RWJF Nurse Faculty Scholars Address Pressing Health Issues

Nurse Educators Robin Knobel and Laura Larsson are searching for answers that will keep some of the most vulnerable people in their communities healthier.

    • January 27, 2011

There’s a lot of misinformation about radon among people in Montana, where Laura Larsson lives and works. Some people think it’s therapeutic in high doses, and they even pay to sit in radon “health mines” to combat chronic and other illnesses. Other people think it’s a form of man-made pollution. Still others recognize radon as the naturally-occurring, colorless, odorless, radioactive carcinogen that it is.

Larsson is out to set the record straight, in Montana and elsewhere, and educate low-income residents about the need to get out of harm’s way. After winning a highly competitive grant from the Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars program last fall, Larsson, Ph.D., M.P.H., R.N., is using her chemistry, environmental health and nursing skills to conduct research and public education about the dangers associated with residential exposure to radon. At the same time, she is busy teaching pharmacy to the next generation of nurses.

An assistant professor at the College of Nursing at Montana State University, Larsson announced her selection as a Nurse Faculty Scholar last fall, striking a chord in her community. The news coverage about her selection brought people out of the proverbial woodwork to share their views about radon—a hazard throughout Montana, according to the U.S. Environmental Protection Agency. Flooded with reports of both myths and miracles, Larsson was overwhelmed by the response. She heard from senior citizens who were selling their homes and worried about the safety of the young buyers; graduate students living in illegal basement apartments concerned about high levels of radon; workers who made their livings in radon mines; people who were sick and wanted to know the cause of their illnesses and others who were searching for cures; public health officials; politicians; and fellow researchers from around the country.

These conversations confirmed a conclusion that Larsson had reached earlier in her research: Low-income people who rented their homes were less likely to have had them tested them for radon, or to have mitigation if levels of the noxious gas were high. So she redoubled her efforts to find ways for low-income tenants to access radon home test kits so they could learn if the dangerous gas was putting them at risk for lung cancer and take action, if needed.

“There are no U.S. laws that govern indoor radon testing for renters,” Larsson said. “As public health workers, we look into a lot of things. We inspect homes, pools and tattoo parlors—but not rented homes.”

“Low-income women, in particular, tend to spend a lot of time at home,” she added, so the safety and quality of the air they breathe matters.

In a community that can be hostile to government regulations, Larsson is taking a different approach. She is using her RWJF Nurse Faculty Scholar research grant to place flat screen monitors in the waiting rooms of county programs that provide food subsidies for women, infants and children. One screen posts information about radon and the availability of reduced-price test kits. The other provides general messages about health and safety. Larsson’s goal is to determine which messages on these “digital bulletin boards” most effectively generate interest in purchasing and using home radon test kits.

Her goal is to normalize testing for vulnerable families, who tend to be younger, low-income and to rent their homes.

Larsson is one of just 12 nurse educators from around the country who were selected for the prestigious RWJF Nurse Faculty Scholar program this year, as the program’s third cohort. The program supports junior faculty who show outstanding promise as future leaders in academic nursing. It aims to help curb the shortage of nurse educators—a key goal of the Institute of Medicine’s new report, The Future of Nursing, Leading Change, Advancing Health, which was supported by RWJF. Nurse Faculty Scholars like Larsson receive three-year, $350,000 grants to support their research, as well as salary support, mentoring, leadership training and networking opportunities.

Robin Knobel, Ph.D., R.N., an assistant professor at the School of Nursing at Duke University, is also part of the third cohort of RWJF Nurse Faculty Scholars. She is using her research grant to study a vexing health challenge: how to address the health risks associated with hypothermic body temperatures for extremely premature babies.

Babies born at less than 29 weeks of gestation are frequently exposed to cold air during nursing and medical procedures during their first few days of life. They have immature neurological systems and little ability to generate heat or regulate their blood flow, so the cold temperatures can put them at risk for gastrointestinal infections, bleeding in the brain and other potentially lethal complications.

Knobel has been interested in the physiology of these infants for years. Her clinical experience in neonatal intensive care units, and later as a neonatal nurse practitioner, taught her the importance of—and challenges associated with—keeping these fragile babies warm. “I once picked up an infant on transport who had been placed on a vent,” she said. “The fluids and heart rate were fine, but the nurses had forgotten to turn on the warmer bed and the baby’s temperature was 91 degrees. That infant died three weeks later.”

That experience helped make Knobel “passionate about studying thermoregulation. I love conducting research to answer questions and improve outcomes for tiny infants.” As a Nurse Faculty Scholar, she can do just that. Knobel’s new research will build on a previous study she conducted that found that extremely premature babies suffer from abnormal blood flow that keeps hands and feet warmer than body cores. Colder temperatures indicate low blood flow, which can decrease available oxygen to those areas—a precursor of health problems.

In her new project, supported by the RWJF Nurse Faculty Scholars program, Knobel seeks to better understand the physiological process that leads to low blood flow and cold temperatures. Her goal is to find ways to correct for this abnormality among premature infants and stave off health complications that can last a lifetime. The scholarship “will allow me to collaborate with interdisciplinary teams to further my research goals and help me excite students in my research and inspire future nurse researchers,” she said.

This year’s other Nurse Faculty Scholar award recipients and their research projects are:

  • Betty Bekemeier, Ph.D., R.N., University of Washington, Creating A System For Monitoring How Changes to Public Health Services Impact the Health of Vulnerable Populations;
  • Alison M. Colbert, Ph.D., A.P.R.N., B.C., Duquesne University, Intensive Case Management for Recently Incarcerated Women;
  • Jodi Ford, Ph.D., R.N., The Ohio State University, The Contribution of Neighborhood and School Disadvantage during Adolescence to Sexual Risk and STI during Young Adulthood: A Multi-Level Analysis;
  • Terrah L. Foster, Ph.D., R.N., C.P.N.P., Vanderbilt University, A Legacy-Making Intervention to Reduce Suffering of Children with Cancer;
  • Alison Holman, Ph.D., F.N.P., University of California, Irvine, Susceptibility to Acute Stress and Cardiovascular Ailments: A Genetic-Environmental Analysis;
  • Maria Katapodi, Ph.D., R.N., University of Michigan, Development of a Family Communication and Decision-Support Intervention for Women who Carry a BRCA1 or a BRCA2 Mutation and Their At-Risk Family Members;
  • Elizabeth A. Kostas-Polston, Ph.D., A.P.R.N., W.H.N.P.-B.C., St. Louis University, Genomic Instability: Oncogenic Mechanisms of HPV Oncoprotiens;
  • Laurie Theeke, Ph.D., R.N., West Virginia University, Story-Sharing to Decrease Loneliness and its Sequelae in Chronically Ill Older Appalachian Adults;
  • Andrea S. Wallace, Ph.D., N.D., A.P.R.N.-B.C., A.D.M., University of Iowa, Implementation of Diabetes Self-Management Support in Community Primary Care; and
  • Shannon Zenk, Ph.D., M.P.H., R.N., of Illinois at Chicago, Stress-Environment Interactions and Obesity-Related Behaviors in Urban African-American and Hispanic Women.