Collaboration: Going Greater Together
How College of Nursing faculty are working with interdisciplinary colleagues to solve health problems.
As the heart of the health care system, nurses are well-known for their abilities to collaborate and identify the need for patient advocacy and access. At the University of Florida, College of Nursing faculty are being recognized for their interdisciplinary collaboration on groundbreaking research and innovative solutions. The College of Nursing has achieved national recognition through a steady increase in National Institutes of Health, or NIH, research funding and was ranked No. 21 in 2018 for NIH funding among public universities in the country. Here are three examples of how College of Nursing faculty are working with interdisciplinary researchers from across the academic health center, university and nation to solve specific problems facing health care today.
Equity in Cancer Research
From Coast-To-Coast
The National Cancer Institute awarded a five-year, $16 million grant to establish a cancer health equity center at the University of Florida, Florida A&M University and the University of Southern California.
The Florida-California Cancer Research, Education and Engagement, or CaRE2, Health Equity Center is co-led by Diana Wilkie, PhD, RN, FAAN, the Prairieview Trust-Earl and Margo Powers Endowed Professor at the College of Nursing and director of the Center for Palliative Care Research and Education, and Folakemi T. Odedina, PhD, a professor in the colleges of Pharmacy and Medicine.
The center will bring together researchers from the two states with the highest cancer incidence and mortality to create a bicoastal minority cancer research and training center. Florida and California also have uniquely rich and heterogeneous populations of Blacks and Latinos, who are the focus of this study.
“We have done a lot to reduce cancer mortality and morbidity in general, but research for Blacks and Latinos has not kept pace with the majority population,” Wilkie said. “With the CaRE2 Health Equity Center, we are focusing on the biological and human experience that can be altered from one’s cultural background to improve cancer outcomes for Blacks and Latinos. We want to better understand how one’s biology, beliefs and attitudes affect engagement with care and survivorship.”
A ribbon-cutting ceremony in Orlando marked the launch of the CaRE2 Health Equity Center. Participants included (left to right): Jose Trevino, MD; Michael Weaver, PhD, RN, FAAN; Angela Adams, PharmD, MPH; Thomas Schmittgen, PhD; Diana Wilkie, PhD, RN, FAAN; Reginald Frye, PharmD, PhD; Folakemi Odedina, PhD; Paul Okunieff, MD; and Jacques Turgeon, BPharm, PhD.
At UF, researchers come from across multiple campuses, including the colleges of Medicine, Pharmacy, Nursing and Education, the UF Research and Academic Center Lake Nona, and UF Health Jacksonville, as well as from UF Health Shands. The team includes researchers with expertise across the spectrum, from molecular biology and bioinformatics to community outreach and clinical interventions.
For the first phase of the center, two full research projects and one pilot project will be conducted that are focused on prostate and pancreatic cancers, two cancers with noted disparities among Blacks and little-known information among Latinos.
Each project has a team at each of the partnering institutions.
Another goal of the center is to provide research training opportunities for underrepresented minority trainees and early-stage investigators that foster their individual career development.
“This center really ‘takes a village’ to address cancer health disparities,” Odedina said. “Our strength is in our diversity, with the center being led by five underrepresented minority scientists and four women.”
“At UF and UF Health, not only will the center advance health disparities research in Black and Latino populations and provide opportunities for underrepresented minority researchers, it will also aid in the university’s application to become an NCI-designated Cancer Center,” said David R. Nelson, M.D., interim senior vice president for health affairs at UF and president of UF Health.
Within the five-year grant period, the researchers have various scholarly productivity goals, including 39 presentations, 20 scientific publications, 25 grants submitted with at least 15 being awarded, 26 undergraduate trainees, 28 postbaccalaureate trainees, 34 graduate student trainees, 21 postdoc trainees, five awards and seven community reports.
The center is backed by the unique contributions of its researchers who are passionate about addressing knowledge gaps in cancer disparities research among subpopulations of Blacks and Latinos.
“While the center is a win-win situation for UF, FAMU and USC, the real winners are cancer patients, especially Blacks and Latinos in Florida and California,” Odedina said.
From Teeth To Heart
Partnering For Vulnerable Populations
Denise Schentrup, DNP, APRN, knows how difficult it is for her patients to have access to care, especially dental care. Schentrup is the college’s associate dean for clinical affairs and clinic director of Archer Family Health Care, the college’s nurse-managed primary care practice. With the help of a grant from the Florida Blue Foundation, Schentrup is collaborating on a novel project with the UF College of Dentistry to improve health care for vulnerable populations while providing valuable learning opportunities for students.
The three-year, $286,000 Advance Innovation and Promote Solutions in the Health Care System grant will allow Archer Family Health Care to work with the College of Dentistry’s on-campus teaching clinics to provide point-of-care service, a two-directional referral source and communication between nursing and dentistry sites to solve specific problems facing both clinics. Both settings care for underserved populations, who are often the most affected by a disjointed health care delivery system.
This innovative collaboration is the first of its kind in Florida and is led by Schentrup and Cesar Migliorati, DDS, MS, PhD, a College of Dentistry professor and associate dean for clinical affairs and quality.
“This grant will create a partnership that will bridge the gap for health care services. It will also serve as a stepping stone for future projects between nursing and dentistry and give students the opportunity to have interprofessional clinical practice experience.”
-Denise Schentrup, DNP,APRN, associate dean for clinical affairs and clinic direct or Archer Family Health Care
Denise Schentrup, Associate dean of clinical affairs, Nursing and Cesar Migliorati Dentistry Associate Dean of Clinics and Quality Assurance.
At the dental teaching clinics, care can be delayed for a significant portion of patients at the time of their procedure due to complex health assessments and evaluation. Patients are redirected to their primary care provider, if they have one, to obtain a clearance to be treated. Meanwhile, about 60 percent of Archer Family Health Care’s patient population has limited access to timely dental evaluation and treatment.
To solve these problems, a nurse practitioner will be embedded in the College of Dentistry’s teaching clinics to provide immediate medical assessment, treatment and referral to primary care for dental patients, as needed. Health assessments completed immediately by the nurse practitioner would allow for dental care to continue without delay. If the nurse practitioner determines a more in-depth medical consult is necessary or if patients have an untreated chronic disease, the nurse practitioner can initiate a referral to a medical facility, such as Archer Family Health Care.
On the Archer Family Health Care side, a licensed clinical social worker has been hired to connect patients to the College of Dentistry for dental treatment.
“This grant will create a partnership that will bridge the gap for health care services,” Schentrup said. “It will also serve as a stepping stone for future projects between nursing and dentistry and give students the opportunity to have interprofessional clinical practice experience. Student exposure to and adoption of innovative models of care are paramount to making changes in health care delivery.”
In addition to the benefits to patients, students will be part of a unique interprofessional model of practice while gaining more skills to manage medically compromised patients and to communicate effectively with fellow health care professionals about their patients’ problems.
“Underserved populations face many difficulties in accessing medical and dental care, which prevents these individuals from achieving total body and oral health,” Migliorati said. “With this partnership, dental students will work under professional supervision with a nurse practitioner to demonstrate a new model of medical and dental care and decrease complications for patients.”
Promoting the Health of Florida Farm Communities
Jeanne-Marie Stacciarini, PhD, RN, FAAN, an associate professor in the College of Nursing, is embarking on a three-year journey around the state for a research project that aims to advance the understanding and promotion of the well-being of rural farmworkers and small farmers.
Stacciarini joins Gülcan Önel, PhD, an assistant professor in the food and resource economics department of the UF Institute of Food and Agricultural Sciences; and Antonio Tovar, PhD, a community partner from the Farmworker Association of Florida. The team was selected for the Robert Wood Johnson Foundation’s Interdisciplinary Research Leaders program.
Members of the Robert Wood Johnson Foundation Interdisciplinary Research Leaders Program. From left: Antonio Tovar, Ph.D., a community partner from the Farmworker Association of Florida; Jeanne-Marie Stacciarini, Ph.D., R.N., an associate professor in the UF College of Nursing; Gülcan Önel, Ph.D., an assistant professor in the Food and Resource Economics Department at the UF Institute of Food and Agricultural Sciences.
Designed for teams of two researchers and one community leader, Interdisciplinary Research Leaders supports engaged research, crafted and conducted by innovative teams to explore a problem and apply a solution in real time, making an immediate positive impact in their home communities. Stacciarini, Önel and Tovar make up the first group of researchers and community leaders from the state of Florida to be selected and the third overall cohort for the program.
The trio all have diverse and complementary research and community engagement skillsets and a strong commitment with rural communities. They have worked together as a team on smaller projects before applying for the Interdisciplinary Research Leaders program.
Stacciarini’s program of research has focused on social health determinants of mental well-being in rural Latinos and has included community-based participatory research and mixed methods in the United States and internationally. She is committed to understanding the needs of minority communities, and throughout her career, she has developed innovative research strategies and collaborations to help address psychosocial determinants of mental health within rural communities
“This team is equipped to look at socioeconomic determinants of rural well-being and equity,” Stacciarini said. “We bring various perspectives on the complex socioeconomic causes of health inequity in rural Florida, and we are ready to pursue research for developing a novel framework of rural well-being that has the potential to improve the livelihoods of farmworkers and small-scale farmers in the rural areas of our state.”
The Interdisciplinary Research Leaders program supports and connects leaders who are committed to bringing about meaningful change and building a national culture of health. Participants build the interdisciplinary skills and relationships necessary to extend their influence and impact, break down silos, address health disparities and make communities healthier. The program provides participants with annual support of up to $25,000 and a one-time research grant of up to $125,000 per team.
“Despite their contribution to the economy and sustainability of food production systems, little attention has been given to the unique social, economic and political circumstances impeding health equity and well-being of rural farm communities in Florida,” Önel said. “These underserved groups face significant, yet distinct, socioeconomic issues that have been overlooked in previous health and well-being studies.”
For the next three years, the team will engage with various rural farm communities and diverse stakeholders to develop and strengthen relationships with growers and Hispanic and Haitian farmworker communities to learn their concerns and perspectives on health issues, create trust and develop an approach for effective communication throughout the project. Community-based participatory research will be used so that the community can be active and engaged in the research development and implementation.
“The end goal is to cultivate a sense of community and connectedness between farmers and the farmworkers, who otherwise may have opposing social views and policy priorities,” Tovar said. “The objective of the Interdisciplinary Research Leaders program is to bring about a culture of health within one’s communities. We aim to make well-being a common cause among Florida’s rural communities.”
