Newswise — Faculty and researchers at The Johns Hopkins University School of Nursing (JHUSON) are leading studies aimed at improving cardiovascular health, assessing the health of communities, and bringing the heart and science of nursing practice to at-risk populations.
At the Heart of the Community—JHUSON researcher Jerilyn K. Allen, ScD, RN is heading a five-year $2.5 million study of a team- and community-based health care delivery system designed to manage the total cardiovascular health of 500 high-risk patients. The investigation incorporates the skills of a three-person team—a physician, a nurse practitioner, and a community health worker. The team is managing the health care of study participants recruited from clinics operated by Baltimore Medical System (BMS), a non-profit community health center system providing care to 35,000 medically underserved people in Baltimore's poorest areas. Half of the study patients will receive care from the team, and half will receive a more traditional form of treatment. "The reality is that very few patients have only one risk factor, and they need a more comprehensive approach to prevent the progression of cardiovascular diseases," says Allen. "We're bringing together the best of three types of care providers to improve outcomes in urban clinics and underserved populations."
Heart and Soy—In another community-based study—also led by Allen—nurse researchers explored the beneficial effects of soy. The array of results garnered from the multi-year study focused on cholesterol reduction, metabolic syndrome, and recruitment for clinical trials. Key findings from the study group of 216 healthy postmenopausal African American and white women with moderately elevated low-density lipoprotein (LDL) cholesterol levels included:"¢ Those who received isolated soy protein containing isoflavones experienced a significant decrease in total cholesterol, LDL cholesterol, and lipoprotein particles. "¢ Those with metabolic syndrome (MS)—a clustering of at least three CVD risk factors: high blood pressure, high triglycerides, low levels of high-density lipoprotein (HDL) cholesterol (good cholesterol), high glucose, or abdominal obesity (large waist measurement)—had lower levels of HDL cholesterol and higher levels of triglycerides without significant differences in total cholesterol. "¢ African American and White women in the study differed significantly in their response to various forms of mass media and personalized techniques employed to recruit participation in the clinical trial. The most effective mechanism for African American women was direct mail (52%) followed by radio (15%); newspapers were less effective. Conversely, white women responded best to newspaper ads (36%) followed by direct mail (32%); and radio was less effective.
Heart of the West—JHUSON Associate Professor Miyong T. Kim, PhD, RN and colleagues have found there is a steeply increasing incidence of coronary heart disease (CHD) in developing countries undergoing rapid westernization, including South Korea. Their in-depth assessment of CHD—based on the 2001 Korea National Health and Examination Survey—concludes: ""¦contrary to the popular notion of relatively better coronary heart health status in Asian countries, the results of this analysis indicate that the overall coronary health of the adult Korean population is comparable to that of other developed countries." Factors cited as contributing to the problem were poor management of high blood pressure, fairly high low high-density lipoprotein cholesterol, and a strikingly high smoking rate among men (61.6 %). Diabetes mellitus was also implicated.
Language of the Heart—In ongoing research studies among Korean American populations, Dr. Kim also is leading two unique community-based research initiatives that are providing health literacy, awareness, and interventions to underserved Korean Americans at risk for diabetes and high blood pressure. Working in partnership with the Korean Resource Center in Howard County, MD, Kim is employing community-based participatory research methods to address and surmount the health care barriers facing many ethnic minority populations today. In one study, she is exploring health literacy interventions for Korean Americans with high blood pressure (HBP), and in another is focusing on improving disease control and quality of life for Korean Americans with type 2 diabetes. Both initiatives are helping Kim and co-investigators to gather much needed pilot and feasibility data on how effective diabetes self-management procedures can be adapted for a population where diabetes is now a growing health problem and limited English language skills can create barriers to care.
Heart of Africa—Participatory community health practices originally developed in East Baltimore, MD by JHUSON Dean and researcher Martha N. Hill, Phd, RN are now being used by another Hopkins nurse researcher, Cheryl Dennison, PhD, CRNP to address and reduce hypertension (HBP) among South African populations. Hill and Dennison recently found in a study of 220 women and 183 men who received public or private primary care services in three South African townships near Cape Town, that the majority of the study participants had uncontrolled blood pressure—despite making regular visits to primary health care facilities for treatment and receiving HBP medications. Dennison notes "The data reinforces our view that hypertension must be approached at the policy, care setting, provider, and patient levels. We must consider a wider array of techniques and approaches in addition to medications, including significant policy-level changes that support care that actually improves blood pressure control and reduces cardiovascular morbidity and mortality."
The Johns Hopkins University School of Nursing is a global leader in nursing research, education and scholarship and is ranked among the top 10 nursing higher education institutions in the country. The School's community health program is second in the nation and the nursing research program now holds eighth position among the top nursing schools for securing federal research grants. The School continues to maintain its reputation for excellence and educates nurses who set the highest standards for patient care, exemplify scholarship, and become innovative national and international leaders in the evolution of the nursing profession and the health care system. For more information, visit http://www.son.jhmi.edu/
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