Six R01 Research Projects Funded at the Johns Hopkins School of Nursing 

In the last few weeks, Dr. Junxin Li, Dr. Laura Samuel, Dr. Deb Gross, Dr. Ariana Chao, Dr. Bonnie Swenor, and Dr. Kali Thomas have been awarded R01 grants (Research Project grants) from the National Institutes of Health (NIH) and Dr. Ariana Chao has been awarded an R56 (a NIH High-Priority, Short-Term Project Award), which helps renew funding for an existing, funded R01 project. This is an awesome achievement as only about 10 percent of R01 grants receive funding.  

Strengthening Parenting, Young Children’s Social-Behavioral Competence, and Kindergarten Readiness in Schools Serving Low-Income Communities 

Deborah Gross, DNSC, MS, BSN, RN, FAAN 

RO1 funded through the National Institute of Child Health and Human Development (NICHHD) 

Young children’s social-emotional-behavioral health and school success are inextricably linked, and both have been adversely affected by racial and economic inequities exacerbated by the COVID-19 pandemic. This study will 1) test the effects of a universal group-based parenting intervention in prekindergarten on a range of parent, child, and school outcomes associated with children’s wellbeing and later academic success and 2) evaluate its cost, acceptability, implementation, and sustainability when offered in different formats (virtual vs in-person) in urban and rural public schools serving low-income students. This study seeks to improve children’s social-emotional-behavioral wellbeing, kindergarten readiness skills, and school outcomes by building on parents’ strengths and promoting engagement in their children’s education during the early years. 

Making Enrollment a Snap for people with disabilities with a SNAP Cross-Enrollment  

Laura Samuel, PhD, MSN, BS, RN, FAAN

Bonnielin Swenor, PhD, MPH, BS

R01 funded through the National Institute of Health (NIH) 

This trial leverages existing data from a newly launched SNAP cross enrollment outreach and enrollment assistance program among 900,000 Michigan Medicaid beneficiaries in order to: 

1) Estimate the effect of SNAP outreach and enrollment assistance on health, health care utilization and SNAP utilization among low-income adults with disability; and  

2) Characterize the subgroups who may benefit most from the program, based on race/ethnicity, age and chronic conditions. Information from the proposed research is urgently needed to advance health equity and improve food access. 

mHealth facilitated Physical Activity Toward Health (mPATH) for low-income older adults

Junxin Li, PhD, MS, BS, RN, FAAN 

R01 funded through the National Institute on Aging  

The study aims to determine if a personalized physical activity program delivered through mobile health technology (mPATH) can enhance cognitive function and sleep quality in low-income older adults without dementia. 

Low-income older adults are a population that experiences multiple social inequalities and health disparities and at high risk for Alzheimer’s disease. While exercise has shown benefits for cognition and sleep in older adults, it hasn’t been thoroughly studied in this specific group.  The study aims to determine if a personalized physical activity program delivered through mobile health technology (mPATH) can enhance cognitive function and sleep quality in low-income older adults without dementia. The study will also examine whether physical activity impacts Alzheimer’s disease pathology biomarkers and whether sleep and these biomarkers underline the effect of physical activity on cognitive function.  If successful, the findings will support clinicians and the public to engage low-income older adults in physical activity for better sleep and cognitive health.

Stepped Care for Weight Loss Maintenance

Ariana Chao, PhD, MSN, BSN, RN, FNP-BC 

R01 funded through the National Institute for Nursing Research

Weight loss maintenance remains the Achilles’ heel of obesity management. That’s why this study seeks to evaluate the effectiveness of digital tools in providing accessible and tailored support for weight loss maintenance. By utilizing digital interventions and a stepped-care model, it may offer more personalized and effective support for individuals managing obesity. This addresses a crucial gap in obesity treatment, potentially leading to better outcomes for many, and potentially transforming clinical strategies for weight loss maintenance.

Food supplementation intervention to improve weight loss for adults with food insecurity and obesity 

Ariana Chao, PhD, MSN, BSN, RN, FNP-BC 

R56 funded through the National Institute for Nursing Research  

This research project conducts a randomized controlled trial in adults with obesity and food insecurity to assess whether behavioral weight loss treatment and providing food or resources for food can improve weight loss, diet quality, and perceived physical and mental health in individuals with obesity and food insecurity. “Food insecurity” is the lack of regular access to enough safe and nutritious food for normal growth and development and an active, healthy life. 

About the project 

Memory Care in Assisted Living: Does it Improve Quality Outcomes? 

Kali Thomas, PhD, MA 

R01 funded through the National Institute on Aging 

This study focuses on the quality of care for people with Alzheimer’s Disease and Alzheimer’s Disease-Related Dementias in assisted living communities. Some of these facilities offer specialized “memory care,” but we don’t know much about the quality of that care, and critically, if the higher cost of memory care (which is about 36 percent more expensive than regular assisted living rooms) is justified by the quality of care provided. The study has three main goals: 

• To compare quality in assisted living communities, measured by worker satisfaction, resident/family satisfaction, and healthcare utilization. 
• To compare quality differences within assisted living communities, and determine if residents with Alzheimer’s Disease and Alzheimer’s Disease-Related Dementias receive poorer care than those without.  

• To identify care processes most linked to satisfaction and positive experiences for residents with Alzheimer’s Disease and Alzheimer’s Disease-Related Dementias. 

This study is important because it will provide nationwide data about the quality of care for people living with AD/ADRD in assisted living communities and help us make informed decisions for better care.

Private Equity Expansion in Assisted Living: Implications for Dementia Care 

Kali Thomas, PhD, MA 

R01 funded through the National Institute on Aging 

This study looks at how private equity firms investing in assisted living facilities might affect older adults, especially those with Alzheimer’s or related dementias. While some argue they bring more money for improvements, there is concern that they may prioritize profit over quality of care, and unlike nursing homes, assisted living facilities don’t have strong national rules to ensure quality care after private equity takes over.  

The main goal is to understand which types of ALs PE firms choose and how this impacts residents with ADRD. We think ALs in high-demand areas, offering memory care, and with less strict regulations are more likely to be bought by PE firms. We also believe that once acquired, the ALs might change how they operate, which could affect the types of residents they have and their outcomes. 

This study is important because it sheds light on how private equity firms investment in assisted living facilities impacts the care of vulnerable older adults, especially those with dementia, and will be important for policymakers to ensure quality care.