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Scholar Spotlight: Tedra Hamel

Tedra Hamel

Tedra “Teddi” Hamel is an Accelerated Bachelor’s in Nursing Science student and the de Tornyay Center’s 2022-2023 Myrene C. McAninch Undergraduate Scholar. Her project is “Understanding Age-related Psychological Changes: A Secondary Data Analysis”. Her faculty mentor is Dr. Basia Belza.

 

Why did you choose nursing?

Coming from a background in outdoor education, I am used to working with a group of ten students for four or eight weeks. It’s a life changing experience for those students, but it’s a small population to work with. I wanted my next profession to be more accessible to more people. I hope to work in the ER at some point. The ER is a place where you serve anyone and everyone –people don’t have to be healthy enough to go on a backpacking trip. So it’s about giving my energy and resources to more people instead of just ten at a time.

What made you want to do research?

I come from a liberal arts background. My BA was in history and I had to do a thesis for graduation. I did a full year of research during my senior year of undergrad. I feel like doing research helps you delve into the issues of a field in a way that you might not fully get if you’re just working.

Could you briefly describe your project with the de Tornyay Center?

My project will be on the psychological changes that are self-identified in older adults, using the Engaging with Aging framework initially developed by Doris Carnevali.

The main framework of Engaging with Aging is identifying coping mechanisms and adaptations that older people are already using.

I’ll be analyzing the transcripts that have already been collected and looking for broad themes of psychological changes with the hope of identifying strategies and resources, that older adults already use themselves to get through those challenges and changes. Knowing these adaptations can be very helpful for those that work with older adults.

What sort of psychological changes are you looking for in the transcripts?

What I’ve seen is that a lot of it is changes in emotional feelings, or how emotions are expressed, or all of a sudden they’re feeling a lot of sadness or feeling less emotion. So, how their psychological understanding of themselves and their feelings change over time.

Why is this research important to do?

I like this project based on the fact that we’re hearing older adults’ voices on how they are experiencing aging, instead of just applying blanket techniques, or band-aids, or what we think is right.

I know the Engaging with Aging research is informing providers on good ways to support older folks in their own self-identified strengths and adaptations versus just applying something outside of them.

What interests you about healthy aging?

I was young when three of my four grandparents died, but my mom’s mom lived until 2019. She had dementia for the last seven years of her life, and seeing her go through that and seeing my mom support her was eye opening. Our society doesn’t have good solutions or good structures in place for everyone that has to go through aging. I think that sparked my care and passion for it.

Then, the last few years I’ve been working in rural health in Eastern Washington as a medical assistant and also an EMT, and there’s so many people in the older population that just don’t have the resources. It’s really hard to live out there, and so the EMS system is used a lot to support them. If they fall at home, they’ll call 911 and then the EMTs get sent out there to help them get up.

There’s only 12 beds in the local assisted living facility and there’s always a year long wait list. So people tough it out at home, even though that area receives up to four feet of snow every winter. It was a really interesting place to get introduced to aging at home because a rural place is a totally different ball game than the city. So I got curious about how we help folks age gracefully in our society.

What are your plans after graduation?

I do want to get ER experience here in the city. I want to be a flight nurse at some point in the future. That environment really suits my skill set but that would allow for a lot of other work too. I could see myself being a clinical nurse in my small community in eastern Washington. That position is a really cool combination of nursing skills. You set up flu vaccine clinics at the local assisted living centers, as well as being the nurse at the local urgent care, etc. You end up working with the whole population. But mostly I’m planning to graduate, and probably work in a hospital for a few years to get experience.

Scholar Spotlight: Dariga Tugan

Dariga Tugan is an ABSN student and one of the de Tornyay Center’s 2022-2023 Healthy Aging Undergraduate Scholars. Her project is “A descriptive analysis of variability in exercise (VO2 Max) to address differences in physical function and alleviation of symptoms in older adults living with HIV”. Her faculty mentor is Dr. Allison Webel.

Why did you choose nursing?

I chose nursing because it’s an interesting blend of arts and sciences where you get to tailor your care to the patient’s needs. I wanted to master the art of spreading love during times of fear and uncertainty in people’s lives. Spreading joy, helping people heal, and understanding the human body with its interactions in medicine is beautiful to me.

What interested you about nursing research?

I absolutely love research. In my free time, I’d often print out articles from PubMed and just read through them. But the reason why I got interested in research was, unfortunately, health care is extremely racist. A lot of our research is catered to white males.

The way that our health care system works is the therapies, the medications, even the non-pharmacologic therapies are all based on research, which is primarily done on white males. So, entering the space where you can advocate for more diversity and bridge that huge lack of diversity in research, specifically with people of color, was a big interest to me.

What interested you about healthy aging?

I started off my nursing career in a nursing home around 2020. I became passionate about alleviating suffering for those during the final stages of their lives because oftentimes I was the last person that patients would see as they passed. The reason for this is our facility didn’t allow any visitors during the height of the pandemic, and I began to ask myself questions. How do I utilize my privilege of being the last person they see to ensure that they are suffering less? Is restricting access to seeing their family really benefiting or keeping older adults safe in the pandemic?

I would see how this nursing home specifically would charge patients fifteen thousand dollars a month for subpar care. I got really interested in brainstorming new ideas and solutions to address healthy aging and the gerontology populations. It was these ideas that drew me to join the honors route for the BSN program to better understand and create awareness around the need for quality nursing homes, especially for the people who can’t afford them.

Could you briefly describe your project?

It’s a descriptive analysis of variability and exercise to address differences in physical health, aka the VO2 max, in older adults living with HIV. VO2 Max is a measure of cardiovascular fitness and aerobic insurance based on the maximal oxygen consumption of individuals in a defined exercise protocol.

There’s a myriad of research surrounding VO2 Max in older adults, and it’s actually the strongest independent predictor of future life expectancy in both healthy and individuals with cardiorespiratory disease.

We have a lot of studies on VO2 Max and exercise in older adults, as well as exercise in older adults living with HIV, and VO2 Max and HIV specifically. But my study would be addressing the gaps in our knowledge. Specifically, the data will be surveyed using VO2 max at baseline and excelerometry at baseline between decades of people in their fifties, sixties, and seventies.

A lot of these studies also do not focus on older adults with HIV, so data that compares the age groups would be of utmost importance.

I did a literature review and there’s a call for action to have better definitions and studies on interventions that can improve physical function and VO2 Max in HIV-infected patients. I think that these data that I analyze can inform and empower older adults living with HIV to engage in strategies to improve their physical function.

What are your plans after graduation?

I plan on working in ICU, but I am dual enrolled in a post-bacc premed program right now, so I’m applying to medical school in October. I love pharmacology and pathophysiology. I think that becoming an ICU nurse and then going to medical school will allow me to study more pathophysiology, but also bring an interesting nursing perspective, which is holistic.

Is there anything else you want to share?

I’m an immigrant from Almaty, Kazakhstan, and not many people know what Kazakhstan is. But it is the ninth biggest country in the world. It was a part of the Soviet Union, so they speak Russian there. It has a huge Russian culture. A lot of the background is also Muslim. So you have the Muslim culture, the Russian culture, and our own Kazak culture, which is a nomadic culture, which is beautiful because you have such an intersection of so many different personalities and viewpoints.

It’s allowed me to be diverse in my own thinking and the way I approach people and solutions. My own family is Christian. Balancing my relatives being Muslim and then my own Christian family, it’s all balanced like the yin and yang of life. I love being an immigrant, and I like being from Kazakhstan.

(Article correction: The original article mentioned a lack of women in research before 1976, which has been removed, as there were clinical trials before that date which included women).

Congratulations to our 2022-2023 Healthy Aging Scholars!

The de Tornyay Center for Healthy Aging is pleased to announce the 2022-2023 Healthy Aging Scholarship recipients.

Please join us in congratulating these exceptional scholars and their faculty mentors!

PHD RESEARCH SCHOLARSHIPS:

Emily Ahrens, Myrene C. McAninch Doctoral Scholar
Topic: Fidelity of the ABCDEF bundle for patients with language barriers
Faculty Mentor: Hilaire Thompson PhD, RN, ARNP, CNRN, AGACNP-BC, FAAN

Karl Cristie Figuracion, Healthy Aging Doctoral Scholar
Topic: Environmental enrichment and cortical changes among brain tumor survivors
Faculty Mentor: Hilaire Thompson PhD, RN, ARNP, CNRN, AGACNP-BC, FAAN

Kuan-Ching Wu, Healthy Aging Doctoral Scholar
Topic: A theoretical framework for urinary tract infection prevention and management in community-dwelling older persons with dementia
Faculty Mentor: Oleg Zaslavsky PhD, MHA, RN

UNDERGRADUATE RESEARCH SCHOLARSHIPS:

Tedra Hamel, Myrene C. McAninch Undergraduate Scholar
Topic: Understanding age-related physiological changes: a secondary analysis
Faculty Mentor: Basia Belza PhD, RN, FAAN, FGSA

Esther Mwaniki, Germaine Krysan Undergraduate Scholar
Topic: Examining symptoms of post-intensive care syndrome in older intensive care unit survivors with end-stage renal disease
Faculty Mentor: Maya Elias PhD, MA, RN

Dariga Tugan, Healthy Aging Undergraduate Scholar
Topic: A descriptive analysis of variability in exercise (VO2 Max) to address differences in physical function and alleviation of symptoms in older adults living with HIV
Faculty Mentor: Allison Webel RN, PhD, FAAN

Scholar Spotlight: Michael Drake

Michael Drake is a 4th year BSN student, and the recipient of the 2021 Queen Silvia Nursing Award, hosted by the Queen of Sweden. Drake’s idea for the award is a platform that allows patients and their caregivers to easily share information with medical providers. His areas of interest include acute care, palliative care, end of life care

Why did you choose nursing?

Years ago, my mother was diagnosed with a terminal illness. I quit my job and school to be their full-time end-of-life caregiver, up until her passing in March of 2018. After she passed away, I felt that I could not go back to what I was doing before. I love nursing and was inspired by our hospice nurses, so I decided then and there that I would become a nurse. It’s one of the best decisions I have ever made.

What has been an unforgettable experience during your time at the school of nursing?

In spring quarter, I needed to care for my partner’s grandfather, who was going through their own end-of-life, which required me to travel to a small town in Colorado. This meant that I’d be missing some of my clinical days and hours, so I was concerned that my teachers wouldn’t be understanding. That wasn’t the case at all – two of my clinical teachers, Gaylene Altman and Amy Walker, were extremely supportive and gave me the flexibility I needed to care for my partner’s grandfather. Amy Walker went one step further and mentored me throughout that experience – completely of her own volition. The support I received has been the highlight of my time at UW.

How has your experience with the school of nursing helped with your career trajectory?

Well, I’m a high school dropout – I really struggled through school for a long, long time. So, even though I got good grades in my pre-reqs at Bellevue College, I really didn’t think I would get into a place like UW. It means a lot to me that I got into the School of Nursing at UW. Being educated by leaders in the field, having experiences, especially clinical experiences, I would not have had at other nursing schools has made me a more well-rounded student and nurse.

Could you briefly describe your idea for the award you received?

The idea I submitted for the Queen Silvia Nursing Award is a platform for caregivers of patients to store and share important information for their care. For example, if you are a family caregiver of someone with dementia and you are working with an organization that sends certified nursing assistants (CNA) or respite caregivers, you can share information through this technology platform to let the new caregivers or CNAs know who the patient is, what they like, what they dislike, what medications they are on, what to do in an emergency, how to navigate the house, and how to accommodate language and communication preferences.

If you are a physician and you’re receiving a patient who has autism, a caregiver or family member can use this service to send a QR code so that the provider can see what they need to know prior to their first visit. Does the patient have sensory issues? Does the patient need earmuffs or dimmer lighting because of sensory needs? What’s the best way to communicate to the patient? Is the patient verbal or selectively mute? All of this information is important, and sometimes is requested and recorded by a medical assistant or the front desk, usually before the first meeting with the provider.  However, it can take a lot of time and relies upon the patient or family caregiver to verbally report the information.  The platform I’m working on gives patients and their caregivers access and ability to edit this information and share it safely to anyone who needs it.

Patients do a lot of the stuff my idea wants to do already, but they do it with a pen and paper, or they print out their information and put it in the folder. When I was taking care of my mother, I kept all of her medications in an excel spreadsheet, and I would just share it with people who were coming in. Often they didn’t know how to use excel so that was difficult. So, my idea is to make information sharing for patients easier by being accessible and easy to use, especially because a lot of healthcare information systems are not any of those things.

Where are you at with this idea?

It is in the customer research and discovery phase. I just got done with the University of Washington’s CoMotion’s I-Corps program. I got to interview many, many different people, which was a lot of fun. I’ve got a wide variety of perspectives on this problem I’m trying to solve with QRx. Currently, I have a design prototype that demonstrates how it will work, but the systems behind it and all that stuff is going to have to wait until after I graduate.

What have you been hearing in the interviews?

That the problems people experience in our healthcare system with care coordination and transition management are a huge issue. For example, I talked to a healthcare worker at a local clinic. They’re a specialist who had a patient come in with a problem that originally happened in another hospital, which required them to get an MRI scan. The patient got the MRI scans either at that hospital or another organization, probably a small diagnostic clinic, so the specialist couldn’t see them easily. In a perfect world, you would call in to the clinic and say, “Hey! I have patient ‘so-and-so’; could you please send me those MRI scans? The patient wants you to share it”, and they send it over.  However, it isn’t that easy, and even if they decide to send the MRIs it can still take weeks to receive them. Often patients can’t wait a week because they have a serious health issue, so instead the specialist will just order another MRI. This is totally unnecessary, and the patient pays for that, or if that patient is on Medicare or Medicaid, then we all pay for it. Also, for some procedures like X-rays, they and others get exposed to radiation unnecessarily.  So, talking to that specialist and other providers, they wish they had a way for patients to share that information easily.

I had one interview with a person who was a patient that saw lots of physicians.  They talked about how they have to bring medications to physicians’ appointments, who often spend lots of time struggling to reconcile it all.  The patient told me of a time it took three hours for a new provider to go through all their medications and past medical history. Let’s say they had a list or a program or solution to help facilitate that process, like the one I’m proposing – that would have made the patient and the physician’s experience a lot better.

What interests you about healthy aging?

I think the value of a society is in how it treats the most vulnerable. Older adults, especially older adults of color or from marginalized backgrounds, are not treated very well in the United States. This is the case for all people with dementia, but especially African Americans with dementia – they are not given the attention or the care that they deserve. I think that is awful and unacceptable, and I personally feel that it is important to work with groups of patients and populations that need that attention, that compassion, and someone to be there for them when it’s difficult, to advocate for their needs. That’s why I like working with older populations; at least in the United States, these patient populations are not a priority for our culture, and as a nurse it’s a priority for me. That’s the reason why I want to work in palliative care. Palliative does work with lots of people with dementia, and you generally work with older adults going through a serious illness.

What are your plans after graduation?

I’ve had a great education at the University of Washington, but I am a nursing student in the pandemic, so that has definitely affected my educational opportunities. So I am trying to get a nursing residency for after graduation in something that will expose me to lots of different experiences and give me a well-rounded education on how to provide care. I’m looking for something in acute care or emergency care, and after a few years, I want to move into palliative care. In palliative, it helps if you have acute care experience in intensive or emergency departments. So I’m aiming for both of those with the eventual goal of moving into gerontological palliative care.

Is there anything else you want to share?

If anyone comes from an engineering, technical, or user experience design background in medicine that’s interested in solving these problems, definitely contact me! I’d love to talk to people who are passionate about solving the types of issues my idea is trying to solve!

Scholar Spotlight: Meaghan Oakes

Meaghan Oakes is one of the de Tornyay Center for Healthy Aging’s 2021-2022 Healthy Aging Doctoral Scholars. Oakes’ de Tornyay Center project is “Improving Advance Care Planning within the Geriatrics Department at Confluence Health”, and her faculty mentor is Dr. Katie Kemble.

What are your areas of interest?

My areas of interest are family practice and health across the lifespan. I like the idea of watching patients grow, whether they’re elderly and grow into old age or they’re young and grow to become teenagers. I am looking forward to having a patient panel that I get to know well and helping them meet their health goals.

Why did you choose nursing?

I was always interested in medicine, and nursing seemed like a natural path for me. I love the holistic aspect to patient care. And I wanted to go back to school to become a nurse practitioner because I wanted to have more autonomy and be able to provide broader care to patients.

What’s been an unforgettable experience during your time at the school of nursing?

Our rural health rotation. I’ve had one with Confluence but also had great rural health experiences elsewhere. I enjoyed getting to know the communities I was in and providing care to whole families in areas that may not have the same amount of resources.

How has your experience at the school of nursing helped you with your career trajectory?

UW is a great DNP program that’s not only helped me to become a family nurse practitioner, which was my goal. They also help prepare you for leadership and making changes at an individual and systems level.

What interests you about healthy aging?

As a family nurse practitioner, I’m interested in caring for patients throughout the lifespan, though I do enjoy working with the geriatric population. What’s exciting about caring for an aging population is being able to support them in meeting their healthcare goals, because usually they have pretty concrete ideas of what they want to do with their lives and how they want to age. It’s great to help them do that.

Could you briefly describe your project with the de Tornyay Center?

The purpose of my project was to improve advanced care planning with Confluence Health. With the help of my agency contacts, I ended up implementing a pilot program to improve their advanced care planning [ACP] for geriatric patients within the palliative care department.

That involved creating and implementing a workflow process so that everyone from the receptionist to the medical assistant to the provider served as a touch point for advanced care planning. The goal is for the patients to understand what an advanced directive is, feel comfortable thinking about what they want for their health care in the event that they can’t speak for themselves, and to have resources to navigate completing those documents. This process can be overwhelming and confusing.

What does the workflow process you created look like?

I created a process map. The workflow process was divided by role, but then from top to bottom, it was organized from when the patient arrived to an appointment onward, including the receptionist calling them before they even had the appointment. So thinking about the whole patient experience, trying to find different touch points for advanced care planning. Within that workflow map, there was a referral process so that patients could have more time with the ACP team to talk and work through that paperwork and get to know a little bit more about what advanced care planning is.

How does that differ from what they had before?

Most of it was provider-driven so there wasn’t a standard workflow. The department I worked in was palliative care. They’re really interested in advance care planning. That’s an important part of what they do. Being able to work with people that were interested in this project was helpful because I got great feedback and because it can be difficult in a short period of time to implement a pilot program.

What interested you about this project in particular?

Advanced care planning is not something that we talk about very often. I think we’re all hesitant to think about death and dying. Advanced care planning can serve as an empowering way for patients to have control over their health and to communicate their healthcare wishes to their healthcare team, so we know what they want for their health.

I worked in an emergency department as a nurse before, and I have seen the impact that not having an advanced directive can have. Patients will arrive to the ER and you don’t know what their wishes are. So you do the best you can, but that doesn’t necessarily mean that’s what they wanted.

Why is this project important to do?

I think it’s important because a lot of times even providers and healthcare workers don’t know how to approach the topic. There’s a lot of fear around talking to patients about this, not wanting to upset the patient or they don’t feel like they have enough knowledge around the topic to appropriately address it. Time is also a big barrier. Every adult should have an advanced care directive, and we are all far from that. It’s a pretty big problem that isn’t often addressed in healthcare.

Was there anything that surprised you are working on this project?

There are always some unforeseen barriers, COVID being one of them. It can take a lot of time and flexibility to implement any change, but I was pleasantly surprised with how passionate the department that I worked with was about this project. In school, they prepare us that change is hard and it takes time, which is all true, but it was great to have amazing agency contacts and team members who were willing to take my suggestions and run with them.

What are your plans after graduation?

Ideally, finding a family practice to work in, but keeping my options open and see where I land.

Top Cited Article: Thai Frailty Scale

Former de Tornyay Scholar Inthira Roopsawang’s paper “The Reported Edmonton Frail Scale-Thai version: Development and Validation of a Culturally-Sensitive Instrument”, in Nursing & Health Science was listed as one of the journal’s top-cited articles!

Want to learn more about the research? Find Roopsawang’s paper here and find the center’s article on her work and frailty below, originally published in the local newspaper NW Primetime in 2019. 

Frailty across Cultures

While some see frailty as a natural consequence of aging, the reality is much more complicated than that. Frailty is a set of symptoms that come with aging muscles and bones, but this process is much faster in some individuals than others – so many older adults are not considered frail.

Typically someone is considered frail if they have three out of five classic symptoms: walking slowly, weak grip, exhaustion, low physical activity and unintentional weight loss. Frailty increases individuals’ risks of disabilities and other health concerns, such as falling and complications after surgery, so it’s important that health care providers can identify and address it.

Inthira Roopsawang, a graduate student at the UW School of Nursing, received the de Tornyay Center for Healthy Aging’s PhD Pathways to Health Aging award for her research in frailty. She became interested in the topic after working as an orthopedic nurse in rural Thailand and seeing many frail older adults come in and out of the hospital. But the hospital had no way of identifying who was at higher risk for surgical complications because of frailty.

“Why did older peoples who have the same surgery procedure, age, gender, and health conditions present different outcomes after surgery?” Inthira wondered. After digging deeper, she found that frailty seemed to be the answer. “However, the knowledge of frailty is new in some areas, including Thailand.”

There are several ways to measure and identify frailty for English speakers, but none in Thai. Roopsawang set out to translate a measurement tool for frailty to the Thai language and culture that health care workers could use in the clinic to identify frailty. She purposely used a survey that didn’t take a lot of training to administer or time to complete, so that it would be realistic to implement in rural settings with less resources.

From initial testing, her translated tool appears to work. She successfully used it to identify individuals with frailty who were at a greater risk for longer hospital stays and complications after surgery in Thailand. As the first way to measure frailty in Thai, this tool could open up new opportunities for Thai frailty research, help compare frailty across cultures, and improve treatment for Thai older adults who are frail.

By understanding and identifying patients who are frail, health care providers can modify treatment to reduce patients’ risk, especially for any surgeries. They can also work with patients to combat their symptoms through lifestyle changes.

Habits such as getting regular exercise, can reduce frailty, as well as eating a healthy diet. Recent research led by UW School of Nursing professor Dr. Oleg Zaslavsky found that the Mediterranean diet, which is rich in vegetables, nuts and whole grains reduced the risk of death in older women with frailty.

“The burden of frailty will impact the health of all older adults globally,” said Inthira. “Gaining more understanding of frailty is the key to provide better care and promote health.”

Scholar Spotlight: Lia Kaluna

Lia Kaluna is the de Tornyay Center for Healthy Aging’s 2021-2022 Germaine Krysan Undergraduate Scholar. A fourth year BSN student, her project is Identifying Key Landmarks of Central District’s Historically Black Neighborhoods. The project is a part of the Seattle SHARP study. SHARP Portland was originally developed by Raina Croff, PhD, an anthropologist at Oregon Health State University. A local team is now developing SHARP Seattle based on the findings from Dr. Croff and her team. Kaluna’s faculty mentor is Dr. Basia Belza.

Why did you choose nursing?

Originally, I chose nursing because I wanted to support and promote the wellbeing of people in vulnerable states. That transitioned to promoting their health holistically, by looking at more than physical health, like people’s mental health, spiritual health, and social environments. I love nursing because it allows me to encourage and empower patients to care for themselves as best as they can.

I also really like the diversity of the field. You can transition to different areas of care, like research, community health, and critical care. Those are all things that I could do over my entire career and still feel like I’m contributing meaningfully to healthcare overall.

How has your experience at the school of nursing helped with your career trajectory?

The School of Nursing provides students with really good connections. I joined the VALOR (Veterans Affairs Learning Opportunity Residency) program at the Seattle VA because of it, and that was a connection to support an underserved population.

Also, the School of Nursing is focusing a lot on teaching community health and ambulatory care, so preventative care and the outpatient setting. All my healthcare experience before starting nursing school was inpatient. We will always need inpatient care but it’s crucial to meet patients before problems manifest and use preventive care to promote health. UWSoN has given me a greater perspective on holistic, lifelong care, rather than just acute inpatient.

What are you plans after graduations?

There are two different tracks on my mind right now. One is the critical care route straight out of undergrad and then pursuing further education to become a nurse anesthetist. I also have an interest in community-based care, working with Pasifika community members in promoting their health. As kanaka maoli (Native Hawaiian), I feel an obligation to supporting and serving my Pacific Islander (PI) communities. I intend to return to Hawai’i where I can serve and commune with fellow kānaka and work in a community health clinic for kānaka.

What is the research project you’re working on with Ola Pasifika?

Ola Pasifika is a Pasifika led research lab at the UW School of Social Work. Ola Pasifika has partnered with several WA based Pacific Islander community organizations, such as the Pacific Islander Community Association of Washington (PICA WA), an organization that serves the health and social needs of Pasifika people statewide. With PICA WA, our principle investigators are collaborating with the PI community to create a community health model, which aligns with my aspiration to work in community health with Pasifika people.

With Ola Pasifika, I’m analyzing focus group interviews our lab conducted in collaboration with PICA WA. The focus groups documented the health and economic experiences of different Pasifika communities, like the Marshallese, Tongan, and Samoan communities. Our researchers are looking at what the community believes would benefit their health and economic wellness during the pandemic, as well as how COVID has affected their resilience and health through access to welfare, education, development of community resources, and Pasifika networks of support. For example, with COVID-19 social distance policies, it’s much harder for these Pasifika communities to gather socially, like in church and other community gatherings, as a form of resilience. Social gatherings are prominent places to share information and life experiences, engage in cultural practices, and maintain kinship, which is protective of mental and spiritual wellness.

How did you first get involved with that work?

Ola Pasifika posted an application on Instagram. I applied to work with them because I am committed to revitalizing my culture and engaging in PI community spaces. I wanted to socially engage with other PI community members and give back to my community. I’ve attended cultural clubs at UW for community and social interaction, but Ola Pasifika gave me an opportunity to engage in research that serves the greater PI community. Western-supported research often does not comprehensively capture the experiences of these communities, especially queer and transgender Pacific Islanders (QTPI), which contributes to an overall lack of health interventions that are for and informed by them. Ola Pasifika intends to use the knowledge of QTPI community informants to develop culturally-relevant interventions to promote health.

I grew up in Seattle and I’m mixed identity. So, while I am kanaka, I haven’t always been able to participate in my community as much as I wanted to. I am working through understanding the complexity of my identities while building community. Ola Pasifika provides a unique opportunity for me to learn about and invest in my communities and become more aligned with our collective values. Revitalizing my culture and contributing to my community’s resilience are lifelong commitments I hold gratefully and fiercely.

How did you first get involved with the SHARP [Sharing History through Active Reminiscence and Photo-Imagery] study?

I applied for the UW nursing honors program and was given a list of potential projects to join and support. I was interested in SHARP Seattle, because it is an opportunity for me to collaborate with local Black communities and support a culturally celebratory and community-informed project. As a person of color, I also have an ethical responsibility to invest in anti-oppressive work that supports the BIPoC community at large. My positions of privilege incentivize me to engage further and enter spaces humbly. I must support BIPoC communities and our collective demands for equity and social justice.

Why is are projects like SHARP important?

SHARP Seattle intends to promote the cognitive health of local older Black adults. SHARP addresses the need to create programs for and informed by Black communities, because there’s a lack in Western research. I’ve learned that older Black adults are at higher risk for Alzheimer’s and other dementia related illnesses due to various systemic barriers and social determinants of health, signaling a need for relevant health promotive interventions.

The project focuses on the Central District because it homes historically Black communities. However, due to gentrification, many Black community members have been displaced and the neighborhoods’ dynamics have changed drastically. This poses a problem for older Black adults who then lack tight-knit community and socialization, factors that promote successful aging in place. It promotes cognitive health to be embedded communities where we have a sense of belonging and history and can maintain meaningful social engagement as we age.

SHARP is creating walking routes that can prompt discussion around landmarks that are identified as significant to historically Black Central District neighborhoods. The routes prompt reminiscence, socialization, and exercise, and promote cognitive, social, and physical health.

In my coursework, when we talk about gerontology it tends to be from a White perspective, so having this opportunity is unique. It makes me look at gerontology in a different way. I know that there are many different disparities that older adults face, but I hadn’t explicitly considered aging in my view of intersectionality until I began working on this project. It’s a new perspective.

What’s been an unforgettable experience during your time at the school of nursing?

My community health clinical was an unforgettable experience at the school of nursing. It was my first nursing clinical, and my group partnered with the University District Children’s Center (UDCC) to work on a community-based participatory research (CBPR) project. It was the first time I was introduced to a CBPR model, which I use in my research with Ola Pasifika and SHARP, so it was unknowingly critical to a lot of the work I’m doing now. It’s encouraging to build my skills and make connections between my work throughout my undergraduate career.

Learning about community-based participatory research expanded my view of research and emphasized the importance of partnering with the community to support their ideas and goals in health and wellness. I had a limited understanding of what research could be before this clinical, so engaging in this clinical widened my perspective. I was also interested in understanding how to promote a community’s health rather than an individual patient and understanding the dynamics and challenges in that work.

The UDCC was particularly fun to work with because we got to hang out with kids after about a year being in the pandemic. We weren’t back to being fully in-person, but my clinical group got to visit the site a few times and that uplifted my mood and was really exciting. I’m so grateful to have been able to do some of our community health clinical in-person and work with this community site.

de Tornyay Center-Sponsored Conference Presenters

The de Tornyay Center is proud to fund travel for six students to travel to the Western Institute of Nursing’s annual conference, Apil 6 – 9 in Portland, Oregon:

  • Frances Chu, PhD student, is presenting, “Implementation of Task Sharing of Tele-Mental Interventions in Primary Care for Older Adults has been accepted”.
  • Jingyi Li, PhD student is presenting, “Exercise and behavioral management for dementia care at home: A systematic review”.
  • Wonkyung Jung, PhD Student,is presenting, “Social Integration: Concept Analysis”.
  • Lia Kaluna, undergraduate student, is presenting, “Reminiscence on Mood, Cognition, and Social Engagement: A Scoping Review.”
  • Karl Cristie Figuracion, PhD student, is presenting, “Integrating Neuroimaging Measures in Nursing Research.”
  • Sarah McKiddy, PhD student, is presenting “Cognitive Health: Mind the Equity Gap.”

Additionally at the Annual Scientific Meeting of the American Geriatrics Society, Kuan-Ching Wu, PhD student is presenting, “Behavioral change and retention in online interventions for caregivers in dementia”.

Scholar Spotlight: Claire Kane

Claire Kane is the de Tornyay Center for Healthy Aging’s 2021-2022 Myrene C. McAninch Undergraduate Scholar. Kane’s areas of interest are nurse-midwifery, women veterans, perinatal substance use disorder. Her de Tornyay Center project is, “Exploring Women Veteran’s Experiences of Substance Use Disorder Treatment in the Puget Sound Veterans Affairs Healthcare System: A Mixed Methods Approach”, and her faculty mentor is Dr. Ira Kantrowitz-Gordon.

Why did you choose nursing?

My background is in perinatal substance use disorder treatment, so the treatment of pregnant and postpartum folks who have substance use disorders or addictions. I saw how the nursing model of care can provide holistic and comprehensive care to that population, which not only needs outstanding clinical and medical care, but also needs an array of social services and advocacy. I felt like nursing and particularly nurse-midwifery would prepare me well to work with those populations and provide the holistic type of care that they need.

What’s been an unforgettable experience during your time at the school of nursing?

This is the first quarter that we were in the hospital. We had two days a week where we’re on medical-surgery floors at Harborview or Virginia Mason or other hospitals. It’s been really valuable to apply skills that we learned in the classroom to the in-person care of patients, and learning collaboratively with my classmates in small groups. We debrief each day and talk through our cases. It’s been awesome to learn from each other and also have each other’s support in learning how to provide in-person care.

How has your experience at the school of nursing helped you with your career trajectory?

I was interested in the de Tornyay Center scholarship and working with the center. Being in the nursing program afforded me that opportunity. I am hoping that my involvement with this program and the center will help provide me a little bit more knowledge and experience with women identified veterans that I can then use to inform my future practice.

Could you briefly describe your project with the de Tornyay Center?

I am working with researchers at the VA to explore women veterans’ experiences accessing substance use disorder treatment through the VA.

Women fare significantly worse than men when using web-based alcohol interventions. These findings in the civilian population are mirrored among US veterans, as evidenced by women veterans experiencing worse outcomes compared to their male counterparts after the completion of the VA’s web-based alcohol intervention, VetChange. Research is needed to inform changes to VetChange that could improve outcomes for women veterans. So, we are designing a study protocol to collect data from women veterans with alcohol use disorder and clinicians treating women veterans with alcohol use disorder about their opinions of the current VetChange program. The protocol explores the ways in which the web-based intervention can improve recovery-related coping behaviors in order to adequately address women veterans’ alcohol use disorder.

How did you first get involved with the project?

I was interested in this topic and saw that there were research funds available. I contacted my mentor, Ira, and asked if he’d be willing to support me. Then, I connected with a researcher at the VA, who has focused a lot of her work on women veterans’ substance use disorder treatment and gave me the opportunity to assist with this project

What interested you about working with women who are veterans?

I mentioned my background is in perinatal substance use disorder treatment. I became increasingly interested in the growing rates of substance use disorders among women identified veterans. Veterans from the Iraq and Afghanistan conflicts are now seeking care from VA facilities and we have more women veterans than we ever have before. I was interested in whether or not the VA system at large was meeting these patients’ needs, because it originally was not designed to provide women focused care.

Why is this research and project important to do?

Women are the fastest growing segment of the US military. We do have data from the VA showing that more and more of them are accessing substance use disorder treatment. And we have studies among the general population that show gender-specific substance use disorder treatment improves outcomes and is valued by patients. So it’s important to assess whether or not gender-specific care is also valued by women veterans and whether or not it plays a role in improving their outcomes.

Another thing is that there are very few VA facilities throughout the country that offer gender-specific care. So we need more research to understand women veterans’ feelings and their experiences with it to inform whether or not more substance use disorder treatment interventions should include it.

Why might gender-specific care be helpful over general care?

There are a variety of reasons, one being that some women tend to feel safer in those environments, both in-person and virtually. Also if you’re having a women only or a gender-specific group, you can cater the content a little more. The facilitators can design modules around topics that may be more relevant. Sexual harassment is a prevalent issue in the military and we know it’s disproportionately experienced by women compared to men in the military, although it affects men as well. So, for example, some gender-specific women VA programs do incorporate content around trauma, sexual harassment, and coping when that might be a factor that’s affecting your substance use. There also might be content on motherhood or other reproductive health topics.

What interests you about healthy aging?

I am especially interested in the perspectives of older adult women veterans who have participated in VetChange, because we know that this population tends to experience more difficulties accessing online treatment interventions.

Beyond that I’m also interested in how age effects women’s experiences seeking care and whether or not they feel like their individual needs associated with their stage of life are being met with the services available to them. We know that veterans and folks with substance use disorders tend to have higher morbidity and mortality rates. Ensuring that they have access to treatment that meets their needs promotes healthy aging.

What are your plans after graduation?

I’m in the ABSN to Doctor of Nursing Practice, Nurse-Midwifery program. I’m hoping to work as an RN during at least the first year of the DNP. Then long term I plan to work as a nurse-midwife. I would love to provide care to veterans who need those services. I think the cool thing about midwifery is that you not only provide perinatal and postpartum care, but you can also be somebody’s primary care provider, so I could see patients across the lifespan.