Nursing Students at the Undergraduate Research Symposium

Presenter: Rikhia Chatterjee, Senior, Psychology, Nursing,  Mary Gates Scholar

Mentors: Allison Webel, Nursing, School of Nursing & Vitor Oliveira, Family and Child Nursing, Nursing

Session: Poster Session 1 | Commons West | Easel #21 | 11:00 AM to 1:00 PM

Abstract: Despite advances in treatment regimens for people living with HIV (PLWH), structural factors like food insecurity and housing inaccessibility continue to impact the populations’ health outcomes. As effective treatments, such as antiretroviral therapy (ART), improve health outcomes of PLWH, a new demographic of aging PLWH emerges. Older PLWH balance typical aging conditions like fragility and inflammation buildup with ART polypharmacy adherence within a complex system of social determinants of health (SDOH). SDOH are societal-driven conditions that impact prospective health outcomes such as race, socioeconomic status, access to adequate, nutritious food and shelter. Food security or the consistent access to sufficient, affordable, and healthy food is an upstream factor that greatly influences inflammation. Specific diet patterns such as high-carb and fat diets can also increase inflammation, in turn affecting health outcomes for aging PLWH. Inflammation induces negative side effects for aging PLWH on ART. Using the data collected from the four-year prospective PROSPER-HIV study, we assess the impact of food insecurity and inflammation on PLWH. We evaluate food insecurity using self-reported questions regarding food access scaled on a 5-point Likert scale. In addition, we assess diet-associated inflammation through a dietitian-led food recall. We hypothesize a strong correlation between food insecurity and aging. We expect the results to show how systemic factors significantly impact the health outcomes of PLWH. The findings have implications for policy development and resource needs for marginalized communities facing food insecurity. Uplifting marginalized communities occurs by identifying research gaps and implementing system-wide policies that address those shortcomings to diminish health disparities and promote health equity.

Presenter: Katie Chan, Senior, Nursing, UW Honors Program | Amanda Yang She Her, Fifth Year, Nursing

Mentors: Ira Kantrowitz-Gordon, Family and Child Nursing

Session: Poster Session 1 | Commons East| Easel #24 | 11:00 AM to 1:00 PM

Abstract: Sleep deficiency is a common challenge during pregnancy. Lack of sleep puts pregnant individuals and their fetuses at risk for poorer health outcomes. Pregnancy symptoms are known to be one of the main obstacles that prevent pregnant individuals from getting quality sleep. Mindfulness is a therapeutic practice where individuals focus on their feelings, thoughts, and bodily sensations in the present moment. Mindfulness meditation targets emotional and cognitive reactivity, which is a common pathway for developing depression and insomnia symptoms. Mindfulness-based interventions are known to help with sleep disorders, but little research has been conducted in regards to the possible relationship between mindfulness and sleep during pregnancy. A cross-sectional study was done to explore the associations amongst sleep hygiene, mood, and mindfulness. The aim of this study is to evaluate the relationship between pregnancy symptoms and morning restfulness in pregnant individuals with insomnia prior to the mindfulness intervention. We are examining the relationships among daily sleep habits, pregnancy symptoms, and quality of sleep in sleep diaries of pregnant individuals with insomnia. Preliminary findings show stronger relations between symptoms of worry and sickness to poorer sleep quality. These preliminary results will better inform mindfulness-intervention design specific to pregnant individuals with insomnia.

Presenter: Anny Qiu, Senior, Nursing, UW Honors Program | Melodie Tallegas She, They, Senior, Nursing

Mentors: Jillian Pintye, Biobehavioral Nursing & Health Systems

Session: Poster Session 1 | Commons West | Easel #11 | 11:00 AM to 1:00 PM

Abstract: Sub-Saharan Africa (SSA) accounts for the majority of global preterm births. Preterm birth can occur for various reasons but often the etiology is unknown. One potential cause is the impact of stress on the hypothalamic-pituitary adrenal axis which contributes to inflammatory processes. Chronic stressors may exacerbate during pregnancy and lead to adverse birth outcomes. Few studies have examined biomarkers for stress among pregnant populations in SSA who have unique considerations. To date, there is no specific biomarker for identifying individuals with high stress and an increased risk of preterm birth. In this study, we evaluate hair cortisol concentrations (HCC) as a biomarker for perinatal stress. In a cohort study in Kenya, 4500 cisgender women were enrolled during pregnancy and parent-infant pairs were followed through 9 months postpartum. HCC levels were extracted using ELISA methods from hair specimens collected from participants at 6 weeks postpartum. We evaluated the association between HCC, maternal stressors (e.g., intimate partner violence, behavioral risk for HIV), and preterm births using linear regression models. HIV risk behaviors were assessed using an empirical risk score validated to predict risk of HIV acquisition among pregnant cisgender women (high risk = scores >6). Among 153 participants included in this study, those with a partner known to be living with HIV or a unknown status had mean HCC levels that were 42.0% (95% confidence interval [CI]:4.9%- 92.2%) greater than those with HIV-negative partners (p=0.023). Individuals with high HIV acquisition risk had 43.1% (95% CI:6.1%-93.1%) higher mean HCC compared to those with lower HIV risk (p=0.019). Mean HCC levels did not differ between participants who had preterm vs. term births (mean difference 8.3%, 95% CI:-30.6%-68.8%, p=0.725). In summary, HCC levels were associated with some stressors during the perinatal period and could have implications for using HCC as a biomarker for antenatal stress.

Presenter: Audrey Santoyo, Senior, Nursing, UW Honors Program | Lyndsy Vasquez She, Her, Fifth Year, Nursing, UW Honors Program

Mentors: Amy Walker, Nursing

Session: Poster Session 1 | Commons East| Easel #25 | 11:00 AM to 1:00 PM

Abstract: Nursing is recognized as a high stress career that is linked to depression, anxiety, and burnout. Today’s healthcare environment is even more challenging due to distrust of medicine, racial tensions, and understaffing related to the seemingly endless COVID-19 pandemic. The prevalence of burnout, depression, and suicide among healthcare professionals is high. Nursing students are experiencing the chronic stress of COVID-19 as they train in trauma-filled environments. Students need foundational clinical knowledge and skills learned during nursing school; however, they also need resiliency skills to manage stressors throughout their training and into their careers. Resiliency skills have the potential to mitigate poor mental health outcomes and burnout, which ultimately contribute to retaining nurses in the profession. To build resilience, we need to understand the full picture of students’ baseline resilience, mental health, and stressors, including adverse childhood events (ACE). The purpose of this study, therefore, is to explore the contributions of ACE scores, university stressors, self-efficacy, and perceived stress on self-reported resilience and mental health of nursing students at University of Washington (UW). We (Vasquez, Santoyo), with our mentor Amy Walker, participated in all aspects of developing and implementing this study. We performed statistical and thematic analysis. We expect to find high levels of perceived stress, numerous university stressors, and low levels of resiliency in undergraduate and graduate nursing students. The findings will be used to identify targets for future interventions to improve the resilience of nursing students during their education and their transition to practice.

Presenter: Woo Hong Lee, Senior, Nursing

Mentors: Allison Webel, Nursing, School of Nursing & Vitor Oliveira, Family and Child Nursing, Nursing

Session: Poster Session 1 | Commons West | Easel #22 | 11:00 AM to 1:00 PM

Abstract: With advancements in antiretroviral therapy (ART), the prevalence of older people living with HIV (PLWH) continues to rise. Accompanying this increase in life expectancy among PLWH, there has also been subsequent evolving symptomatology. These include an increased burden of age-related comorbidities such as increased fatigue, frailty (i.e., muscle shrinking, weakness, slowness, poor endurance), and a lower sense of perceived well-being (e.g., poor mental health, depression, self-image). Research has demonstrated that physical activity (PA) can reduce some of these symptomatologies, especially those related to physical health. However, the implications of using PA to prevent the evolving symptomatologies of older PLWH are still yet to be explored. This study examines the variability of exercise training responses between men and women with HIV. The study considers multiple scalable data and measurements (e.g., Short Physical Performance Battery, fried frailty criteria, patient health questionnaire-9). Using descriptive analysis, this study provides further insight into the impacts of exercise response for PLWH based on Sex. Sex is likely to influence the physical functioning of PLWH. Data was obtained from the High-Intensity Exercise Study to Attenuate Limitations and Train Habits in Older Adults with HIV (HEALTH). This ongoing study incorporates exercise and biobehavioral coaching interventions to determine the efficacy of high-intensity interval training (HIIT) in older PLWH. The HEALTH study involves a randomized trial of 100 older PLWH (≥ 50 years of age) who self-report fatigue and a sedentary lifestyle. Due to the current limitation of sample sizes, the study has been considered with respect to sex-based analyses in the general population. Results of the study is expected to indicate differences in the physical and mental benefits of exercise comparing sex.

Presenter: Sissy Vazquez Cruz She,Her, Senior, Nursing | Dawson Jet Dai (Dawson) Dang He,They, Senior, Nursing

Mentors: Molly Altman, Family and Child Nursing, University of Washington School of Nursing

Session: Poster Session 1 | Commons East | Easel #23 | 11:00 AM to 1:00 PM

Abstract: In order to fully engage in reproductive justice, it is imperative that we address the ongoing erasure and exclusion of QTBIPoC (Queer, Transgender, Black, Indigenous, People of Color) families and birthing people, and other underserved communities within family building spaces. Perinatal research fails to include the experiences and voices of folks from these communities. This purposeful exclusion was created to continue centering white-cis-hetero bodies and to further oppress folks with identities that deviate from this “standard.” This causes real harm and because of this discrimination, QTBIPoC folks face worse health outcomes and maltreatment within healthcare. This is why we need to center the experiences of QTPBIPoC birthing people and their families, as they are at the highest risk of poor perinatal outcomes. In the Birth Includes Us study pilot my partner and I hope to employ a non-traditional social media recruitment strategy to effectively capture the experiences of QTBIPoC families to address disparities and highlight the communities’ strengths. Current methods fail to capture a large and diverse sample of participants, as they don’t properly reach or build trust within the community. Afterward, my partner and I will be evaluating how effective this recruitment strategy is in engaging a large and diverse sample of QTBIPoC participants. If the recruitment plan is successful, we intend to use this recruitment strategy as a model to connect with “hard to reach” populations such as the QTBIPoC community and build this model so that others can replicate and better engage the community. In addition if the recruitment strategy is successful, we want to 1) increase our knowledge and inclusion in research, 2) build evidence-based inclusive and affirming practices and interventions to improve care/experiences, and 3) address/eliminate disparities within sexual and reproductive care.

Presenter: Jeshua Reign Sales, Senior, Nursing, UW Honors Program

Mentors: Kendra Kamp, Biobehavioral Nursing & Health Systems, Nursing

Session: Poster Session 1 | Commons East | Easel #27 | 11:00 AM to 1:00 PM

Abstract: Irritable bowel syndrome (IBS) is a gastrointestinal disorder that affects more than 11.2% of the global population. Anxiety, a common comorbidity, has been shown to exacerbate the progression of IBS. This relationship between anxiety and IBS is hypothesized to be connected by the gut microbiome through the gut-brain axis. The gut-brain axis is a two-way connection, in which disruption in the gut causes an imbalance in the brain and vice versa. Therefore, understanding how bacterial populations may shift among IBS patients with anxiety compared to those without anxiety could provide insight into IBS development. We have data from a cohort of patients with IBS that includes profiled bacterial populations through 16S sequencing, demographics, and Hospital Anxiety Depression Scale (HADS) scores for anxiety. We are identifying IBS patients with and without anxiety based on their HADS score for anxiety. We are comparing the ratio of two bacterial phyla (Firmicutes and Bacteroidetes) in the gut of patients with IBS without anxiety, IBS and anxiety, and healthy controls with neither IBS nor anxiety. Additionally, we are examining other factors such as race, age, and sex. We hypothesize that individuals with IBS and anxiety will have a higher ratio of Firmicutes to Bacteroidetes compared to individuals with IBS without anxiety and healthy controls. By further understanding the relationship of the gut-brain axis, we hope to introduce new research directions to improve therapeutic options for people with IBS and anxiety.

Presenter: Michael J Drake, Senior, Nursing, UW Honors Program

Mentors: Kendra Kamp, Biobehavioral Nursing & Health Systems, Nursing

Session: Poster Session 1 | Commons West | Easel #20 | 11:00 AM to 1:00 PM

Abstract: Irritable Bowel Syndrome (IBS) is a functional condition of the bowels which affects 10% – 15% of the global population. IBS is characterized by abdominal pain and changes in bowel movement frequency and consistency. While the cause of IBS is unknown, evidence suggests that developmental and psychological factors play a significant role. Patients who score high in Adverse Childhood Experience (ACE) and Early Trauma Inventory Self Report-Short Form (ETI-SR) assessments have an increased risk of developing IBS. The purpose of this study is to compare heart rate variability (HRV) and IBS subtypes between individuals with IBS with and without a history of sexual and physical abuse. We recruited women with IBS and healthy controls using community advertisements. IBS subtypes were recorded. Participants completed measures of traumatic experience during adolescence (Childhood Trauma Questionnaire) and adulthood (Lifetime Sexual and Physical Abuse Questionnaire). HRV was measured using 12 hours of Holter ECG recordings. Participants were categorized via ROME-III diagnostic criteria for IBS. ROME-III Criteria defines IBS by recurrent abdominal pain or discomfort for 3 days per month within a 12 week period, along with stool consistency patterns, the latter of which is used to define a patient’s IBS subtype: IBS-Constipation (IBS-C), IBS-Diarrhea (IBS-D), IBS-Mixed (IBS-M), or IBS-Unclassified (IBS-U). We hypothesize that individuals with a history of abuse will have lower night heart night-time variability, as well as specific IBS subtypes. We expect that the findings from this study to broaden our understanding of how traumatic experience in childhood impacts IBS symptoms and related physiology in adulthood, as well as the causes of IBS. Findings have implications for developing trauma-informed care practices for patients with IBS, as well as trauma-exposed children at risk of developing IBS.

Presenter: Lyndsy Vasquez She, Her, Fifth Year, Nursing, Mary Gates Scholar, UW Honors Program | Melinda Schultz {She, Her}

Mentors: Tatiana Sadak, Nursing & Emily Ishado, Biobehavioral Nursing & Health Systems

Session: Poster Session 2 | MGH 241 | Easel #72 | 1:00 PM to 2:30 PM

Abstract: Undergraduate nursing students—the next generation of health care providers—play a pivotal role in caring for people living with dementia (PLWD) as their numbers continue to rise. Unfortunately, new graduates may not be adequately prepared by their educational programs to care for PLWD. This study aimed to capture students’ current attitudes about and barriers to working with older adults and PLWD post-graduation, especially related to their desire for receiving additional clinical and didactic curricular content. We also evaluated students’ interest in enrolling in the elective dementia and Long-Term Care (LTC) Externship. An initial survey was distributed to first and second-year bachelor of nursing (BSN) students at the University of Washington School of Nursing (SoN) in April 2021. The survey consisted of 20 questions modified from the Dementia Attitude Scale (DAS) and 8 questions related to respondents’ health care experience and attitudes about nursing care of older adults. The survey was completed by 76 first and second-year BSN students. The survey focused on students’ comfort level working with PLWD and their willingness to expand geriatric and dementia care skills. To gather more illustrative qualitative data, we conducted a focus group with 8 BSN students. The survey results indicated low self-reported knowledge of nursing care for PLWD as well as a lack of desire to work in the discipline immediately following graduation. However, the majority of focus group members (N= 6) expressed interest in acquiring additional knowledge and hands-on learning opportunities in care for older adults and PLWD. Key components that would attract students to geriatrics training and a LTC externship included: structured seminar; access to interactive, relevant pre-study materials developed by professionals; and 4-6 hour clinicals of hands-on skills. Conclusions: The findings from these surveys have informed the development of a LTC Externship, which is currently being piloted and evaluated.

Presenter: Claire Kane, Fifth Year, Nursing

Mentors: Ira Kantrowitz-Gordon, Family and Child Nursing

Session: Session L-2D: Clinical and Biomedical Sciences | Zoom | 12:00 PM to 1:30 PM

Abstract: 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 following completion of the VA’s web-based alcohol intervention “VetChange” compared to their male counterparts. Research is needed in order to inform adaptations to the “VetChange” web-based alcohol intervention that improve outcomes for women veterans. This project utilized a “think-aloud” methodology to collect data from women veterans with substance use disorder (SUD) and clinicians treating women veterans with SUD about their opinions of the current “VetChange” program. In accordance with “think-aloud” methodology, researchers observed participants’ use and impressions of VetChange during a period of unstructured access to the website, followed by a semi-structured qualitative interview to gather overall impressions of VetChange and what changes they recommend. Expected results include the ways in which the web-based intervention can improve two specific outcome measures, situational confidence and recovery-related coping behaviors, in order to adequately address women veteran’s SUD. The protocol and eventual data collection are of critical importance given that increasing numbers of women veterans are seeking SUD treatment and women veterans are dying at disproportionately younger ages than their civilian counterparts. Moreover, findings from this project can inform effective web-based interventions for women in the civilian population.

Presenter: Lia Kaluna, Senior, Nursing, UW Honors Program, Undergraduate Research Symposium Population Health Recognition Award Recipient

Mentors: Basia Belza, Nursing

Session: Poster Session 3 | Balcony | Easel #52 | 2:30 PM to 4:00 PM

Abstract: African Americans are at higher risk for cognitive decline due to historical and ongoing systemic inequities. Research shows that African Americans are often under-included in healthy aging research, contributing to a lack of generalizable data and health interventions specific for this population. The Sharing History through Active Reminiscence and Photo-imagery (SHARP) Study in Portland developed a brain health intervention in partnership with Portland’s elder Black community members. The intervention involves walking routes that prompt conversation of key landmarks in Portland’s historically Black neighborhoods. The purpose of this study is to model the SHARP Portland Study in Seattle’s historically Black Central District neighborhoods and identify key community landmarks and themes through community partnerships. We will use community-based participatory research (CBPR) to collect data to inform the development of the walking routes. With assistance from my colleagues, I conducted two focus groups with a total of ten African Americans aged 55 years and older that live or have lived in Central District’s historically Black neighborhoods. Focus groups solicited information about significant landmarks, people, and events in the community. We anticipate that these findings highlight the history and values significant to the Central District’s aging Black communities. I am helping code the interviews using a thematic analysis to inform the development of the prompted walking routes. This study lays the foundation for translating the SHARP intervention into a Seattle community.