United States residents from racial and ethnic minorities remain at higher risk for morbidity and mortality, despite efforts to address these health disparities. Nursing is the nation’s largest health care profession, with more than 2.7 million registered nurses, four times the number of physicians. However, the current shortage of registered nurses in practice and in academia is expected to increase significantly in the next two decades (American Association of Colleges of Nursing, 2005). The proportion of racial/ethnic minorities (13.4%) in nursing is lower than the proportion (28.2%) in the United States (Bureau of Health Professions, 2005). The School of Nursing at Florida International University is addressing the shortage of nurses and the health disparities for racial/ethnic minorities through its new Ph.D. program and faculty research.

With funding from the Division of Nursing, Health Resources and Services Administration, the Ph.D. in nursing program prepares nurse leaders and researchers in minority health. Coursework includes research in health care for multicultural, diverse and vulnerable populations; academic, health care, and political systems; accessing, managing, and packaging information; and research methods and statistics. Students select content courses to develop their expertise in their chosen research area. An important feature is mentorship by research-active faculty with funded programs of research.

School of Nursing faculty have funding to conduct research in maternal and child health, HIV/AIDS, and aging with culturally diverse, vulnerable, and/or underserved groups. Research is beginning in other areas, including couples with breast cancer, adolescents and young adults with sickle cell disease, families with a child with Asperger’s syndrome, and complementary therapies for persons with fibromyalgia, among others.

MATERNAL AND CHILD HEALTH.
Dorothy Brooten, Ph.D., RN, FAAN, has tested a model of transitional care provided by masters prepared advanced practice nurses (APNs) to high risk, high cost, high volume patient groups over the last 20 years. In her randomized clinical trials with primarily African-American participants, she has consistently found that women and children in the treatment groups experienced lower morbidity, lower infant deaths, and lower health care costs than the group receiving routine care. With a grant from the National Institute of General Medical Sciences, National Institutes of Health, Brooten and colleagues are analyzing the process of care recorded by the APNs during the randomized trials to describe health problems and APN interventions for women during and following high risk pregnancy and to begin to establish links between health problems, APN interventions, APN time, and number of contacts with maternal and infant outcomes and health care costs.

Sandra Lobar, Ph.D., ARNP-RN, BC PNP, heads the Center for Leadership in Pediatric and Family Nursing funded by the U.S. Maternal and Child Health Bureau. The center was created to develop a cadre of APN leaders who can advocate for culturally diverse families at risk for health disparities. The center achieves this goal by educating graduate students about leadership skills, providing practicum experiences, and offering workshops on health disparities for children and families.

Luz Porter, Ph.D., RN-BC (FNP), ARNP, FAAN, is pursuing a longstanding interest in improving parenting skills and promoting mother-child relationships. In her pilot study, the parenting enhancement program showed promise for improving motherchild relationships, and mothers reported greater self-esteem and self care. With a grant from the U.S. Maternal and Child Health Bureau, Porter and her research team are studying the effect of the program with and without infant massage on outcomes for substance abusing mothers and their infants.

JoAnne Youngblut, Ph.D., RN, FAAN, studies the functioning of families of critically ill children. Funded by a grant from the National Institute of Nursing Research, National Institutes of Health, Youngblut and her research team are investigating effects of a preschool child’s head injury on parent and family functioning during the child’s hospitalization and at two weeks, three, six, and 12 months after hospital discharge in a culturally diverse sample. Findings demonstrate that, in the hospital, parents are concerned about the child’s experience and their role as a parent. Parents’ social support and mental health had important effects on parent and family functioning after the child’s discharge.

Healthy Children Healthy Homes is a program to increase community awareness of asthma and asthma triggers in children. With funding from SC Johnson through RTI International, Brooten, Youngblut, and Lobar and Laura Hernandez have trained parents and teachers to be Asthma Amigos and to disseminate information about asthma triggers to primarily low-income Hispanic neighborhoods. Testing shows that the program is successful in increasing awareness and intent to use strategies to avoid asthma triggers. The team has packaged this intervention for nationwide distribution.

HIV/AIDS. Sande Gracia Jones, Ph.D., ARNP, ACRN, CS, C, BC, FAAN, has focused her research on prevention of HIV transmission. With funding from DHHS’s Office of Women’s Health, Jones and her team have designed and tested the SENORITAS program to help FIU students become aware of the risk of HIV and the need to practice safer sex. A multi-ethnic group of senior undergraduate nursing students taught the “Amigas Care!” curriculum to FIU students. The program had a positive impact on FIU students’ knowledge and attitudes about safer sex and HIV.

AGING. Marie-Luise Friedemann, Ph.D., RN, is conducting a study to understand differences in perception of need and use of formal and informal resources for Hispanic, black non-Hispanic, and white non-Hispanic caregivers of elders receiving home care services. With a grant from the National Institute of General Medical Sciences, National Institutes of Health, Friedemann and her colleagues are building the knowledge needed to advise caregivers in the use of culturally congruent formal and informal resources to prevent exhaustion and family crisis.

Much research is needed to address health disparities experienced by racial and ethnic minorities in the U.S. Nurse researchers are uniquely suited to conduct this research because of their holistic approach to the care of culturally diverse, vulnerable, and underserved groups. Through its ongoing faculty research and its commitment to educating nurse leaders and researchers in minority health, FIU’s School of Nursing is making a difference in the health of diverse communities.

REFERENCES
American Association of Colleges of Nursing. Nursing fact sheet.
www.aacn.nche.edu/Media/FactSheets/nursfact. htm. Accessed April 25, 2005.

Bureau of Health Professions. Distribution of registered nurses by racial/ethnic background, March 2000.
bhpr.hrsa.gov/nursing/images/raceth.jpg. Accessed April 25, 2005.

JoAnne M. Youngblut, PhD, RN, FAAN, is professor and coordinator of research in the School of Nursing at Florida International University.