Allison P Squires

Faculty

Prof. Allison P Squires headshot

Allison P Squires

FAAN PhD RN

Professor

1 212 992 7074

433 First Ave
New York, NY 10010
United States

Accepting PhD students

Allison P Squires, Ph.D., FAAN, RN, is a professor and the Director of the Global Consortium of Nursing and Midwifery Studies, or GCNMS. The GCNMS is an 82-country research consortium collaborating on research capacity-building projects in nursing and midwifery globally. The consortium's current research study is examining the long-term effects of the COVID-19 pandemic on the nursing and midwifery workforces globally to understand how to improve global pandemic response implementation protocols for the largest frontline workforce cadre. Domestically, her research focuses on improving immigrant and refugee health outcomes with a special interest in addressing inequities in health outcomes resulting from language discordance during a healthcare encounter. For both, she is an expert in contextual considerations of global health care services implementation.

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 140+ in peer-reviewed journals. She serves as an associate editor of the top-ranked International Journal of Nursing Studies since 2012. She was the 2019–2020 Distinguished Nurse Scholar in Residence for the National Academy of Medicine where she worked on the consensus study "Future of Nursing 2020–2030: Charting a Path to Achieve Equity". In 2023, she received the Outstanding Mentor Award from the Interdisciplinary Research Group on Nursing Issues interest group of Academy Health.

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 U.S. healthcare system. Her practice has since shifted largely to community-based nursing roles as a volunteer.

Prof. Squires received her Ph.D. at Yale University, MSN at Duquesne University, and BSN with a minor in Latin American Studies 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 Rory Meyers College of Nursing at NYU, she holds affiliated faculty appointments/affiliations with the Department of General Internal Medicine at the Grossman School of Medicine, the Center for Latin American Studies, and the Center for Drug Use and HIV Research.

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

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)

Exploring longitudinal shifts in international nurse migration to the United States between 2003 and 2013 through a random effects panel data analysis

Squires, A., Ojemeni, M. T., & Jones, S. (2016). Human Resources for Health, 14. 10.1186/s12960-016-0118-7
Abstract
Abstract
Background: No study has examined the longitudinal trends in National Council Licensure Exam for Registered Nurse (NCLEX-RN) applicants and pass rates among internationally-educated nurses (IENs) seeking to work in the United States, nor has any analysis explored the impact of specific events on these trends, including changes to the NCLEX-RN exam, the role of the economic crisis, or the passing of the WHO Code on the International Recruitment of Health Personnel. This study seeks to understand the impact of the three aforementioned factors that may be influencing current and future IEN recruitment patterns in the United States. Methods: In this random effects panel data analysis, we analyzed 11 years (2003-2013) of annual IEN applicant numbers and pass rates for registered nurse credentialing. Data were obtained from publicly available reports on exam pass rates. With the global economic crisis and NCLEX-RN changes in 2008 coupled with the WHO Code passage in 2010, we sought to compare if (1) the number of applicants changed significantly after those 2 years and (2) if pass rates changed following exam modifications implemented in 2008 and 2011. Results: A total of 177 countries were eligible for inclusion in this analysis, representing findings from 200,453 IEN applicants to the United States between 2003 and 2013. The majority of applicants were from the Philippines (58 %) and India (11 %), with these two countries combined representing 69 % of the total. Candidates from Sub-Saharan African countries totalled 7133 (3 % of all applications) over the study period, with half of these coming from Nigeria alone. No significant changes were found in the number of candidates following the 2008 economic crisis or the 2010 WHO Code, although pass rates decreased significantly following the 2008 exam modifications and the WHO Code implementation. Conclusion: This study suggests that, while the WHO Code has had an influence on overall IEN migration dynamics to the United States by decreasing candidate numbers, in most cases, the WHO Code was not the single cause of these fluctuations. Indeed, the impact of the NCLEX-RN exam changes appears to exert a larger influence.

How Factor Analysis Results May Change Due to Country Context

Brzyski, P., Kózka, M., Squires, A., & Brzostek, T. (2016). Journal of Nursing Scholarship, 48(6), 598-607. 10.1111/jnu.12249
Abstract
Abstract
Purpose: To present how factor analysis results of a Practice Environment Scale of the Nursing Work Index (PES-NWI) translation changed due to country context. Design: Validity and reliability analysis of a cross-culturally adapted, Polish translation of the PES-NWI came from a cross-sectional, national survey that included 2,605 registered nurses working in surgical (50.4%) and medical (49.6%) units of 30 Polish hospitals. Methods: Exploratory factor analysis (EFA) using the principal component analysis (PCA) method with varimax rotation and confirmatory factor analysis (CFA) was used to examine factor structure of the instrument in the Polish context. Zero-order and partial Pearson correlation coefficients were used to establish the range of variance shared by the dimensions of the Polish version. The Cronbach's alpha coefficient determined internal consistency reliability. The internal consistency of the scale was also tested based on Kline's criterion. Findings: The PCA conducted in the sample of Polish nurses extracted six factors, explaining together 56% of the total variance. The varimax rotation, however, restricted results to five factors, explaining 52.7% of the total variance and generating a factor structure closer to that based on previous studies. The CFA model, based on a PCA solution with five nonorthogonal factors, fitted data better than the theoretically driven model. Conclusions: Dimensions of the PES-NWI nurses’ work environments remain conceptually consistent in Poland, but load differently. Health system or nursing profession factors related to the country context are potential explanations for these differences. Clinical Relevance: When using a translation of the Practice Environment Scale of the Nursing Work Index-Revised to examine the influences of work environment quality on nursing and patient outcomes, it is important to consider contextual differences when using results to inform policy.

Investing in Nurses is a Prerequisite for Ensuring Universal Health Coverage

Kurth, A. E., Jacob, S., Squires, A. P., Sliney, A., Davis, S., Stalls, S., & Portillo, C. J. (2016). Journal of the Association of Nurses in AIDS Care, 27(3), 344-354. 10.1016/j.jana.2016.02.016
Abstract
Abstract
Nurses and midwives constitute the majority of the global health workforce and the largest health care expenditure. Efficient production, successful deployment, and ongoing retention based on carefully constructed policies regarding the career opportunities of nurses, midwives, and other providers in health care systems are key to ensuring universal health coverage. Yet nurses are constrained by practice regulations, workplaces, and career ladder barriers from contributing to primary health care delivery. Evidence shows that quality HIV care, comparable to that of physicians, is provided by trained nurses and associate clinicians, but many African countries' health systems remain dependent on limited numbers of physicians and fail to meet the demand for treatment. The World Health Organization endorses task sharing to ensure universal health coverage in HIV and maternal health, which requires an investment in nursing education, retention, and professional growth opportunities. Exemplars from Haiti, Rwanda, Republic of Georgia, and multi-country efforts are described.

Language and communication issues impact healthcare providers around the world

Squires, A., & Jacobs, E. A. (2016). International Journal of Nursing Studies, 54, 5-6. 10.1016/j.ijnurstu.2015.12.002

Military service and other socioecological factors influencing weight and health behavior change in overweight and obese Veterans: A qualitative study to inform intervention development within primary care at the United States Veterans Health Administration

Jay, M., Mateo, K. F., Squires, A. P., Kalet, A. L., & Sherman, S. E. (2016). BMC Obesity, 3(1). 10.1186/s40608-016-0087-3
Abstract
Abstract
Background: Obesity affects 37 % of patients at Veterans Health Administration (VHA) medical centers. The VHA offers an intensive weight management program (MOVE!) but less than 10 % of eligible patients ever attend. However, VHA patients see their primary care provider about 3.6 times per year, supporting the development of primary care-based weight management interventions. To address gaps in the literature regarding Veterans' experiences with weight management and determine whether and how to develop a primary care-based weight management intervention to both improve obesity counseling and increase attendance to MOVE!, we conducted a qualitative study to assess: 1) Veterans' personal experiences with healthy weight-related behavior change (including barriers and facilitators to behavior change and experiences with primary care providers, staff, and the MOVE! program), and 2) potential new approaches to improve weight management within primary care at the VHA including goal setting and technology. Methods: Overweight/obese VHA patients (aged 18-75, BMI greater than 30 or greater than 25 with at least 1 co-morbidity) were recruited for focus group sessions stratified by gender, MOVE! referral, and attendance. Each session was facilitated by a trained moderator, audio-recorded, and professionally transcribed. Using an iterative coding approach, two coders separately reviewed and coded transcripts, and met frequently to negotiate codes and synthesize emerging themes. (Continued on next page) Results: Of 161 eligible patients, 54 attended one of 6 focus groups (2 female, 4 male, 9-11 participants per session): 63 % were male, 46 % identified as African-American, 32 % White/Caucasian, 74 % were college-educated or higher, and 61 % reported having attended MOVE!. We identified two major themes: Impact of Military Service and Promotion and Sustainability of Healthy Behaviors. After service in a highly structured military environment, Veterans had difficulty maintaining weight on their own. They perceived physical activity as having more impact than diet, but chronic pain was a barrier. We identified individual/interpersonal-, community/environment-, and healthcare system-related factors affecting healthy behaviors. We also received input about Veteran's preferences and experiences with technology and setting health goals. Conclusions: Unique factors influence weight management in Veterans. Findings will inform development of a technology-assisted weight management intervention with tailored counseling and goal-setting within primary care at the VHA.

Notes from the Field: Residents’ Perceptions of Simulation-Based Skills Assessment in Obstetrics and Gynecology

Winkel, A. F., Niles, P., Lerner, V., Zabar, S., Szyld, D., & Squires, A. (2016). Evaluation and the Health Professions, 39(1), 121-125. 10.1177/0163278714563601
Abstract
Abstract
Simulation in obstetrics and gynecology (OBGYN) training captures a range of interpersonal, cognitive, and technical skills. However, trainee perspectives on simulation-based assessment remain unexplored. After an observed structured clinical examination (OSCE) simulation hybrid exam, two focus groups of residents were conducted. Analysis grounded in a thematic coding guided the qualitative research process. Responses suggest a valuation of cognitive and technical skills over interpersonal skills. Realism was seen as critical and residents perceived the assessment as more valuable for the educator than the learner. Feedback was highly valued. Resident perspectives on this exam give insight into their perceptions of simulation-based assessment as well as their conceptions of their own learning through simulations.

Nursing's opportunity within the global refugee crisis

Squires, A. (2016). International Journal of Nursing Studies, 55, 1-3. 10.1016/j.ijnurstu.2015.10.014

Seeding a profession: The intersection of the state, international interests, and the early development of Brazilian nursing

Oguisso, T., De Freitas, G. F., Squires, A., & Bonini, B. B. (2016). Cultura De Los Cuidados, 20(44), 30-50. 10.14198/cuid.2016.44.04
Abstract
Abstract
State and international entities can have profound effects on the development of a country's nursing profession. Through a global health governance lens, this paper explores the development of nursing in Brazil during the early twentieth century, and its intersections with national and international interests. Accordingly, we will show how state policies established an environment that fostered the institutionalization of nursing as a profession in Brazil and supported it as a means to increase the presence of females in nation building processes. The State focused on recruiting elite women for nursing, in part due to the Rockefeller Foundation's involvement in the country. Nurses who worked for Rockefeller came from well-educated classes within US society with specific ideas about who should be a nurse and the roles of nurses in a healthcare system. These women served as the primary vehicles for interacting with Brazilian health authorities responsible for health system development. Their early efforts did not, however, ensure a system capable of producing nursing human resources at a rate that, in present day Brazil, could meet the health needs of the country. Findings from this paper offer new avenues for historians to explore the early roots of professional nursing through a global health governance lens, improve the understanding of the intersection between international politics and professionalization, and highlight how these factors may impact nursing human resources production in the long term.

Barriers and facilitators to providing primary care-based weight management services in a patient centered medical home for Veterans: A qualitative study

Jay, M., Chintapalli, S., Squires, A., Mateo, K. F., Sherman, S. E., & Kalet, A. L. (2015). BMC Family Practice, 16(1). 10.1186/s12875-015-0383-x
Abstract
Abstract
Background: Obesity is highly prevalent among Veterans. In the United States, the Veterans Health Administration (VHA) offers a comprehensive weight management program called MOVE!. Yet, fewer than 10 % of eligible patients ever attend one MOVE! visit. The VHA has a patient-centered medical home (PCMH) model of primary care (PC) called Patient-Aligned Care Teams (PACT) at all Veterans Affairs (VA) Medical Centers. PACT teamlets conduct obesity screening, weight management counseling, and refer to MOVE!. As part of a needs assessment to improve delivery of weight management services, the purpose of this study was to assess PACT teamlet and MOVE! staff: 1) current attitudes and perceptions regarding obesity care; 2) obesity-related counseling practices 3) experiences with the MOVE! program; and 4) targets for interventions to improve implementation of obesity care in the PC setting. Methods: We recruited 25 PACT teamlet members from a single VA study site - 11 PC physicians, 5 registered nurses, 5 licensed practical nurses, 1 clerical assistant, and 3 MOVE! staff (2 dietitians, 1 psychologist) - for individual interviews using a combination of convenience and snowball sampling. Audio recorded interviews were professionally transcribed and iteratively coded by two independent reviewers. The analytic process was guided by discourse analysis in order to discover how the participants perceived and provided weight management care and what specific attitudes affected their practices, all as bounded within the organization. Results: Emerging themes included: 1) role perceptions, 2) anticipated outcomes of weight management counseling and programs, and 3) communication and information dissemination. Perceived role among PCPs was influenced by training, whereas personal experience with their own weight management impacted role perception among LPNs/RNs. Attitudes about whether or not they could impact patients' weight outcomes via counseling or referral to MOVE! varied. System-level communication about VHA priorities through electronic health records and time allocation influenced teams to prioritize referral to MOVE! over weight management counseling. Conclusion: We found a diversity of attitudes, and practices within PACT, and identified factors that can enhance the MOVE! program and inform interventions to improve weight management within primary care. Although findings are site-specific, many are supported in the literature and applicable to other VA and non-VA sites with PCMH models of care.

Building Skills in North and Central America: Barriers and Policy Options toward Harmonizing Qualifications in Nursing

Squires, A., & Beltrán-Sánchez, H. (2015). (1–). Migration Policy Institute.