Allison P Squires

Faculty

Prof. Allison P Squires headshot

Allison P Squires

FAAN PhD RN

Associate Professor

1 212 992 7074
Accepting PhD students

Allison P Squires's additional information

Allison P Squires, Ph.D., FAAN, RN, is an associate professor and was the director of the Florence S. Downs Ph.D. Program in Nursing Research & Theory Development at NYU Rory Meyers College of Nursing from 2020-2022. She was the 2019–2020 Distinguished Nurse Scholar in Residence for the National Academy of Medicine where she worked on the consensus study for the next Future of Nursing 2020–2030 report. An internationally recognized health services researcher, Prof. Squires has led or participated in studies covering 50 countries. She currently leads the Global COVID Nursing and Midwifery Study (GCNMS) multinational study examining how global pandemic response implementation has affected the personal and professional lives of nurses and midwives. Domestically, her research focuses on improving immigrant and refugee health outcomes with a special interest in breaking down language barriers during the healthcare encounter.

Prof. Squires has consulted with the Migration Policy Institute and the World Bank on nursing and health workforce issues and produced several major policy analyses with their teams. A prolific writer, Squires has authored over 200 publications, including 125+ in peer-reviewed journals. She serves as an associate editor of the International Journal of Nursing Studies (the top-ranked nursing journal in the world) since 2012.

Prior to entering academia full-time, Squires worked as a staff nurse in solid organ transplant and as a staff educator for 11 years in the US healthcare system. Her practice has since shifted largely to community-based nursing roles as a volunteer.

Prof. Squires completed her Ph.D. at Yale University, MSN at Duquesne University, and BSN at the University of Pennsylvania. She completed a Post-Doctoral Fellowship in Health Outcomes Research at the University of Pennsylvania. In addition to her primary appointment at the College of Nursing, she holds affiliated faculty appointments with the Grossman School of Medicine, Center for Latin American Studies, and the Center for Drug Use and HIV Research at NYU.

She is currently accepting Ph.D. students and/or post-doctoral fellows/associates with interests in the following areas: 1) global health, 2) migration & immigrant health, and 3) health services and workforce research.

Post-Doctoral Fellowship - University of Pennsylvania
PhD - Yale University
MSN - Duquesne University
BSN - University of Pennsylvania

Global
Immigrants
Gerontology
Health Services Research

Academy Health
American Nurses Association
Consortium of Universities for Global Health
Interdisciplinary Research Group on Nursing Issues (Academy Health)
National Council for Interpreting in Health Care
Sigma Theta Tau International

Faculty Honors Awards

Chair of the Nursing Section of the New York Academy of Medicine (2022)
Co-Chair, American Academy of Nursing's Global Health Expert Panel (2021)
Chair of the Nursing Section of the New York Academy of Medicine (2021)
Vice-Chair, Global Health and Health Care Interest Group for Academy Health (2020)
Co-Chair, American Academy of Nursing's Global Health Expert Panel (2020)
Chair, Interdisciplinary Research Group on Nursing Issues for Academy Health (2020)
Chair of the Nursing Section of the New York Academy of Medicine (2020)
Distinguished Nurse Scholar in Residence, National Academy of Medicine (2020)
Vice-Chair, Global Health and Health Care Interest Group for Academy Health (2019)
Co-Chair, American Academy of Nursing's Global Health Expert Panel (2019)
Chair, Interdisciplinary Research Group on Nursing Issues for Academy Health (2019)
Chair of the Nursing Section of the New York Academy of Medicine (2019)
Distinguished Nurse Scholar in Residence, National Academy of Medicine (2019)
Chair, Global Health and Health Care Interest Group for Academy Health (2019)
Outstanding Scholarly Contribution to Gerontological Nursing Practice, International Journal for Older People Nursing (2018)
Chair of the Nursing Section of the New York Academy of Medicine (2018)
Chair, Global Health and Health Care Interest Group for Academy Health (2018)
Prose Award, “A New Era in Global Health” (W. Rosa, Ed.) (2018)
Vice Chair, Interdisciplinary Research Group on Nursing Issues for Academy Health (2018)
Fellow Ambassador to the Media, New York Academy of Medicine (2017)
Distinguished Alumna, Duquesne University (2015)
Fellow, American Academy of Nursing (2015)
Fellow, New York Academy of Medicine (2014)
Fellow, Yale World Fellows Program (2003)

Publications

The power of the language we use: Stigmatization of individuals and fellow nurses with substance use issues

Foli, K. J., Choflet, A., Matthias-Anderson, D., Mercer, M., Thompson, R. A., & Squires, A. (2023). Research in Nursing and Health, 46(1), 3-8. 10.1002/nur.22295

Adapting the Geriatric Institutional Assessment Profile for different countries and languages: A multi-language translation and content validation study

Zisberg, A., Lickiewicz, J., Rogozinski, A., Hahn, S., Mabire, C., Gentizon, J., Malinowska-Lipień, I., Bilgin, H., Tulek, Z., Pedersen, M. M., Andersen, O., Mayer, H., Schönfelder, B., Gillis, K., Gilmartin, M. J., & Squires, A. (2022). International Journal of Nursing Studies, 134. 10.1016/j.ijnurstu.2022.104283
Abstract
Abstract
Background: Hospitalization can be hazardous for older people, but most hospitals in Europe are not prepared to meet the unique needs of older adult inpatients. Adaptations of the physical environment, care processes, and staff knowledge and skills in geriatric care are essential to improve the quality of care for older people. An assessment of baseline organizational approaches to older adult care is an important first step toward recognizing the challenges organizations face when delivering acute care services to older adults and attempting to improve them. The Geriatric Institutional Assessment Profile could be a promising tool for this endeavor. Objectives: To describe a systematic process implemented across seven countries and languages that sought to develop valid and culturally-appropriate translations of the Geriatric Institutional Assessment Profile. Design: Cross-cultural instrument translation and content validation study. Setting and participants: Expert review panels comprised of 68 practicing nurses from seven European or EU associated countries (Austria (German), Belgium (Dutch), Denmark (Danish), Israel (Hebrew), Poland (Polish), Switzerland (German, French), and Turkey (Turkish)) evaluated cross-cultural relevance, including translation, of the Geriatric Institutional Assessment Profile. Method: A systematic approach to translating and validating a cross-cultural survey instrument, including back-to-back translation, adaptation, and evaluation of content validity using content validity indexing (CVI) techniques for each country and language, assessing translation and relevance content validity separately. The item, subscale and domain content validity index scores were calculated and adjusted for chance agreement among raters for all parts of the Geriatric Institutional Assessment Profile: the four subscales of geriatric care environment, the general knowledge about older adults subscale, and the clinical geriatric knowledge subscale. Consensus discussions among the raters then finalized translations. Results: CVI scores for relevance and translation were all in the “good” to “excellent” range. The geriatric care environment scale's CVI scores were 0.84 to 0.94 for relevance and 0.82 to 0.98 for translation. The clinical geriatric knowledge subscale's CVI scores were 0.83 to 0.97 for relevance and 0.94 to 0.98 for translation. The general knowledge about older adults subscale received high translation agreement (0.93 to 0.99) but slightly lower scores for relevance, ranging from 0.46 to 0.94. Conclusion: Study results provided preliminary evidence of the applicability and validity of a multi-factor measure of age-friendly care in diverse health care systems, in German, Dutch, Danish, Hebrew, Polish, French, and Turkish languages.

Assessing the influence of patient language preference on 30 day hospital readmission risk from home health care: A retrospective analysis

Squires, A., Ma, C., Miner, S., Feldman, P., Jacobs, E. A., & Jones, S. A. (2022). International Journal of Nursing Studies, 125. 10.1016/j.ijnurstu.2021.104093
Abstract
Abstract
Background: In home health care, language barriers are understudied. Language barriers between patients and providers are known to affect a variety of patient outcomes. How a patient's language preference influences hospital readmission risk from home health care has yet to be determined. Objective: To determine if home care patients’ language preference is associated with their risk for hospital readmission from home health care within 30 days of hospital discharge. Design: Retrospective cross-sectional study of hospital readmissions from an urban home health care agency's administrative records and the national electronic home health care record for the United States, captured between 2010 and 2015. Setting: New York City, New York, USA. Participants: The dataset comprised 90,221 post-hospitalization patients and 6.5 million home health care visits. Methods: First, a Chi-square test was used to determine if there were significant differences in crude readmission rates based on language group. Inverse probability of treatment weighting was used to adjust for significant differences in known hospital readmission risk factors between to examine all-cause hospital readmission during a home health care stay. The final matched sample included 87,561 patients with a language preference of English, Spanish, Russian, Chinese, or Korean. English-speaking patients were considered the comparison group to the non-English speaking patients. A Marginal Structural Model was applied to estimate the impact of non-English language preference against English language preference on rehospitalization. The results of the marginal structural model were expressed as an odds ratio of likelihood of readmission to the hospital from home health care. Results: Home health patients with a non-English language preference had a higher hospital readmission risk than English-speaking patients. Crude readmission rate for the limited English proficiency patients was 20.4% (95% CI, 19.9–21.0%) overall compared to 18.5% (95% CI, 18.7–19.2%) for English speakers (p < 0.001). Being a non-English-speaking patient was associated with an odds ratio of 1.011 (95% CI, 1.004–1.018) in increased hospital readmission rates from home health care (p = 0.001). There were also statistically significant differences in readmission rate by language group (p < 0.001), with Korean speakers having the lowest rate and Spanish speakers having the highest, when compared to English speakers. Conclusions: People with a non-English language preference have a higher readmission rate from home health care. Hospital and home healthcare agencies may need specialized care coordination services to reduce readmission risk for these patients. Tweetable abstract: A new US-based study finds that home care patients with language barriers are at higher risk for hospital readmission.

Causes of medication non-adherence and the acceptability of support strategies for people with hypertension in Uganda: A qualitative study

Wilkinson, R., Garden, E., Nanyonga, R. C., Squires, A., Nakaggwa, F., Schwartz, J. I., & Heller, D. J. (2022). International Journal of Nursing Studies, 126, 104143. 10.1016/j.ijnurstu.2021.104143
Abstract
Abstract
BACKGROUND: Hypertension is the most common non-communicable disease in Uganda and its prevalence is predicted to grow substantially over the next several years. Rates of hypertension control remain suboptimal, however, due in part to poor medication adherence. There is a significant need to better understand the drivers of poor medication adherence for patients with non-communicable diseases and to implement appropriate interventions to improve adherence.OBJECTIVE: The purpose of this study was two-fold. First, this study sought to understand what factors support or undermine patients' efforts to adhere to their hypertensive medications at baseline. Second, this study sought to explore the acceptability and feasibility of adherence interventions to both providers and patients.METHODS: This study was conducted at a large, urban private hospital in Kampala, Uganda. We conducted key informant interviews with both providers and patients. We explored their beliefs about the causes of medication non-adherence while examining the acceptability of support strategies validated in similar contexts, such as: daily text reminders, educational materials on hypertension, monthly group meetings (i.e. "adherence clubs") led by patients or providers, one-on-one appointments with providers, and modified drug dispensing at the hospital pharmacy.STUDY DESIGN AND PARTICIPANTS: Fifteen healthcare providers and forty-two patients were interviewed. All interviews were transcribed, and these transcripts were analyzed using the NVIVO software. We utilized a conventional content analysis approach informed by the Health Belief Model.RESULTS: Of the proposed interventions, participants expressed particularly strong interest in adherence clubs and educational materials. Participants drew connections between these interventions and previously underexplored drivers of non-adherence, which included the lack of symptoms from untreated hypertension, fear of medication side effects, interest in traditional herbal medicine, and the importance of family and community support.CONCLUSIONS: Both providers and patients at the facility recognized medication non-adherence as a major barrier to hypertension control and expressed interest in improving adherence through interventions that addressed context-specific barriers.

Changing language, changes lives: Learning the lexicon of LGBTQ+ health equity

Soled, K. R., Clark, K. D., Altman, M. R., Bosse, J. D., Thompson, R. A., Squires, A., & Sherman, A. D. (2022). Research in Nursing and Health, 45(6), 621-632. 10.1002/nur.22274

Different countries and cultures, same language: How registered nurses and midwives can provide culturally humble care to Russian-speaking immigrants

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Dimensional Analysis of Shared Decision Making in Contraceptive Counseling

Gerchow, L., & Squires, A. (2022). JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing, 51(4), 388-401. 10.1016/j.jogn.2022.04.005
Abstract
Abstract
Objective: To conduct a dimensional analysis to identify conceptual gaps around shared decision making (SDM) in reproductive health care and to refine the conceptual definition of SDM as related to contraceptive counseling. Data Sources: We identified source data through systematic searches of the CINAHL and PubMed databases. Study Selection: We included peer-reviewed research and nonresearch articles that addressed contraceptive counseling for pregnancy prevention in the United States. We did not consider date of publication as an inclusion criterion. We included 35 articles in the final review. Data Extraction: Using dimensional analysis, we extracted data to clarify the definition of SDM as a socially constructed concept that varies by perspective and context. Data Synthesis: Data synthesis enabled us to compare SDM from patient and provider perspectives and to identify four primary dimensions of SDM that varied by context: Patient Preferences, Relationship, Provider Bias, and Clinical Suitability. Conclusion: The four dimensions we identified illustrate the complexity and depth of SDM in contraceptive counseling encounters and broaden the definition of SDM to more than an encounter in which decision making incorporates clinician expertise and patient participation. We identified several assumptions that indicate the need for improved understanding that SDM is not a universal concept across perspectives and contexts. Most researchers in the included articles addressed the Patient Preferences dimension. Fewer considered the patient–provider relationship, the effect of provider bias, and the effect of specific clinical circumstances on SDM. We propose a conceptual map and model that can be used to refine the concepts that inform SDM and guide providers and researchers. Future research is needed to address the remaining gaps.

Dimensions of Being a Midwife and Midwifery Practice in the United States: A Qualitative Analysis

Thumm, E. B., Stimpfel, A. W., & Squires, A. (2022). International Journal of Childbirth, 12(2), 84-99. 10.1891/IJC-2021-0025
Abstract
Abstract
BACKGROUND: Midwives are a vital component of addressing maternal mortality crisis in the United States (US); however, there is scant understanding of the elements of midwifery practice that affect patient outcomes and the stability of the midwifery workforce in the country. This study investigates US midwives’ perceptions of factors influencing their practice and willingness to stay in the profession. METHODS: We applied a pragmatic qualitative design using summative content analysis techniques to code 1,035 comments from a national sample of 2,887 certified nurse-midwives and certified midwives. Two coders identified categories and themes of midwives’ perceptions of their practice environments, which were confirmed by an independent auditor. RESULTS: Eight themes emerged from the data: I love midwifery but…; feeling valued and respected…or not; workload; time and its consequences; the multilevel geography of midwifery practice; changes at odds with quality midwifery care; midwives withdrawing from practice to cope; and the ambiguity of “I just want to practice like a midwife.” CONCLUSION: Midwives readily identified aspects of their practice environment that negatively impact quality of care and stability of the midwifery workforce, including not valuing midwives, high workload, regulatory restrictions, and moral distress; however, respondents expressed strong commitment to the profession of midwifery. The findings also demonstrated the lack of a universally accepted definition of midwifery care within respondents’ professional communities and among respondents. Initiatives to increase integration of midwifery into the US perinatal health system will benefit from taking these findings into consideration.

Evaluating Polish nurses' working conditions and patient safety during the COVID-19 pandemic

Malinowska-Lipień, I., Wadas, T., Gabryś, T., Kózka, M., Gniadek, A., Brzostek, T., & Squires, A. (2022). International Nursing Review, 69(2), 239-248. 10.1111/inr.12724
Abstract
Abstract
Aim: To study the relationship between Polish nurses' working conditions and their attitudes towards patient safety during the COVID-19 pandemic. Background: Facing the COVID-19 pandemic, caused by the SARS-CoV-2 virus, healthcare worldwide has been reorganised. How these changes affected patient safety for hospitalised persons is not well understood. Introduction: Difficult working conditions related to the outbreak of the COVID-19 pandemic may affect the provision of safe and effective care by healthcare staff. Methods: This observational research was performed on the group of 577 nurses working during the COVID-19 pandemic in isolation infection wards (n = 201) and non-infectious diseases wards (n = 376) in Polish hospitals. The evaluation of working conditions was performed with an author's questionnaire, while the evaluation of factors influencing attitudes towards safety of the hospitalised patients was performed using Safety Attitudes Questionnaire. The STROBE checklist was used to report this study. Results: The procedures developed by management in advance for COVID-19 patient treatment had a statistically significant influence on nurses' ‘evaluation of teamwork climate, safety climate, job satisfaction, perception of management and work conditions’. Providing management with the ability to perform a swab polymerase chain reaction SARS-CoV-2 test for hospital staff in the workplace, and psychological support from professionals and employers were statistically significant for higher ratings of ‘teamwork climate, safety climate, job satisfaction, stress recognition, perception of management and work conditions’ by the Polish nurses. Hospital workload during the COVID-19 pandemic was significantly correlated with lower evaluation of work conditions. Discussion: Our study reinforces the existing literature on many fronts and demonstrates how even when operating under the COVID-19 pandemic conditions, some factors remain critical for fostering a culture of patient safety. Reinforcing patient safety practices is a imperative under these conditions. Conclusions and implications for nursing: Working conditions influence nurses' attitudes towards safety of the hospitalised patients. These are largely modifiable factors related to the workplace and include prior preparation of procedures, restrictions to extending daily work hours and psychological counselling for the staff.

Grouping people by language exacerbates health inequities—The case of Latinx/Hispanic populations in the US

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