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Dordunoo D, Limoges J, Chiu P, Puddester R, Carlsson L, Pike A. Genomics-informed nursing strategies and health equity: A scoping review protocol. PLoS One 2023; 18:e0295914. [PMID: 38100433 PMCID: PMC10723661 DOI: 10.1371/journal.pone.0295914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVE The objective of this scoping review is to map the available evidence on strategies that nurses can use to facilitate genomics-informed healthcare to address health disparities. INTRODUCTION Advancements in genomics over the last two decades have led to an increase in the delivery of genomics-informed health care. Although the integration of genomics into health care services continues to enhance patient outcomes, access to genomic technologies is not equitable, exacerbating existing health disparities amongst certain populations. As the largest portion of the health workforce, nurses play a critical role in the delivery of equitable genomics-informed care. However, little is known about how nurses can help address health disparities within the context of genomics-informed health care. A review of the literature will provide the necessary foundation to identify promising practices, policy, and knowledge gaps for further areas of inquiry. INCLUSION CRITERIA We will include papers that explore strategies that nurses can undertake to facilitate genomics-informed care to address health disparities. METHODS This review will be conducted using JBI methodology for scoping reviews. We will search electronic databases including MEDLINE (OVID), EMBASE, Cochrane Library, PsychInfo, and CINAHL for quantitative and qualitative studies, systematic reviews and grey literature. Theses, books, and unavailable full-text papers will be excluded. The search will be limited to papers from 2013 and beyond. Two reviewers will screen titles and abstracts followed by full-text and disagreements will be resolved by a third reviewer. We will use a data extraction tool using Microsoft Excel and analyse data using descriptive statistics and conventional content analysis. Findings will be presented in the form of evidence tables and a narrative summary. We will report findings using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). DISCUSSION Genomics will continue to transform all aspects of health care across the wellness continuum from prevention, assessment, diagnosis, management, treatment, and palliative care. The identification of nursing strategies to address health disparities will build the foundation for policy and practice to ensure that the integration of genomic technologies benefits everyone.
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Affiliation(s)
- Dzifa Dordunoo
- University of Victoria, School of Nursing, Director, Centre for Evidence informed Nursing and Health Care: JBI Centre of Excellence, Victoria, Canada
| | - Jacqueline Limoges
- Athabasca University, Chair, Ontario Cancer Research Ethics Board, Toronto, Canada
| | | | - Rebecca Puddester
- Memorial University of Newfoundland, Faculty of Nursing, St. John’s, Canada
| | | | - April Pike
- Memorial University of Newfoundland, Faculty of Nursing, St. John’s, Canada
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2
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Pogue D, O'Keefe M. An Interprofessional Precision Health Model for Assessment of Caregiver Impact on Polypharmacy in Elderly Intensive Care Unit Patients: A Team-Based Proposal. Crit Care Nurs Clin North Am 2023; 35:425-451. [PMID: 37838417 DOI: 10.1016/j.cnc.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
Abstract
Elderly critical care patients are one of the largest growing patient population groups according to Medicare data. More than 51% of elderly patients are discharged on inappropriate medications that have the potential to cause harm or interact adversely with other medications. Precision health has the potential to prevent adverse drug events and prescription of inappropriate medications. The purpose of this literature review was to define the concept of precision health and determine the state of science regarding interprofessional models of precision health for assessment of caregiver impact on polypharmacy in elderly intensive care unit patients.
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Affiliation(s)
- Debbra Pogue
- Our Lady of the Lake Regional Medical Center, 5246 Brittany Drive, Baton Rouge, LA 70808, USA.
| | - Mary O'Keefe
- University of Texas Medical Branch at Galveston, Room 4.Room 4.231, Route 1132301 University Boulevard, Galveston, TX 77555-1029
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3
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Flaherty CN, Rattan J, Melson L, O'Neal PV. Incorporating Omics and Precision Health in a Nursing PhD Program: The Perspectives of Student Nurse Scientists. Nurs Educ Perspect 2023:00024776-990000000-00180. [PMID: 37823783 DOI: 10.1097/01.nep.0000000000001200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
ABSTRACT To engage in innovative and novel precision health and omics research, nurse scientists need to be knowledgeable about the genetic, behavioral, and environmental factors that impact health outcomes. This article illustrates the benefits of a nursing omics PhD curriculum at a state university. The purpose is to provide students' perspectives and research interests that were inspired by the omics and precision health curriculum. Exposing these early-career PhD nursing student scientists to omics and precision health engaged them to think broadly about the potential to generate original nurse-led research.
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Affiliation(s)
- Christine Noelle Flaherty
- About the Authors Christine Noelle Flaherty, MS, MBA, RN; Jesse Rattan, MPH, RN; and Lindsay Melson, MSN, APRN, ACNP-BC, are PhD students in a joint PhD Nursing Science Program at The University of Alabama Capstone College of Nursing in Tuscaloosa and The University of Alabama in Huntsville. Pamela V. O'Neal, PhD, RN, is a professor, The University of Alabama in Huntsville College of Nursing. Contact Christine Noelle Flaherty at
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4
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Hampton MD, Williams MY. Maximizing Nurse Scientist Role Potential in Health Care Organizations. Nurs Adm Q 2023; 47:338-349. [PMID: 37643233 DOI: 10.1097/naq.0000000000000594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Before Magnet designation, nurse scientists functioned primarily in academia. The Magnet model's emphasis on new knowledge required that health care organizations demonstrate knowledge generation to achieve and sustain designation. The nurse scientist role definition and function within health care organizations continues to evolve, which contributes to a lack of clarity about who and how nurses generate new knowledge. The purpose of this scoping review was to (1) identify nurse scientist role components in the context of 2 theoretical models (Thompson's Knowledge Brokering Model and Edward's Research Appreciation, Accessibility, and Application Model), (2) explore the strengths and barriers associated with existing nurse scientist practice models in US health care organizations, and (3) describe a unique, expanded practice model applied within Stanford Health Care's Office of Research and its implications for building new knowledge and innovation capacity with recommendations for ongoing role development.
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5
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Keim-Malpass J, Kausch SL. Data Science and Precision Oncology Nursing: Creating an Analytic Ecosystem to Support Personalized Supportive Care across the Trajectory of Illness. Semin Oncol Nurs 2023; 39:151432. [PMID: 37149440 PMCID: PMC10330746 DOI: 10.1016/j.soncn.2023.151432] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 03/27/2023] [Indexed: 05/08/2023]
Abstract
OBJECTIVES The authors' objective is to present an overarching framework of an analytic ecosystem using diverse data domains and data science approaches that can be used and implemented across the cancer continuum. Analytic ecosystems can improve quality practices and offer enhanced anticipatory guidance in the era of precision oncology nursing. DATA SOURCES Published scientific articles supporting the development of a novel framework with a case exemplar to provide applied examples of current barriers in data integration and use. CONCLUSION The combination of diverse data sets and data science analytic approaches has the potential to extend precision oncology nursing research and practice. Integration of this framework can be implemented within a learning health system where models can update as new data become available across the continuum of the cancer care trajectory. To date, data science approaches have been underused in extending personalized toxicity assessments, precision supportive care, and enhancing end-of-life care practices. IMPLICATIONS FOR NURSING PRACTICE Nurses and nurse scientists have a unique role in the convergence of data science applications to support precision oncology across the trajectory of illness. Nurses also have specific expertise in supportive care needs that have been dramatically underrepresented in existing data science approaches thus far. They also have a role in centering the patient and family perspectives and needs as these frameworks and analytic capabilities evolve.
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Affiliation(s)
- Jessica Keim-Malpass
- Associate Professor, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia, USA; Member, Center for Advanced Medical Analytics, University of Virginia, Charlottesville, Virginia, USA.
| | - Sherry L Kausch
- Member, Center for Advanced Medical Analytics, University of Virginia, Charlottesville, Virginia, USA; Data scientist, Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA
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6
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African American Perceptions of Participating in Health Research Despite Historical Mistrust. ANS Adv Nurs Sci 2023; 46:41-58. [PMID: 35984948 DOI: 10.1097/ans.0000000000000435] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A qualitative descriptive approach examined perspectives of African Americans (AA) on their participation in health research despite historical research mistreatment. Nineteen AAs participated in semistructured interviews that provided data that were analyzed using thematic analysis. Salient themes included race concordance, being respected and valued by the researcher, research participation motivators, and cultural experiences of racism in health care. This study challenges dominant ideology that AAs are unwilling to participate in research and offers solutions to promote research inclusive of their perceptions. Therefore, researchers need to design research with inclusiveness and transparency that openly displays how research will impact future generations.
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Taki F, Lurie J, Kaur G. An ethical plan for including forcibly displaced persons in omics and digital technology research. Nat Med 2022; 28:1116-1120. [PMID: 35513531 PMCID: PMC9464352 DOI: 10.1038/s41591-022-01801-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Forcibly displaced persons, such as refugees, are at an increased risk of physical and mental health conditions and so would benefit from novel healthcare technologies, research on which can be conducted under an ethical framework.
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Affiliation(s)
- Faten Taki
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA.
| | - Jacob Lurie
- NewYork-Presbyterian Hospital, New York, NY, USA
| | - Gunisha Kaur
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA
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Kurnat-Thoma E, Fu MR, Henderson WA, Voss JG, Hammer MJ, Williams JK, Calzone K, Conley YP, Starkweather A, Weaver MT, Shiao SPK, Coleman B. Current status and future directions of U.S. genomic nursing health care policy. Nurs Outlook 2021; 69:471-488. [PMID: 33487404 PMCID: PMC8282091 DOI: 10.1016/j.outlook.2020.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/26/2020] [Accepted: 12/11/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND As genomic science moves beyond government-academic collaborations into routine healthcare operations, nursing's holistic philosophy and evidence-based practice approach positions nurses as leaders to advance genomics and precision health care in routine patient care. PURPOSE To examine the status of and identify gaps for U.S. genomic nursing health care policy and precision health clinical practice implementation. METHODS We conducted a scoping review and policy priorities analysis to clarify key genomic policy concepts and definitions, and to examine trends and utilization of health care quality benchmarking used in precision health. FINDINGS Genomic nursing health care policy is an emerging area. Educating and training the nursing workforce to achieve full dissemination and integration of precision health into clinical practice remains an ongoing challenge. Use of health care quality measurement principles and federal benchmarking performance evaluation criteria for precision health implementation are not developed. DISCUSSION Nine recommendations were formed with calls to action across nursing practice workforce and education, nursing research, and health care policy arenas. CONCLUSIONS To advance genomic nursing health care policy, it is imperative to develop genomic performance measurement tools for clinicians, purchasers, regulators and policymakers and to adequately prepare the nursing workforce.
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Affiliation(s)
- Emma Kurnat-Thoma
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD; School of Nursing and Health Studies, Georgetown University, Washington, DC
| | - Mei R Fu
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA.
| | | | - Joachim G Voss
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
| | | | | | - Kathleen Calzone
- National Cancer Institute, Center for Cancer Research, Genetics Branch, Bethesda, MD
| | | | | | | | - S Pamela K Shiao
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA
| | - Bernice Coleman
- Nursing Research and Performance Improvement, Cedars-Sinai Medical Center, Los Angeles, CA
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Dewell S, Benzies K, Ginn C. Precision Health and Nursing: Seeing the Familiar in the Foreign. Can J Nurs Res 2020; 52:199-208. [DOI: 10.1177/0844562120945159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Precision health is the integration of personal genomic data with biological, environmental, behavioral, and other information relevant to the care of a patient. Genetics and genomics are essential components of precision health. Genetics is the study of the effects of individual genes, and genomics is the study of all the components of the genome and interactions between genes, environmental factors, and other psychosocial and cultural factors. Knowledge about the role of genetics and genomics on health outcomes has increased substantially since the completion of the human genome project in 2003. Insights about genetics and genomics obtained from bench science are now having positive clinical implications on patient health outcomes. Nurses have the potential to make distinct contributions to precision health due to their unique role in the health care system. In this article, we discuss gaps in the development of precision health in nursing and how nursing can expand the definition of precision health to actualize its potential. Precision health plays a role in nursing practice. Understanding this connection positions nurses to incorporate genetic and genomic knowledge into their nursing practice.
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Affiliation(s)
- Sarah Dewell
- Faculty of Nursing, University of Calgary, Canada
| | | | - Carla Ginn
- Faculty of Nursing, University of Calgary, Canada
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Wright ML, Newhall K, Barcelona V, Taylor JY. African American mothers' attitudes towards genetic testing in the InterGEN study. J Community Genet 2020; 11:285-290. [PMID: 31811592 PMCID: PMC7295918 DOI: 10.1007/s12687-019-00440-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 10/02/2019] [Indexed: 10/25/2022] Open
Abstract
The paucity of representation of people of color, particularly those of African ancestry, is a major issue in contemporary omics research. Metadata summarizing genome-wide association studies from 2005 to 2015 suggest that nearly 80% of participants are of European ancestry and only 2.4% are of African ancestry. Negative attitude towards genetic testing is a commonly cited belief as to why there is low representation of Americans of African ancestry participating in genetic studies. Using the attitudes towards genetic testing survey, administered as part of our parent (epi)genome-wide association study, we characterized the perceptions of genetic research among our cohort of African ancestry women (n = 168). Our data show generally favorable perceptions of genetic testing among our cohort. Further, we demonstrate that more favorable attitudes towards genetic testing correlated with higher levels of income, even when accounting for commonly cited negative predictors such as maternal age, education, country of origin, and religion. Overall, our data characterize generally positive perceptions of genetic testing among women of African ancestry.
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Affiliation(s)
- Michelle L. Wright
- School of Nursing, University of Texas, Austin, TX USA
- Dell Medical School, Department of Women’s Health, Austin, TX USA
| | - Kevin Newhall
- Department of Medicine, Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, NY USA
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11
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Hinds PS, Linder L. A Central Organizing Framework for Pediatric Oncology Nursing Science and Its Impact on Care. PEDIATRIC ONCOLOGY 2020. [DOI: 10.1007/978-3-030-25804-7_1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Williams JK, Bonham VL, Wicklund C, Coleman B, Taylor JY, Cashion AK. Advocacy and actions to address disparities in access to genomic health care: A report on a National Academies workshop. Nurs Outlook 2019; 67:605-612. [PMID: 31395393 DOI: 10.1016/j.outlook.2019.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 05/17/2019] [Accepted: 06/15/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND In the United States, access to genomic risk assessment, testing, and follow up care is most easily obtained by those who have sufficient financial, educational, and social resources. Multiple barriers limit the ability of populations without those resources to benefit from health care that integrates genomics in assessment of disease risk, diagnosis, and targeted treatment. PURPOSE To summarize barriers and potential actions to reduce genomic health care disparities. METHOD Summarize authors' views on discussions at a workshop hosted by the National Academy of Medicine. DISCUSSION Barriers include access to health care providers that utilize genomics, genetic literacy of providers and patients, and absence of evidence of gene variants importance in ancestrally diverse underserved populations. CONCLUSION Engagement between underserved communities, health care providers, and policy makers is an essential component to raise awareness and seek solutions to barriers in access to genomic health care for all populations.
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Affiliation(s)
- Janet K Williams
- College of Nursing, The University of Iowa, Iowa City, IA; American Academy of Nursing, Washington, DC.
| | - Vence L Bonham
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD
| | | | - Bernice Coleman
- American Academy of Nursing, Washington, DC; Cedars-Sinai, Los Angeles, CA
| | - Jacquelyn Y Taylor
- American Academy of Nursing, Washington, DC; New York University Rory Meyers College of Nursing, New York, NY
| | - Ann K Cashion
- American Academy of Nursing, Washington, DC; National Institute of Nursing Research, National Institutes of Health, Bethesda, MD
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Williams JR, Lorenzo D, Salerno J, Yeh VM, Mitrani VB, Kripalani S. Current applications of precision medicine: a bibliometric analysis. Per Med 2019; 16:351-359. [PMID: 31267841 DOI: 10.2217/pme-2018-0089] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
A bibliometric analysis was conducted to describe trends in the publication of precision medicine literature over time. Searches identified 5552 articles with exponential growth from 2012 to 2018. Most were published in medical specialty journals, particularly oncology. Precision medicine definitions focused on tailored/individualized/personalized treatments and genetics/biology. Little attention was given to social and environmental determinants of health and health disparities. To fulfill the promise of precision medicine to positively impact broad populations, work is needed to develop the science of precision medicine for addressing health disparities and social and environmental determinants of health. While some precision medicine definitions include all factors that contribute to individual differences in health (e.g., genes, environments and lifestyles), future empirical work that includes and integrates all three areas is also required.
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Affiliation(s)
- Jessica R Williams
- School of Nursing, University of North Carolina at Chapel Hill, NC 27599, USA
| | - Dalia Lorenzo
- School of Nursing & Health Studies, University of Miami, FL 33146, USA.,Center for Research, Baptist Health South Florida, FL 33143, USA
| | - John Salerno
- Department of Behavioral & Community Health, School of Public Health, University of Maryland College Park, MD 20742, USA
| | - Vivian M Yeh
- Center for Clinical Quality & Implementation Research, Vanderbilt University Medical Center, TN 37203, USA.,Division of General Internal Medicine & Public Health, Department of Medicine, Vanderbilt University Medical Center, TN 37232, USA
| | | | - Sunil Kripalani
- Center for Clinical Quality & Implementation Research, Vanderbilt University Medical Center, TN 37203, USA.,Division of General Internal Medicine & Public Health, Department of Medicine, Vanderbilt University Medical Center, TN 37232, USA
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Hickey KT, Bakken S, Byrne MW, Bailey DCE, Demiris G, Docherty SL, Dorsey SG, Guthrie BJ, Heitkemper MM, Jacelon CS, Kelechi TJ, Moore SM, Redeker NS, Renn CL, Resnick B, Starkweather A, Thompson H, Ward TM, McCloskey DJ, Austin JK, Grady PA. Precision health: Advancing symptom and self-management science. Nurs Outlook 2019; 67:462-475. [PMID: 30795850 PMCID: PMC6688754 DOI: 10.1016/j.outlook.2019.01.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 01/09/2019] [Accepted: 01/15/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Precision health considers individual lifestyle, genetics, behaviors, and environment context and facilitates interventions aimed at helping individuals achieve well-being and optimal health. PURPOSE To present the Nursing Science Precision Health (NSPH) Model and describe the integration of precision health concepts within the domains of symptom and self-management science as reflected in the National Institute of Nursing Research P30 Centers of Excellence and P20 Exploratory Centers. METHODS Center members developed the NSPH Model and the manuscript based on presentations and discussions at the annual NINR Center Directors Meeting and in follow-up telephone meetings. DISCUSSION The NSPH Model comprises four precision components (measurement; characterization of phenotype including lifestyle and environment; characterization of genotype and other biomarkers; and intervention target discovery, design, and delivery) that are underpinned by an information and data science infrastructure. CONCLUSION Nurse scientist leadership is necessary to realize the vision of precision health as reflected in the NSPH Model.
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Affiliation(s)
- Kathleen T Hickey
- Cardiac Electrophysiology, Columbia University School of Nursing, Columbia University Medical Center, New York, NY
| | - Suzanne Bakken
- School of Nursing and Department of Biomedical Informatics, Columbia University, New York, NY.
| | - Mary W Byrne
- Department of Anesthesiology, Columbia University School of Nursing, Columbia University College of Physicians and Surgeons, New York, NY; Center for Children and Families, Columbia University School of Nursing, Columbia University College of Physicians and Surgeons, New York, NY
| | | | - George Demiris
- University of Pennsylvania, School of Nursing, Philadelphia, PA
| | | | - Susan G Dorsey
- Department of Pain and Translational Symptom Science, School of Medicine, University of Maryland Baltimore, Baltimore, MD; Department of Anesthesiology, School of Medicine, University of Maryland Baltimore, Baltimore, MD
| | - Barbara J Guthrie
- Bouve College of Health Sciences, Northeastern University School of Nursing, Boston, MA
| | - Margaret M Heitkemper
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA
| | | | - Teresa J Kelechi
- Medical University of South Carolina, College of Nursing, Charleston, SC
| | - Shirley M Moore
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
| | - Nancy S Redeker
- Section of Pulmonary, Critical Care and Sleep Medicine, Yale University, New Haven, CT
| | - Cynthia L Renn
- Department of Pain and Translational Symptom Science, University of Maryland Baltimore, Baltimore, MD
| | - Barbara Resnick
- Organizational Systems and Adult Health Nursing Department, University of Maryland Baltimore, Baltimore, MD
| | | | | | - Teresa M Ward
- University of Washington School of Nursing, Seattle, WA
| | | | - Joan K Austin
- National Institute of Nursing Research, Bethesda, MD; Indiana University School of Nursing, Bloomington, IN
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Knisely MR, Maserati M, Heinsberg LW, Shah LL, Li H, Zhu Y, Ma Y, Graves LY, Merriman JD, Conley YP. Symptom Science: Advocating for Inclusion of Functional Genetic Polymorphisms. Biol Res Nurs 2019; 21:349-354. [PMID: 31023072 PMCID: PMC6700869 DOI: 10.1177/1099800419846407] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Incorporating biologically based data into symptom science research can contribute substantially to understanding commonly experienced symptoms across chronic conditions. The purpose of this literature review was to identify functional polymorphisms associated with common symptoms (i.e., pain, sleep disturbance, fatigue, affective and cognitive symptoms) with the goal of identifying a parsimonious list of functional genetic polymorphisms with evidence to advocate for their inclusion in symptom science research. PubMed was searched to identify genes and functional polymorphisms associated with symptoms across chronic conditions, revealing eight functional genetic polymorphisms in seven different genes that showed evidence of association with at least three or more symptoms and/or symptom clusters: BDNF rs6265, COMT rs4680, FKBP5 rs3800373, IL-6 rs1800795, NFKB2 rs1056890, SLC6A4 5-HTTLPR+rs25531, and TNFA rs1799964 and rs1800629. Of these genes, three represent protein biomarkers previously identified as common data elements for symptom science research (BDNF, IL-6, and TNFA), and the polymorphisms in these genes identified through the search are known to impact secretion or level of transcription of these protein biomarkers. Inclusion of genotype data for polymorphisms offers great potential to further advance scientific knowledge of the biological basis of individual symptoms and symptom clusters across studies. Additionally, these polymorphisms have the potential to be used as targets to optimize precision health through the identification of individuals at risk for poor symptom experiences as well as the development of symptom management interventions.
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Affiliation(s)
| | - Megan Maserati
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Lisa L. Shah
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Hongjin Li
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yehui Zhu
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yumi Ma
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - John D. Merriman
- New York University Rory Meyers College of Nursing, New York, NY, USA
| | - Yvette P. Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
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Williams JK, Anderson CM. Omics research ethics considerations. Nurs Outlook 2018; 66:386-393. [PMID: 30001880 DOI: 10.1016/j.outlook.2018.05.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 05/29/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND Pending revisions to the Common Rule include topics consistent with respect for persons, justice, and beneficence for research subjects in studies using omics technologies and are relevant to omics research. PURPOSE Synthesize trends in bioethics, precision health, and omics nursing science for novice and experienced nursing scholars from which to consider bioethics questions. METHODS Review topics addressed in the National Institute of Nursing Research (NINR) strategic plan, Common Rule pending revisions, and publications regarding human subjects protection policies. DISCUSSION Omics research involves decisions regarding understandable informed consent, broad consent, data sharing, trust, equal benefit, equal access, societal variables, privacy, data security, and return of findings to participants. CONCLUSION Principles of respect for persons, justice, and beneficence as articulated in the Belmont report and reflected in the American Nurses Association (ANA) Code of Ethics provide guidance for human subjects protection procedures to advance omics and nursing science.
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Taylor JY, Sun YV, Barcelona de Mendoza V, Ifatunji M, Rafferty J, Fox ER, Musani SK, Sims M, Jackson JS. The combined effects of genetic risk and perceived discrimination on blood pressure among African Americans in the Jackson Heart Study. Medicine (Baltimore) 2017; 96:e8369. [PMID: 29069027 PMCID: PMC5671860 DOI: 10.1097/md.0000000000008369] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Both genomics and environmental stressors play a significant role in increases in blood pressure (BP). In an attempt to further explain the hypertension (HTN) disparity among African Americans (AA), both genetic underpinnings (selected candidate genes) and stress due to perceived racial discrimination (as reported in the literature) have independently been linked to increased BP among AAs. Although Gene x Environment interactions on BP have been examined, the environmental component of these investigations has focused more on lifestyle behaviors such as smoking, diet, and physical activity, and less on psychosocial stressors such as perceived discrimination.The present study uses candidate gene analyses to identify the relationship between Everyday Discrimination (ED) and Major Life Discrimination (MLD) with increases in systolic BP (SBP) and diastolic BP (DBP) among AA in the Jackson Heart Study. Multiple linear regression models reveal no association between discrimination and BP after adjusting for age, sex, body mass index (BMI), antihypertensive medication use, and current smoking status.Subsequent candidate gene analysis identified 5 SNPs (rs7602215, rs3771724, rs1006502, rs1791926, and rs2258119) that interacted with perceived discrimination and SBP, and 3 SNPs (rs2034454, rs7602215, and rs3771724) that interacted with perceived discrimination and DBP. Most notably, there was a significant SNP × discrimination interaction for 2 SNPs on the SLC4A5 gene: rs3771724 (MLD: SBP P = .034, DBP P = .031; ED: DBP: P = .016) and rs1006502 (MLD: SBP P = .034, DBP P = .030; ED: DBP P = .015).This study supports the idea that SNP × discrimination interactions combine to influence clinically relevant traits such as BP. Replication with similar epidemiological samples is required to ascertain the role of genes and psychosocial stressors in the development and expression of high BP in this understudied population.
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Affiliation(s)
| | - Yan V. Sun
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
- Department of Biomedical Informatics, School of Medicine, Emory University, Atlanta, GA
| | | | - Mosi Ifatunji
- Department of Sociology and Carolina Population Center, University of North Carolina, Chapel Hill, NC
| | - Jane Rafferty
- Program for Research on Black Americans, Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Ervin R. Fox
- Department of Medicine, Jackson Heart Study, University of Mississippi Medical Center, Jackson, MS
| | - Solomon K. Musani
- Department of Medicine, Jackson Heart Study, University of Mississippi Medical Center, Jackson, MS
| | - Mario Sims
- Department of Medicine, Jackson Heart Study, University of Mississippi Medical Center, Jackson, MS
| | - James S. Jackson
- Program for Research on Black Americans, Institute for Social Research, University of Michigan, Ann Arbor, MI
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