centered features and functions of a novel personal health network software designed for palliative care.

Engaging Patients with Personal Health Network Technology for Chemotherapy Care Coordination
Principal Investigator:
Jill Joseph
School of Nursing Co- Investigators: Katherine KimEster Carolina Apesoa-Varano, Janice Bell
Other UC Davis collaborators: Nick Anderson
Funder: Center for Future Technologies in Cancer Care / Boston University
Award: $77,465
Period: July 1, 2014, to June 30, 2015
Nurse care coordination is an approach used to assist patients navigating complex care and treatment and has been demonstrated to improve both the patient experience and health care utilization. The School of Nursing is funded by the McKesson Foundation to conduct a preliminary trial. This research explores whether an innovative personal health network technology can improve outcomes for cancer chemotherapy patients receiving nursing care coordination. Researchers hope to identify patient perceptions of facilitators and barriers of personal health network technology use, and evaluate Its features and functions and to identify and analyze patient questions and support needs during use of the technology. This funding supplements technology development and nursing care coordination capacity being implemented and evaluated with a McKesson Foundation grant.

Improving the Usability, Usefulness and Acceptance of Personal Health Network (PHN) Technology for Chemotherapy Care Coordination among Registered Nurses
Principal Investigator:
Janice Bell
School of Nursing Co-Principal Investigators: Ester Carolina Apesoa-Varano, Jill Joseph, Katherine Kim
Other UC Davis collaborators: Richard Bold
Funder: Academic Senate Committee on Research, University of California, Davis
Award: $25,000
Period: July 1, 2014, to Sep. 30, 2015
Emerging evidence suggests that mobile technologies can support care coordination by promoting patient engagement, facilitating team communication and providing a tool for patient-driven social networking; however, little research and development to date has been conducted in this area. In this study, researchers test user experiences of a novel personal health network technology using simulated patient scenarios, “think aloud” methods, key informant interviews and validated survey instruments in a purposive sample of 40 registered nurses.

Patient-Oriented Scalable National Network for Effectiveness Research (pSCANNER) - Phase I (subaward)
Principal Investigator:
Katherine Kim
Funder: University of California, San Diego /Patient-Centered Outcomes Research Institute (PCORI)
Award: $450,433
Period: April 2, 2014, to Oct. 1, 2015
The Patient-Centered Outcomes Research Institute (PCORI) provided funds to create a network of clinical data research networks (PCORnet) to conduct efficient, large-scale, patient-centered comparative effectiveness research. The Patient-Oriented Scalable National Network for Effectiveness Research (pSCANNER) will integrate three existing networks: University of California Research Exchange (UC ReX), Scalable National Network for Effectiveness Research (SCANNER) and VA Informatics and Computing Infrastructure (VINCI).  Katherine Kim leads pSCANNER’s patient engagement efforts, which will include the creation of stakeholder advisory panels for the networks three focus conditions: weight management and obesity, heart failure and Kawasaki’s disease.

HEALTH LEAP: pSCANNER’s Health Systems Leadership Project (subaward)
Subrecipient PI: Katherine Kim
Funder: Patient-Centered Outcomes Research Institute (PCORI)
Award: $62,703
Period: July 1, 2015, to Dec. 31, 2015
HEALTH LEAP builds upon the extensive engagement of patients, clinicians and researchers in research prioritization conducted by pSCANNER. The project extends engagement by incorporating health system leaders into the discussion of health system priorities. Health system leaders also provide direct feedback on the priority research topics identified by the pSCANNER stakeholder research prioritization panels on weight management and obesity, heart failure and Kawasaki’s disease. HEALTH LEAP uses an iterative developmental approach that supports the diversity of participants — patients and patient advocates, clinical leaders and system executives. In-person gatherings, one in Northern California and one in Southern California, will be held to allow for maximum participation of leaders from pSCANNER’s clinical sites and the patient leaders from the current Stakeholder Advisory Board.

Enhancing Tribal Health and Food Security in the Klamath Basin by Building a Sustainable Regional Food System (subaward)
Principal Investigator: Katherine Kim
Funder: UC Berkeley/USDA
Award: $27,174
Period: Sep. 1, 2014, to Aug. 31, 2015
This integrated multistate and multi-institutional research, extension and education program seeks to achieve a sustainable food system in the Klamath Basin that results in healthy communities, healthy ecosystems and healthy economies among the Klamath, Karuk and Yurok Tribes, as well as becomes a model for other tribal and rural communities. In this Youth Initiative, using community based participatory research and action research approaches, Katherine Kim partners with local tribal liaison Grant Gilkison of the Mid-Klamath Watershed Council and a team of Karuk youth to enable leadership development among tribal youth through training and experiential learning. Within the Youth Initiative, researchers also seek to demonstrate the use of mobile technology in community health and food assessment and public health interventions.

Exploring Opportunities for Enhanced Mental Health Capabilities in Family Nurse Practitioners and Physician Assistants
Principal Investigator
: Debra Bakerjian
Funder: California Office of Statewide Planning and Development Healthcare Workforce Policy Commission
Award: $100,000
Period: July 1, 2013, to Aug 15, 2015
The primary purpose of this project is to perform a feasibility study of the merits of a mental health fellowship program for physician assistants and nurse practitioners in conjunction with county mental health facilities in areas of need surrounding Sacramento, particularly in the underserved areas of California where UC Davis students typically reside. The School of Nursing will explore potential nurse practitioner and physician assistant graduate mental health education in order to increase the skills and confidence of graduates in those clinical and knowledge areas and increase the availability of skilled mental health practitioners in the community. The principal investigator will work closely with Department of Psychiatry partners in the development of this feasibility study. Areas of focus include adult, child and adolescent inpatient services, as well as outpatient case management.

Nurses and the Population’s Health
Principal investigator
: Jeri L. Bigbee, Ph.D., R.N., F.N.P.-B.C., F.A.A.N.
Betty Irene Moore School of Nursing graduate-student researcher: Susan Perez, M.P.H.
Undergraduate research assistant: Lissette Jacobo
Funder: The National Council of State Boards of Nursing
Award: $92,743 | February 2012-September 2013
This research assesses whether the supply of registered nurses is associated with healthier communities. This question is critical because nurses make up the largest group of health professionals, but they are not distributed uniformly across the country and there is a shortage in the nursing workforce, particularly in rural areas. This study analyzes national data from all 50 states to answer questions including: whether higher nurse-to-population ratios are associated with better levels of population health, whether nurse education and professional licensure levels influence population health outcomes, and which population characteristics—such as socioeconomic factors—affect the relationship between the nurse-to-population ratio and health outcomes. This project has implications for nursing workforce planning and regulation.

Pilot: Implementing a Collaborative Incident Response Team to Foster Patient Safety and Reduce Medical Liability
Principal investigator
: JoAnne E. Natale, M.D., Ph.D.
Co-investigators: Jill G. Joseph, M.D., Ph.D., M.P.H. and Deborah Ward, Ph.D., R.N., F.A.A.N.
Betty Irene Moore School of Nursing graduate-student researchers: Theresa Pak, R.N. and Tracy Nord, R.N.
Funders: University of California Office of the President and the UC Center for Health Quality and Innovation
Award:  $163,000 (UC Office of the President) and $50,000 (UC Center for Health Quality and Innovation) | February 2012-January 2014 (UC Office of the President award)
This pilot project focuses on improving hospital response to unfavorable clinical incidents or errors through the use of an Interprofessional Collaborative Incident Response Team (I-CIRT) comprised of specially trained nurses, physicians, psychologists and hospital risk-management representatives. The study assesses the benefits of using I-CIRT to help frontline health-care staff discuss unanticipated health events with patients and their family; assist frontline staff to identify and meet their own need for support following such incidents; and collect information needed to respond to these incidents. The researchers expect that bringing trained, experienced professionals to the scene of an unanticipated health incident will improve safety and decrease liability claims. JoAnne Natale is a faculty member with the Nursing Science and Health-Care Leadership Graduate Group and the School of Medicine.

Organizational Commitment to Quality Improvement in Nursing Homes
Principal investigator:
Elena O. Siegel, Ph.D., R.N.
Betty Irene Moore School of Nursing graduate-student researcher: Perry Gee, R.N., M.S.N.
Betty Irene Moore School of Nursing staff: Vanessa Santillan
Funder: Robert Wood Johnson Foundation
Award: $349,795 | September 2011-August 2014
The improvement of nursing home quality is an issue of growing importance in our aging society. Nursing home leadership teams are in critical positions to improve nursing home quality; yet, little is known about why some are more successful at improving quality than others. Using data collected from nursing home organizational documents and interviews with nursing home leaders—including owners, corporate executives, administrators, and directors of nursing—this study will examine the organizational factors that contribute to leaders’ decisions about which quality improvement projects are adopted and the strategies used to ensure successful implementation and sustainability of those initiatives. The long-term objective of this research is to enhance the capacity of nursing home leaders—and the organizations they serve—to improve the quality and value of care provided in our nation’s nursing homes.

Late-Life Depression Among Women: Socio-Cultural Factors Shaping Illness Experience and Help-Seeking Behaviors Among Latina, Caucasian and African-American Older Women
Principal investigator
: Ester Carolina Apesoa-Varano, Ph.D.
Funder: Betty Irene Moore School of Nursing at UC Davis
Award: $60,000
There are significant knowledge gaps regarding late-life depression in women, especially in ethnic minorities, and these gaps pose barriers to improving depression care and wellness in older women. This research addresses some of these knowledge gaps. It explores how socio-cultural factors shape the experiences and ideas of depression among Latina, Caucasian and African-American women who are 60 to 80 years old. The study aims to identify how older women view the nature, seriousness and causes of their depression, examine their management of their depression, and describe their attitudes toward formal depression care. By investigating the interaction of gender, ethnicity, aging and social factors as they relate to depression care, this research will reduce health disparities and facilitate interventions and policies tailored to improving quality of life for affected individuals.

Before, During and Between: Identifying African-American Women at High Psychosocial Risk for Poor Birth Outcomes
Principal investigators
: Lars Berglund, M.D., Ph.D. and Jann Murray-Garcia, M.D., M.P.H.
Funder: National Center for Research Resources
Award: $10,000 | September 2011-December 2012
The U.S. infant mortality rate among African-Americans continues to be more than twice as high as that among Caucasians. These racial disparities in infant mortality rates are driven by higher rates of preterm and low birth-weight infants born to African-American mothers. This comparative pilot study examined the influence of psychosocial stressors—such as adverse childhood events, perceived discrimination and perceptions of one’s relative status in the social hierarchy—on birth outcomes such as preterm birth, low birth weight and very low birth weight among African-American women. The study seeks to demonstrate the usefulness of a new psychosocial assessment instrument to predict poor birth outcomes. The long-term goal is to develop a tool that can identify African-American women who are at high risk for substandard birth outcomes because of potentially harmful stressors.

Influence of Social Support and Networks on Caregiver Mental and Physical Health
Principal investigatorHeather M. Young, Ph.D., R.N., F.A.A.N. and Ladson Hinton, M.D. 
Betty Irene Moore School of Nursing staff: Tara Sharpp, Ph.D., R.N.
Funder: National Institute of Aging and the UC Davis Alzheimer's Disease Research Center
Award: $39,881 | July 2010-August 2011
This study examined the social networks of those caring for persons with Alzheimer’s disease, and the relationship between the caregivers’ social support and social networks and their mental and physical health. Professor Heather M. Young and Ladson Hinton, director of the Education Core of the UC Davis Alzheimer’s Disease Research Center, led an interdisciplinary team of researchers from nursing, psychiatry and communications departments at UC Davis in this one-year pilot study. In this limited sample, there was a significant prevalence of depressive symptoms among caregivers, with one-third of the caregivers screening positive for depression. This has clinical implications for their long-term mental health and capacity to deliver care during a long-term, progressive neuropsychiatric illness. Another important finding was that caregivers reported a lack of tangible social support, which correlated significantly with a decrease in cognitive abilities among those they were caring for.

Exploring the Management and Administrative Roles of Directors of Nursing Positions in Nursing Homes
Principal investigatorElena Siegel, Ph.D., R.N.
Funder: American Nurses Foundation
Award: $3,485 | July 2010-August 2011
Recurrent reports of poor quality care in nursing homes and high rates of turnover among staff suggest a health-care sector in crisis. Within nursing homes, the director of nursing position is of particular interest, given these directors’ overarching responsibility for the administration and management of nursing services. However, the educational backgrounds of the majority of nursing home directors do not support this complex responsibility, especially its non-clinical aspects. This research explored the management and administrative roles of directors of nursing in nursing homes—specifically, their actual and ideal involvement in the management and administrative aspects of nursing services. The long-term goal of this research is to increase the capacity of nursing management teams who are charged with the organization and delivery of nursing home care.

Increasing Rural Community Engagement in Telehealth Research: Improving Health in Diabetes
Principal investigator: Heather M. Young, Ph.D., R.N., F.A.A.N. and Lars Berglund, M.D., Ph.D.
Betty Irene Moore School of Nursing graduate-student researchers: Deborah Greenwood, R.N., M.Ed. and Frances Patmon, R.N., M.S.N.
Betty Irene Moore School of Nursing staff: Sheridan Miyamoto, M.S.N., F.P.N. and Vanessa Santillan
Funder: National Center for Research Resources
Award: $599,019 | September 2009-September 2011
Diabetes is a growing public health concern, and effective management must include lifestyle and behavioral changes. In underserved communities, where the prevalence of diabetes is higher and resources are less accessible, improving health for individuals with diabetes calls for community outreach and interdisciplinary approaches. The study was a randomized controlled trial of a telehealth intervention with nurses serving as health coaches compared to usual care. Health coaching took place in participants’ homes using telephone or video technology. The research demonstrated increased self-efficacy and improved goal setting among individuals who received the telehealth intervention, and supported the feasibility and acceptability of this approach for rural adults with chronic illness.

Nurse-Led Intervention to Facilitate Patient Activation for Improved Pain Self-Management
Principal investigatorDeborah Ward, Ph.D., R.N., F.A.A.N. 
Funder: Robert Wood Johnson Foundation
Award: $300,000 | September 2009-August 201This study evaluated a counseling intervention designed to support individuals to self-manage their pain after surgery. Study participants were individuals undergoing spine and neck surgery at UC Davis Spine Center. Nurses in this setting play a key role in presurgical screening and postsurgical pain management consultations, working in collaboration with physicians, clinical psychologists and other health colleagues. This study was in part a response to the observations of nurse leaders at the spine center, who saw a need for an intervention to encourage patients’ active participation in their recovery after surgery. Patient self-management tools and resources, funded in part by this grant, may be found here. This website provides a guide for those who have chronic pain and for health professionals interested in motivating clients to self-manage chronic pain. This grant was one of six projects funded in the last phase of the Interdisciplinary Nursing Quality Research Initiative grant solicitation.