UA Center to Address Substance Use Disorders and Health Equity

• in Research

TUSCALOOSA, Ala. – The University of Alabama will be home to a new research center dedicated to the prevention, treatment and management of substance use disorders.

The Board of Trustees of The University of Alabama System approved the Center for Substance Use Research and Related Conditions to focus across the lifespan of conditions to include integrated behavioral health, mental health and more.

Housed in the Capstone College of Nursing and in collaboration with the Alabama Life Research Institute, the mission of the CSURRC is to promote the health and well-being of individuals and communities affected by substance use disorders in Alabama and beyond through innovative, state-of-the-science and culturally responsive research that reduces health disparities, improves health equity and addresses social determinants of health.

“Across the country and in our state, substance use disorders are a critical public health concern made more challenging by limited resources in the areas of prevention, treatment and recovery, particularly in rural areas with poor access to health care,” said Dr. Suzanne Prevost, dean of the Capstone College of Nursing. “The focus of this center fits perfectly with the College, particularly our graduate programs preparing nurse practitioners, nurse administrators, nurse educators and nurse researchers to address the needs of rural communities in Alabama and throughout the U.S.”

The center’s scope is congruent with the state’s priority to combat the substance and opioid use pandemics, as well as the federal government’s initiatives to help end addiction long term, said Dr. Mercy Mumba, associate professor of nursing and center director.

“The center will provide a unifying unit for faculty, students and staff who are interested in substance use research and related conditions,” she said. “Having a center will further strengthen existing interdisciplinary collaborations among these researchers, while at the same time fostering new collaborations.”

Mumba has 10 years of experience as a researcher and scientist, with an extensive background and expertise in substance use disorders. Her funding portfolio of over $15 million represents research and programs all focused on substance use disorders and related conditions.

Another major goal of the center is to support the training of the next generation of researchers, scientists, educators and clinical practitioners. The CSURRC will strive to inspire undergraduates to conduct research, as well as to train graduate and postdoctoral fellows across campus.

“Dr. Mercy Mumba is the ideal nurse-researcher and leader to direct this work and mentor the many students and faculty who will collaborate through the CSURRC to develop and test solutions for the substance use crisis,” Prevost said.

In 2020, over 95,000 individuals died from drug overdoses in the U.S., and almost two-thirds of those deaths were opioid overdoses. Alabama has the highest per-capita opioid prescription rate in the nation at 120 prescriptions per 100 persons, double the national average.

University of Alabama receives $1.8 million to improve patient care in rural Alabama

• in Research, Uncategorized

The University of Alabama’s Dr. Nathan Culmer (College of Community Health Sciences) and Dr. Todd Smith (Capstone College of Nursing) have received $1.8 million in funding this year from the United States Department of Agriculture Rural Development’s Distance Learning and Telemedicine grant program. This funding will significantly increase the Emergency Medical Services’ telemedicine capabilities in rural Alabama, connecting 49 ambulances with approximately 18 hospitals across 19 rural counties in Alabama.

“With this network of telemedically-equipped ambulances and emergency departments in rural Alabama communities, we anticipate better response times to and from patient sites, improved quality of care at the point of need, and reduced financial burden for both patient and provider,” said Dr. Smith. “Dr. Culmer and I feel that we have created a critical infrastructure of EMS telemedicine capabilities that will enhance patient care and outcomes in medically underserved communities across our state.”

Once fully implemented, the project will offer access to higher quality and more efficient patient care by transporting patients to the most appropriate healthcare facility or enabling emergency department personnel to determine that a patient should remain on site, potentially reducing unnecessary hospital transports and 30-day readmissions. Additionally, it will provide for the transmission of more detailed medical and video data directly from EMS providers to emergency physicians and advanced practice providers in emergency departments. With this advanced data and telemedical communications, patients with possibly life-threatening conditions can be transported to the most appropriate facility in the least amount of time, which could save lives and improve quality of life.

“Our earlier research found that telemedicine capabilities in emergency situations had not been widely implemented across the U.S., and especially in rural communities. In fact, we recently found only 13 previous studies directly related to prehospital telemedicine, most of which did not adequately address concerns related to quality, cost, and patient satisfaction,” said Dr. Culmer. “A project on this scale will not only enhance the quality of care for rural Alabamians but will provide data for future research in this critical area.”

This project will be implemented in the following Alabama counties: Bibb, Clarke, Clay, Cherokee, Choctaw, Coosa, Covington, Escambia, Greene, Hale, Lamar, Marengo, Monroe, Perry, Randolph, Sumter, Tallapoosa, Washington and Wilcox.  In 2020, these rural counties had a total of 56,346 EMS calls and 26,056 individuals were transported to a hospital emergency department.

 “Residents in rural Alabama often have limited transportation access due to geographic barriers, which can mean longer distances for ambulance travel, limited communication between first responders and physicians, and a limited number of ambulances spread over a wider geographic range,” said Dr. Elwin Crawford, Alabama State EMS Medical Director. “These factors ultimately yield longer wait times before a patient receives care in hospital facilities, poorer health outcomes, extended transition times, and less patient and provider satisfaction.”

“This project, along with other ongoing initiatives in our state, will do a great deal to address healthcare discrepancies in our rural communities.”

The USDA Rural Development’s Distance Learning and Telemedicine program helps rural communities use the unique capabilities of telecommunications to connect to each other and to the world, overcoming the effects of remoteness and low population density.

Photo captions: TOP: Drs. Nathan Culmer and Todd Smith. BOTTOM: Hale County EMS, represented by Duane Baines, Kade Roberts and Bailey Crawford, will implement the project, connecting telemedically-equipped ambulances and emergency departments in the communities they serve.

Bartlett Awarded $1.2 Million to Build Diversity in Nursing and among Nurse Scientists and Faculty in Alabama

• in Research, Uncategorized

Dr. Robin Bartlett, Associate Dean for Research at the Capstone College of Nursing, and her team have received notice of a $1.2 million Science Education Partnership Award (SEPA) from the National Institute of General Medical Sciences (NIGMS) of the National Institutes of Health for their project, Health Sciences & Technology Academy-Alabama (HSTA-AL). The goal of HSTA-AL is to build a pipeline for underrepresented students to the field of nursing, teaching them to become change agents in their communities.

“Our nation is in dire need for more nurses, particularly nurse scientists, nurse faculty, and RNs from rural areas and diverse racial and ethnic backgrounds,” said Dr. Bartlett. “To change this dynamic, we must encourage students from underrepresented populations to enter the field of nursing before they graduate from high school.”

According to the American Association of Colleges of Nursing, nearly 40% of the U.S. population are Black, Indigenous, and people of color, but these groups comprise only about 20% of the nursing workforce and 16% of full-time nursing faculty.

Dr. Bartlett continued, “Nurses from underrepresented and diverse communities have the potential to become change agents in their communities, employing their understanding and expertise to address health inequities that lead to poorer health outcomes among underserved populations.”

This five-year program seeks to replicate West Virginia’s SEPA-supported Health Sciences & Technology Academy (WV HSTA), but with adaptations specific to the needs of rural Alabama (the program will initially focus its efforts in Hale and Pickens Counties). HSTA-AL aims to support inclusion in nursing, nurse faculty and nursing science roles by opening the doors to higher education for underrepresented high school students.

The SEPA funded WV HSTA has been in existence for more than 25 years and has graduated nearly 3000 students from the program, with an 89% graduation rate among those who matriculate to college. WV HSTA graduates often go on to pursue advanced degrees, and many choose nursing as a profession.

“We will build on WV HSTA’s successes, tailoring HSTA-AL to meet the unique needs of Alabama high school students,” said Dr. Bartlett. “We look forward to opening these students up to the possibilities of a biomedical career, especially a career in nursing.”

“The Hale County School System has a passion for providing opportunities for all students, not only in their education endeavors but also in life. This program will do both,” said Mr. Michael Ryans, Superintendent of Hale County Schools. “I believe that long-term, sustainable change will be accomplished through this program. Together, we can improve the health of Hale County residents while educating and preparing our youth to become the health care professionals of tomorrow.”

Steps taken to encourage students to pursue undergraduate degrees will include (but not be limited to): hosting summer camps on nursing, citizen science and rural health disparities; offering after-school clubs to engage students in community-based participatory research; and providing professional development to HSTA-AL in-service and pre-service teachers.

UA’s Capstone College of Nursing HSTA-AL team includes: Dr. Bartlett, Drs. Mercy Mumba, Paige Johnson and Michele Montgomery, and Mrs. Brandi Lester. Dr. Betty Key from Samford University is also a member of the team, as are Ms. Bethany Hornbeck and Dr. Ann Chester from Apis Creative and Drs. Alan and Sherron McKendall from West Virginia University.

Research reported in this publication was supported by the National Institute of General Medical Sciences of the National Institutes of Health under SEPA Award Number R25GM142027. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

What is HSTA-AL?

CCN Research Society Update

• in Research, Uncategorized

The CCN Research Society is continuously recruiting new members and faculty research mentors. The purpose of this club is to increase student interest in and knowledge of undergraduate research, with the goal of increasing the number of students who develop their own research projects.  

 “Membership in the CCN Research Society provides opportunities for students to experience all of the different aspects of the research process while working alongside a faculty mentor,” Faculty Advisor Dr. Paige Johnson states. “It helps them understand, firsthand, how research and evidence-based practice informs nursing practice. “  

The research club meets once a month on Monday afternoon. Students in both lower division and upper division are encouraged to join the club. In addition to club meetings, members are planning to present at the Undergraduate Research and Creative Activity Conference held this spring.  

A large number of students are working with faculty members on research projects that should yield presentations and publications from their collaboration. Hillary Melton, undergraduate student member, states, “As a member of the CCN Research Society and Randall Research Scholars Program, I have been given the opportunity to present my research on Telomere Length, Life’s Simple 7, and Psychosociocultural Factors Among African American Women to faculty and students.” Melton’s experience working with faculty research mentor, Dr. Theresa Wadas, has encouraged her to, “diversify my nursing practices and select a topic for my ancillary project within the overarching research initiative.” 

Membership in the CCN Research Society is mutually beneficial to both students and faculty. Dr. Johnson affirms, “Faculty benefit tremendously from working with undergraduate students on research projects. Students not only assist in all of the work that has to be done to complete a project but also bring a fresh perspective and new ideas to explore.”  

For more information on becoming a faculty mentor, contact Dr. Paige Johnson (ptjohnso@ua.edu) or Dr. Michele Montgomery (mmontgomery1@ua.edu). Undergraduate students who would like to become involved with the CCN Research Society and want more information, email ccnresearchsociety@gmail.com. 

Fall 2020 Faculty Spotlight: Dr. Robin Bartlett

• in Research, Uncategorized

Dr. Robin Bartlett received her both her Bachelor of Science and Master of Science in Nursing Administration degrees from the University of North Carolina at Greensboro. She earned her PhD from the University of North Carolina at Chapel Hill. Prior to joining the Capstone College of Nursing in August of 2019, Dr. Bartlett taught for several years and served as Director of the PhD in nursing program for four years at the University of North Carolina at Greensboro.

Dr. Bartlett serves as faculty in CCN and is affiliated with the Alabama Life Research Institute in her role as Lifespan Researcher. In these roles, she will be teaching CCN graduate courses and conducting funded research aligned with the mission of the Life Research Institute and an affiliated research center, the Center for Youth Development and Intervention. Dr. Bartlett will also be providing research mentoring to CCN junior faculty and students.

Dr. Bartlett’s clinical practice experiences in mental health settings inspired her to conduct health disparities research. Her primary research focus has been understanding risky behaviors and their associated prevention measures in a population primarily comprised of minority adolescents, particularly African American and Latinx adolescent girls. Dr. Bartlett takes a special interest in risk and protective factors associated with behavior trajectories, health outcomes, health disparities and parenting. For example, she has conducted intervention studies focused on the prevention of risk behaviors that could lead to negative health outcomes for minority adolescent girls.

Her work at CCN is expanding her health disparities work to younger children and rural-residing Alabamian adolescents. Dr. Bartlett’s research efforts are influenced by her positive approach. She exemplifies this perspective by focusing on strengths of diverse ethnic and cultural groups. She is a proponent for shifting focus from deficit research to preventative and proactive measures in research. Dr. Bartlett is honored to be a part of CCN and Life Research Institute community.

Mumba Awarded NIH Grant to Aid in Reversal of Opioid Crisis

• in Research, Uncategorized

Dr. Mercy Mumba, Assistant Professor at the Capstone College of Nursing, grew up in Zambia, where nursing was not a well-respected profession. After moving to the United States, Dr. Mumba earned her Bachelor of Science in Nursing from the University of Texas at Arlington. Only two years after graduating with her BSN, she entered a BSN to PhD program; and four years later she graduated with a PhD from UT Arlington’s College of Nursing and Health Innovation. A passionate researcher, Dr. Mumba has a number of funded grants, most of which concentrate on preventions and treatment of substance abuse disorders and their co-morbid psychiatric mental health conditions.

Dr. Mumba and her team have received notice of an award from the National Center for Complementary and Integrative Health (NCCIH) at the NIH for their proposal entitled “A Mindfulness and Peer Mentoring Program to Improve Adherence to Medication Assisted Treatment for Opioid Use Disorders.” This five-year project, funded through The Helping to End Addiction Long-Term (HEAL) Initiative, is the only one funded from the state of Alabama. This award is one of 375 grant awards across 41 states made by the National Institutes of Health in fiscal year 2019 to apply scientific solutions to reverse the national opioid crisis. Below, we asked Dr. Mumba to share some insight into this project.

Please describe the purpose and goal of this project.

The purpose of this project is to improve adherence to medication-assisted therapies for opioid use disorders, such as buprenorphine and methadone, among others by utilizing a combination of mindfulness-based relapse prevention and peer support specialists.  We are also trying to see if this intervention helps with reducing relapse, cravings, depression, anxiety and stress.

What are the plans and goals of each phase of the project?

In Phase 1, we will be piloting the feasibility and acceptability of this new intervention that we developed to see if it works and to see if people with opioid problems think that this is something they can participate in if it was available. We will also be examining the preliminary efficacy of the intervention in decreasing relapse, cravings, depression, anxiety and stress.

Please elaborate on the mentoring aspect of this study. Why mentoring is important to you?

There is a growing body of evidence showing that using peer mentoring in substance use recovery produces better outcomes. This is because patients have an accountability partner as well as a role model to look up to in their sobriety journey. The road to recovery is often difficult and can be lonely. Therefore, utilizing peer mentoring can improve social engagement, reduce isolation and provide a sense of belonging for individuals recovering from addiction.

What does this grant mean to you and your team?

Our team is excited about the opportunity to increase access to evidence-based treatment modalities for individuals with opioid use disorders. Alabama is one of the hardest hit states when it comes to the opioid crisis and yet, we also have serious problems when it comes to access to care. We believe that our grant is providing a much-needed service and has potential to reduce morbidity and mortality related to opioid misuse.

How do you hope this study will inspire or influence other nurses or researchers in the field?

I think this study challenges all of us to look at individuals with opioid use disorder from a holistic perspective. There are many issues that contribute to addiction and substance abuse; however, when we look at treatment options, they sometimes tend to neglect all the other problems that may have contributed to the addiction in the first place. This is why we believe that addressing co-morbid mental health and other psychiatric disorders in this population is an integral part of promoting sustained recovery.

Dr. Mumba is the principal investigator and program director. Her co-investigators include Drs. Andrea Glenn (Psychology), George Mugoya (Educational Counseling), Rebecca Allen (Psychology), David Albright (Social Work), Lori Davis (Tuscaloosa VAMC), Joshua Richman (Tuscaloosa VAMC) and Ms. Austin Butler (Alabama Community Care).

Research reported in this publication was supported by the National Center for Complementary & Integrative Health of the National Institutes of Health under Award Number R61AT010802. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Mumba Awarded NIH Grant to Aid in Reversal of Opioid Crisis

• in Research, Uncategorized

Dr. Mercy Mumba, Assistant Professor at the Capstone College of Nursing, and her team have received notice of an award from the National Center for Complementary and Integrative Health (NCCIH) at the NIH for their proposal entitled “A Mindfulness and Peer Mentoring Program to Improve Adherence to Medication Assisted Treatment for Opioid Use Disorders.”

This five-year project, funded through The Helping to End Addiction Long-Term (HEAL) Initiative, is the only one funded from the state of Alabama. The trans-NIH research effort aims to improve treatments for chronic pain, curb the rates of opioid use disorder (OUD) and overdose and achieve long-term recovery from opioid addiction.  Phase 1 of the project (R61 phase) is a two-year pilot study to test the feasibility and acceptability of this intervention, and phase 2 (R33 phase) is a three-year clinical trial. The approved budget for Phase 1 is $783,788, and the total budget for the five-year project is $2,793,879. The release of funds for Phase 2 will be contingent upon successful completion of Phase 1. The funded project is summarized below.

There is evidence that combining mindfulness-based interventions and peer recovery support services with medication-assisted therapy (MAT) to treat opioid use disorders (OUD) reduces substance use, cravings, symptoms of depression and anxiety and relapse rates. The intervention can also improve treatment retention and relationships with treatment providers and social supports. The goal of the present study is to determine the effectiveness of a mindfulness-based intervention that also uses peer mentors in addition to professional substance abuse therapists (the Minds and Mentors program [MiMP]) in improving adherence to MAT for OUD and reducing relapse rates in a sample of individuals with OUD. The study hypothesizes that participants in MiMP will demonstrate better adherence; reduced relapse and cravings (primary outcomes measures); reduced depression, anxiety, and stress; improved social support; and reduced cortisol levels and reactivity to drug cues.

Dr. Mumba is the principal investigator and program director. Her co-investigators include Drs. Andrea Glenn (Psychology), George Mugoya (Educational Counseling), Rebecca Allen (Psychology), David Albright (Social Work), Lori Davis (Tuscaloosa VAMC), Joshua Richman (Tuscaloosa VAMC) and Ms. Austin Butler (Alabama Community Care).

This award is one of 375 grant awards across 41 states made by the National Institutes of Health in fiscal year 2019 to apply scientific solutions to reverse the national opioid crisis.

Research reported in this publication was supported by the National Center for Complementary & Integrative Health of the National Institutes of Health under Award Number R61AT010802. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Two CCN Faculty Members Secure over $1.8 Million in Grant Funding

• in Research, Uncategorized

Drs. Alice March and Robin Lawson have been awarded over $1.8 million in grant funding for 2018-2019, all benefiting students in Capstone College of Nursing’s graduate programs.

Dr. Alice March has had two U.S. Health Resources and Services Administration’s grant proposals funded. The Scholarships for Disadvantaged Students (SDS) proposal was funded for $600,000 for the coming year, and the Nurse Faculty Loan Program proposal was funded for $526,001. Dr. March received approval for expanded application of the Nurse Faculty Loan Program this year; now these funds will be available to Doctor of Nursing Practice students, as well as Nursing EdD students.

CCN has dubbed its SDS Program “BAMA Tide to Success for MSN Students.” Scholarship money from the program is intended to support eligible master’s level nursing students during completion of the degree, enabling them to provide primary care to rural and underserved populations. CCN’s goals for program outcomes are to increase enrollment of disadvantaged and minority students, increase retention rates for those students, and, ultimately, prepare about 70 primary care nurses for positions in medically underserved and rural communities. The BAMA Tide to Success funding is available in $600,000 increments each academic year to be distributed among scholarship recipients. To qualify for this graduate scholarship, students must be from an underrepresented group including men in nursing, minority racial or ethnic groups, or from disadvantaged backgrounds, either now or in the past. This means that persons who attended a high school with a high rate of free/reduced lunches or had a low graduation rate may qualify. Some amount of financial need should be demonstrated on the FAFSA form, which is required for consideration.

The UA NFLP Supporting Doctorate of Education and Doctor of Nursing Practice project will increase the nursing faculty workforce in Alabama and the US by providing loans to manage the costs of tuition, books, fees, and related expenses for students in the EdD or the DNP programs at UA. The Capstone College of Nursing and College of Education administer a collaborative doctoral program, the EdD in Instructional Leadership for Nurse Educators to prepare nurses for the faculty role. The CCN will offer DNP students two elective courses to prepare them to function as academic nurse educators. Funds will be made available for 56 EdD and 15 DNP students, with each student receiving $4,375.00 per semester for two semesters and $3,250.00 for one semester of the academic year, totaling $12,000.

Read more about Dr. March’s grants here.

Dr. Robin Lawson, Senior Associate Dean of Academic Programs, received notice that her Advanced Nursing Education Workforce proposal submitted to HRSA was approved for funding of $650,896 for 2018-2019 as part of a 2-year award totaling approximately $1,309,988. The purpose of this project, BAMA-Care, is to prepare primary care nurse practitioner (NP) students to practice in rural and underserved settings through targeted academic and clinical training via an enhanced academic-practice partnership (APP) and supplemental ANEW funding. Through ANEW funding, the University of Alabama Capstone College of Nursing will enhance its current APP with Whatley Health Services, Inc. (WHSI), one of the largest Federally Qualified Health Centers in West Alabama, with 16 locations in rural and/or underserved areas. BAMA-Care students enrolled in the MSN Nurse Practitioner Program and Primary Care for Rural Populations will complete longitudinal, immersive clinical experiences with rural and/or underserved populations with preceptors at WHSI practice sites.

Read more about BAMA-Care here.

The University of Alabama Capstone College of Nursing prepares graduates for the professional practice of nursing. The college is a national innovator in clinical simulation in nursing education, utilizing simulators and telehealth technology in teaching, research and health care delivery.