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Role of nursing research in global health: Q and A with NINR Director Dr Patricia A Grady

January / February 2015 | Volume 14, Issue 1

Headshot of NINR Director Dr Patricia A Grady

Patricia A. Grady, Ph.D., R.N., F.A.A.N.

Dr. Patricia A. Grady became director of the NIH's National Institute of Nursing Research (NINR) in 1995. Her prior position was acting director of the National Institute of Neurological Disorders and Stroke, which she joined in 1988. An internationally recognized researcher, Dr. Grady's focus has been on stroke, with an emphasis on arterial stenosis and cerebral ischemia. Before NIH, she held academic positions, including at the University of Maryland, where she had obtained a master's degree in nursing and a doctorate in physiology. She was elected to the Institute of Medicine in 1999.

What's the role of nursing research in global health?

In September 2000, the UN highlighted eight objectives known as the Millennium Development Goals for the world community. Nurses and nursing science play an important role in virtually all of these. However, our impact is most obvious in reducing child mortality, improving maternal health, and combating HIV/AIDS, malaria and TB, along with the prevention and management of chronic conditions. Particularly in low- and middle-income countries (LMICs), nurses and nurse scientists can help fill a critical need for the education and training of health workers, as well as designing and testing solutions to common health problems.

Approximately 1 billion people across the world have zero access to trained health workers. Many projects we support have shown that low-tech, local health care solutions - such as sari cloth filtering of water in Bangladesh - can be more beneficial than high-tech treatments.

What are examples of NINR's global health successes?

NINR-supported researchers are integrating depression screening into HIV care in Southern India. UNAIDS estimates that 2.5 million of the 34 million people living with HIV are in India. Connecting this population to mental health resources and interventions to treat depression could lead to improved quality of life for those dealing with the multiple burdens of HIV. In Bangladesh, NINR co-funded a study that aims to reduce postpartum hemorrhage, the leading worldwide cause of maternal death and disability.

We also support studies in community-based outreach that show promise to lower the incidence of childhood diarrhea. As I mentioned, an NINR-funded study involved the use of a sari cloth filter to decrease the incidence of waterborne cholera. This is a sustainable intervention that elegantly utilizes readily available, low-cost material while empowering women. NINR is the lead NIH institute for research in advancing end-of-life care, which presents some of the most critical challenges in clinical care today. An NINR-funded end-of-life bereavement study conducted in South Africa showed the remarkable resiliency of adolescents who have lost a loved one to AIDS.

How is NINR engaged in research training?

NINR partners with Fogarty on a number of research training projects. One example is the University of Illinois at Chicago's School of Public Health and College of Nursing's AIDS International Training and Research Program. This multidisciplinary effort fosters long-term scientific capacity to address the AIDS epidemic in Chile, Indonesia and Malawi through hands-on training. Another example is a new interdisciplinary project working with local health care workers in Argentina to study the efficacy of a text messaging intervention to improve medication adherence in TB patients.

What are NINR's global health plans looking forward?

Nursing science has always been based on interdisciplinary collaborations. The WHO has acknowledged the importance of international research collaborations through the designation of Nursing Collaborating Centers, which focus on team-based research of regional or global significance. NINR will continue to facilitate global training partnerships, promote earlier entry of nurses into research training programs, and strengthen the scientific basis for clinical practice. We will also work to integrate technology and advanced interdisciplinary research methods. Data science will remain vital, including use of "big data" from electronic health records, wearable devices, mHealth, point-of-care diagnostics, data visualization and various non-health specific data such as GPS, Google Maps and social media.

NINR will continue partnering with Fogarty and other members of the global health community to identify areas in need of research, disseminate scientific findings and foster international relationships among investigators.

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