Dr. Vorderstrasse is Associate Professor of Nursing with Tenure and Director of the Florence S. Downs PhD Program in Nursing Research and Theory. She received a B.S.N. from Mount Saint Mary College, a M.S.N. from Yale University School of Nursing, and a D.N.Sc. from Yale University School of Nursing.
Dr. Vorderstrasse’s research in the development and implementation of behavioral interventions for diabetes and cardiovascular disease (CVD) aims to expand preventive and self-management support for adults at risk for, or living with chronic diseases. Her contributions in chronic disease prevention have identified that genetic risk testing for chronic conditions may improve risk reduction in particular groups. She is also among the first to demonstrate that virtual environments are a feasible and effective way to provide self-management education and support to improve outcomes in diabetes and CVD. Her research has been supported with competitive funding from the Air Force Medical Sciences, NINR, NLM and NHLBI. As an expert in these areas, she has presented her work at the American Diabetes Association Scientific Sessions, American Heart Association Scientific Sessions, the International Society of Nurses in Genetics, and the American College of Preventive Medicine. She was an invited panelist for the first ANCC Advance Genetics Nursing certification portfolio. Through these presentations, consultations and research studies, she has been a thought leader for research, education and policy in nursing and the implementation of novel technologies, such as genomics and virtual environments.
Prior to joining the faculty at NYU, Dr. Vorderstrasse was Associate Professor of Nursing and Faculty Lead for Precision Health research at the Duke University School of Nursing.
Certificate NIH/NINR Summer Genetics InstituteDNSc, Yale University School of NursingMSN, Yale University School of NursingBSN, Mount Saint Mary College
Fellow, American Academy of NursingInternational Society of Nursing in GeneticsAmerican Heart Association
Psychometric properties of the Norwegian version of the short form of the Problem Areas in Diabetes scale (PAID-5): A validation studyAbstractObjectives To assess the psychometric properties of the short form of The Problem Areas in Diabetes scale (PAID-5) in Norwegian adult patients with type 1 or type 2 diabetes. Design Cross-sectional survey design. Methods Participants (n=143) were included from three Western-Norway endocrinology outpatient clinics. Demographic and clinical data were collected in addition to questionnaires concerning diabetes-related distress, fear of hypoglycaemia, symptoms of depression, emotional well-being and perception of general health. Psychometric evaluation of the PAID-5 included confirming its postulated one-factor structure using confirmatory factor analysis (CFA) and assessing convergent validity, discriminant validity, internal consistency and test-retest reliability. The retest questionnaire was sent out 35±15 days after the initial assessment to those who agreed (n=117). Results The CFA for the PAID-5 scale showed excellent one-factor structure, and there was high internal consistency (α=0.89) and good test-retest reliability (Intraclass Correlation Coefficient, ICC=0.81). The PAID-5 correlated positively with fear of hypoglycaemia (r=0.598) and depression (r=0.380) and negatively with emotional well-being (r= °'0.363) and perception of general health (r= °'0.420), thus satisfying convergent validity. Patients who had experienced episodes of serious hypoglycaemia in the past 6 months had a significantly higher PAID-5 mean score (7.5, SD=4.95) than those who had not had these episodes (5.0, SD=4.2 (p=0.043)). Conclusion The Norwegian PAID-5 was shown to be a reliable and valid short questionnaire for assessing diabetes-related distress among people with type 1 or type 2 diabetes. However, its ability to discriminate between groups needs to be tested further in larger samples. The PAID-5 scale can be a particularly valuable screening instrument in outpatient clinics, as its brevity makes it easy to use as a tool in patient-provider encounters. This short questionnaire is useful in the national diabetes registry or population cohort studies as it enables increased knowledge regarding the prevalence of diabetes-related distress.
Gender differences in the association between migration and cognitive function among older adults in China and India
Migration and cognitive function: a conceptual framework for Global Health ResearchXu, H., Vorderstrasse, A., McConnell, E. S., Dupre, M. E., Østbye, T., & Wu, B. (2018). Global Health Research and Policy.
Participation of Racial and Ethnic Minorities in Technology-Based Interventions to Self-Manage Type 2 Diabetes: A Scoping ReviewAbstractPurpose: Strategies to decrease societal and cultural barriers for ethnic minorities to participate in health research are well established. However, limited data are available regarding participation of ethnic minorities in mobile and Internet technology–based interventions to self-manage type 2 diabetes where health disparities are predominant. Thus, the purpose was to understand the participation of ethnic minorities in technology-based intervention programs to manage type 2 diabetes. Design/Method: A scoping review was used to review a total of 21 intervention studies containing participant information about ethnic minorities and one qualitative study discussing participation of ethnic minorities. Findings: There was limited enrollment and participation of ethnic minorities. Technological barriers in addition to existing societal and cultural barriers were identified. Strategies to decrease the barriers were recommended. Conclusions: Technological barriers were identified on top of the societal and cultural barriers in traditional interventions. Further research to reduce the barriers is warranted.
Place of Residence and Cognitive Function among the Adult Population in IndiaAbstractBackground: The place of residence has been linked to cognitive function among adults in developed countries. This study examined how urban and rural residence was associated with cognitive function among adults in India. Methods: The World Health Organization Study on Global AGEing and Adult Health data was used to examine cognition among 6,244 community-residing adults age 50+ in 6 states in India. Residential status was categorized as urban, rural, urban-to-urban, rural-to-urban, rural-to-rural, and urban-to-rural. Cognition was assessed by immediate and delayed recall tests, digit span test, and verbal fluency test. Multilevel models were used to account for state-level differences and adjusted for individual-level sociodemographic, psychosocial, and health-related factors. Results: Urban residents and urban-to-urban migrants had the highest levels of cognition, whereas rural residents and those who migrated to (or within) rural areas had the lowest cognition. The differences largely persisted after adjustment for multiple covariates; however, rural-to-urban migrants had no difference in cognition from urban residents once socioeconomic factors were taken into account. Conclusion: Cognition among adults in India differed significantly according to their current and past place of residence. Socioeconomic factors played an important role in the cognitive function of adults in urban areas.
Polygenic signal for symptom dimensions and cognitive performance in patients with chronic schizophreniaAbstractGenetic etiology of psychopathology symptoms and cognitive performance in schizophrenia is supported by candidate gene and polygenic risk score (PRS) association studies. Such associations are reported to be dependent on several factors - sample characteristics, illness phase, illness severity etc. We aimed to examine if schizophrenia PRS predicted psychopathology symptoms and cognitive performance in patients with chronic schizophrenia. We also examined if schizophrenia associated autosomal loci were associated with specific symptoms or cognitive domains. Case-only analysis using data from the Clinical Antipsychotics Trials of Intervention Effectiveness-Schizophrenia trials (n = 730). PRS was constructed using Psychiatric Genomics Consortium (PGC) leave one out genome wide association analysis as the discovery data set. For candidate region analysis, we selected 105-schizophrenia associated autosomal loci from the PGC study. We found a significant effect of PRS on positive symptoms at p-threshold (PT) of 0.5 (R2 = 0.007, p = 0.029, empirical p = 0.029) and negative symptoms at PT of 1e-07 (R2 = 0.005, p = 0.047, empirical p = 0.048). For models that additionally controlled for neurocognition, best fit PRS predicted positive (p-threshold 0.01, R2 = 0.007, p = 0.013, empirical p = 0.167) and negative symptoms (p-threshold 0.1, R2 = 0.012, p = 0.004, empirical p = 0.329). No associations were seen for overall neurocognitive and social cognitive performance tests. Post-hoc analyses revealed that PRS predicted working memory and vigilance performance but did not survive correction. No candidate regions that survived multiple testing corrections were associated with either symptoms or cognitive performance. Our findings point to potentially distinct pathogenic mechanisms for schizophrenia symptoms.
Residential Mobility and Cognitive Function Among Middle-Aged and Older Adults in ChinaAbstractObjectives: To assess the association between rural and urban residential mobility and cognitive function among middle-aged and older adults in China. Method: We used data from the World Health Organization Study on global AGEing and adult health that included adults age 50+ from China (N = 12,410). We used multivariate linear regressions to examine how residential mobility and age at migration were associated with cognitive function. Results: Urban and urban-to-urban residents had the highest level of cognitive function, whereas rural and rural-to-rural residents had the poorest cognitive function. Persons who migrated to/within rural areas before age 20 had poorer cognitive function than those who migrated during later adulthood. Socioeconomic factors played a major role in accounting for the disparities in cognition; however, the association remained significant after inclusion of all covariates. Discussion: Residential mobility and age at migration have significant implications for cognitive function among middle-aged and older adults in China.
Type 2 Diabetes Education and Support in a Virtual Environment: A Secondary Analysis of Synchronously Exchanged Social Interaction and SupportAbstractBACKGROUND: Virtual environments (VEs) facilitate interaction and support among individuals with chronic illness, yet the characteristics of these VE interactions remain unknown. OBJECTIVE: The objective of this study was to describe social interaction and support among individuals with type 2 diabetes (T2D) who interacted in a VE. METHODS: Data included VE-mediated synchronous conversations and text-chat and asynchronous emails and discussion board posts from a study that facilitated interaction among individuals with T2D and diabetes educators (N=24) in 2 types of sessions: education and support. RESULTS: VE interactions consisted of communication techniques (how individuals interact in the VE), expressions of self-management (T2D-related topics), depth (personalization of topics), and breadth (number of topics discussed). Individuals exchanged support more often in the education (723/1170, 61.79%) than in the support (406/1170, 34.70%) sessions or outside session time (41/1170, 3.50%). Of all support exchanges, 535/1170 (45.73%) were informational, 377/1170 (32.22%) were emotional, 217/1170 (18.55%) were appraisal, and 41/1170 (3.50%) were instrumental. When comparing session types, education sessions predominately provided informational support (357/723, 49.4%), and the support sessions predominately provided emotional (159/406, 39.2%) and informational (159/406, 39.2%) support. CONCLUSIONS: VE-mediated interactions resemble those in face-to-face environments, as individuals in VEs engage in bidirectional exchanges with others to obtain self-management education and support. Similar to face-to-face environments, individuals in the VE revealed personal information, sought information, and exchanged support during the moderated education sessions and unstructured support sessions. With this versatility, VEs are able to contribute substantially to support for those with diabetes and, very likely, other chronic diseases.
Analyzing Unstructured Communication in a Computer-Mediated Environment for Adults With Type 2 Diabetes:: A Research Protocol PMID: 28438726
Creating a sustainable collaborative consumer health application for chronic disease self-managementAbstractAs the prevalence of chronic diseases increase, there is a need for consumer-centric health informatics applications that assist individuals with disease self-management skills. However, due to the cost of development of these applications, there is also a need to build a disease agnostic architecture so that they could be reused for any chronic disease. This paper describes the architecture of a collaborative virtual environment (VE) platform, LIVE