Bei Wu

Dr. Wu is Dean’s Professor in Global Health and Vice Dean for Research at the NYU Rory Meyers College of Nursing. She is an inaugural Co-Director of the NYU Aging Incubator. Prior to joining NYU, she was the Pauline Gratz Professor of Nursing at Duke University School of Nursing. Prof. Wu is an internationally-known leader in gerontology.

As a principal investigator, Prof. Wu has led numerous projects supported by federal agencies and private foundations, including the NIH and CDC. She is currently leading several NIH-funded projects including a clinical trial to improve oral health for persons

with cognitive impairment, and a large secondary data analysis to examine how the co-occurrence of diabetes and poor oral health may lead to the development of dementia and cognitive decline. She co-leads the newly funded Rutgers-NYU Center for Asian Health Promotion and Equity. Through this center, she also leads a 5-year intervention study that focuses on supporting Chinese and Korean dementia caregivers who are at increased risk for high blood pressure and diabetes due to the physical and emotional demands of caregiving. She is a director of the Research and Education Core for the NIA-funded Asian Resource Center for Minority Aging Research (RCMAR).

As a scholar, Prof. Wu is an internationally known leader in gerontology. Her scholarship has been distinguished by interdisciplinary collaborations with researchers in various disciplines, including nursing and dentistry, in the US and abroad. Her research areas cover a wide range of topics related to aging and global health, including oral health, long-term care, dementia, and caregiving. She is one of the first in the nation to study the linkages between oral health and cognitive decline in older adults. Her research has also addressed knowledge gaps in the linkages between oral health and diabetes.

Prof. Wu has devoted much of her time to training the next generation of aging and nursing scientists from dozens of academic institutions in the U.S. and abroad. She has mentored hundreds of faculty members, visiting scholars, and students from various disciplines, including nursing, gerontology, dentistry, medicine, social work, demography, public health, sociology, public policy, geography, and economics. She is successful in mentoring several dozens of early-stage faculty members in receiving competitive funding from NIH, Robert Wood Johnson Scholars, the Alzheimer’s Society (UK), National Science Foundation of China, China Medical Board, National Medical Research Council (Singapore), and many others.

Prof. Wu is a productive researcher. She has published more than 600 peer-reviewed papers, books, reports, and conference abstracts. Her extensive publications cover a wide range of topics related to aging and global health. She has delivered presentations at hundreds of conferences as an invited speaker. Her work has been widely recognized in the field. Research findings from her team have been featured by the National Institute on Aging, and in numerous media outlets, including the New York Times, CNN, BBC, U.S. News and World Report, MarketWatch, CBS News, Reuters, AARP Bulletin, China Daily, Daily Mail, South China Morning Post, and Financial Review.

Her achievement has been recognized by many international and national organizations and she is a fellow of the Gerontological Society of America, the Association for Gerontology in Higher Education, and the New York Academy of Medicine. She is an honorary member of the Honor Society of Nursing, Sigma Theta Tau International, and is the former president of the Geriatric Oral Research Group of the International Association for Dental Research. She has served on a number of NIH review panels and is a frequent reviewer for multiple international funding agencies. She was honored as the 2017 IADR Distinguished Scientist in Geriatric Oral Research. She is the recipient of the 2022 Wei Hu Inspiration Award from the China Health Policy and Management Society.

PhD - Gerontology Center, University of Massachusetts, Boston

MS - Gerontology Center, University of Massachusetts, Boston

BS - Shanghai University

Gerontology

Global

Honorary Member, Sigma Theta Tau International - Honor Society of Nursing

Distinguished Scientist Award for Geriatric Oral Research, International Association for Dental Research (2017)

Pauline Gratz Professorship, Duke University School of Nursing (2014)

J. Morita Junior Investigator Award in Geriatric Oral Health, International Association for Dental Research (2007)

Fellow, Gerontological Society of America

Fellow, New York Academy of Medicine

Fellow, Association for Gerontology in Higher Education

Effects of a symptom management intervention based on group sessions combined with a mobile health application for persons living with HIV in China: A randomized controlled trial

Han, S., Pei, Y., Zhao, R., Hu, Y., Zhang, L., Qi, X., Zhu, Z., Sun, W., & Wu, B. (2021). International Journal of Nursing Sciences, 8(4), 370-379. 10.1016/j.ijnss.2021.07.002

Abstract

Abstract

Objective: This study aims to evaluate the effects of a symptom management intervention (SMI) based on symptom management group sessions combined with a mobile health (mHealth) application (app) on the knowledge of symptom management, the certainty of symptom self-management, symptom severity, symptom distress, medication adherence, social support, and quality of life among persons living with HIV (PLWH) in China. Methods: A parallel randomized controlled trial with 61 PLWH was conducted in Shanghai, China. The participants in the control group (n = 30) downloaded the Symptom Management (SM) app according to their needs and preferences, and received routine follow-ups. The participants in the intervention group (n = 31) were guided to download and use the SM app, and received four tailored weekly group sessions at routine follow-ups. Each group session lasted for approximately 2 h and targeted one of the major modules of the SM app. All the outcomes were assessed at baseline and post-intervention. The study was registered with the Chinese Clinical Trial Registry (ChiCTR1900024821). Results: The symptom management knowledge and certainty of symptom self-management were significantly improved after the intervention (all P < 0.01). Compared with the control group, the scores of symptoms reasons knowledge score improved 11.47 points (95% CI: 3.41, 19.53) and scores of symptoms self-management knowledge score improved 12.80 points (95% CI: 4.55, 21.05) in the intervention group after controlling for covariates. However, other outcomes did not show statistically significant differences between the intervention group and the control group (P > 0.05). Conclusion: The SMI could improve PLWH's symptom management knowledge and certainty of symptom self-management. Multi-center studies with larger sample sizes and longer follow-ups are needed to further understand the effects of SM app on ameliorating symptom severity and symptom distress. More innovative strategies are also needed to promote and maintain the sustainability of the SM app.

Effects of the Co-occurrence of Diabetes Mellitus and Tooth Loss on Cognitive Function

Luo, H., Tan, C., Adhikari, S., Plassman, B. L., Kamer, A. R., Sloan, F. A., Schwartz, M. D., Qi, X., & Wu, B. (2021). Current Alzheimer Research, 18(13), 1023-1031. 10.2174/1567205019666211223093057

Abstract

Abstract

Objective: Both diabetes mellitus (DM) and poor oral health are common chronic conditions and risk factors of Alzheimer’s disease and related dementia among older adults. This study assessed the effects of DM and complete tooth loss (TL) on cognitive function, accounting for their interactions. Methods: Longitudinal data were obtained from the 2006, 2012, and 2018 waves of the Health and Retirement Study. This cohort study included 7,805 respondents aged 65 years or older with 18,331 person-year observations. DM and complete TL were self-reported. Cognitive function was measured by the Telephone Interview for Cognitive Status. Random-effect regressions were used to test the associations, overall and stratified by sex. Results: Compared with older adults without neither DM nor complete TL, those with both conditions (b =-1.35, 95% confidence interval [CI]:-1.68,-1.02), with complete TL alone (b =-0.67, 95% CI:-0.88,-0.45), or with DM alone (b =-0.40, 95% CI:-0.59,-0.22), had lower cognitive scores. The impact of having both conditions was significantly greater than that of having DM alone (p < .001) or complete TL alone (p = 0.001). Sex-stratified analyses showed the effects were similar in males and females, except having DM alone was not significant in males. Conclusion: The co-occurrence of DM and complete TL poses an additive risk for cognition. Healthcare and family-care providers should pay attention to the cognitive health of patients with both DM and complete TL. Continued efforts are needed to improve older adults’ access to dental care, especially for individuals with DM.

Evaluating the Quality of Home Care in China Using the Home Care Quality Assessment Tool

Tang, X., Ge, S., Ma, C., Chen, X., Pei, Y., Zhou, L., & Wu, B. (2021). Journal of Transcultural Nursing, 32(2), 173-179. 10.1177/1043659620953191

Abstract

Abstract

Introduction: This study aimed to evaluate the quality of home care in China using the Home Care Quality Assessment Tool (HCQuAT). Method: We recruited 38 home health agencies in Shanghai, China, which included 18 in urban areas, 11 in suburban areas, and nine in rural areas. Data on quality of home care from each agency were collected by trained staff using the HCQuAT. Results: On average, these home health agencies scored 74.28/100.00 (SD = 6.80) on the HCQuAT, with an excellence rate of 39.5% and a failing rate of 23.7%. The mean scores on the structure quality module, process quality module, and outcome quality module were 71.2 ± 21.8, 86.6 ± 9.2, and 44.1 ± 37.5, respectively. Significant differences existed across geographic locations (p =.018). Discussion: Significant variations were identified in the quality of home care across quality modules and geographic locations. Outcome quality and quality in rural areas were lower than those for their counterparts.

Immigration and Oral Health in Older Adults: An Integrative Approach

Wu, B., Mao, W., Qi, X., & Pei, Y. (2021). Journal of Dental Research, 100(7), 686-692. 10.1177/0022034521990649

Abstract

Abstract

The aim of this study was to develop an integrative framework on aging, immigration, and oral health. The methodology was a critical review that used immigration as a social determinant framework through which to evaluate its impact on the oral health of older immigrants. We reviewed recent empirical evidence on factors related to oral health in older immigrants. In a systematic search across multiple databases, we identified 12 eligible studies in this review. Among the eligible studies, most were conducted among East Asian immigrants (8 articles), followed by non-Hispanic White/European origin (2 articles), Mexican origins (1 article), and Iran and other Middle East regions (1 article). The research revealed knowledge gaps in the evidence base, including the dynamic relationship between acculturation and oral health, the role of environmental factors on oral health for immigrants, psychosocial stressors and their relationship with oral health, and oral health literacy, norms, and attitude to dental care utilization and oral hygiene practices. The development of the integrative framework suggests the pathways/mechanisms through which immigration exerts influences on oral health in later life. This provides opportunities for researchers, practitioners, and policy makers to gain greater insights into the complex associations between immigration and oral health among older adults.

Perceived discrimination and mental health symptoms among persons living with HIV in China: the mediating role of social isolation and loneliness

Han, S., Hu, Y., Wang, L., Pei, Y., Zhu, Z., Qi, X., & Wu, B. (2021). AIDS Care - Psychological and Socio-Medical Aspects of AIDS HIV, 33(5), 575-584. 10.1080/09540121.2020.1847246

Abstract

Abstract

Perceived discrimination is significantly associated with mental health symptoms among persons living with HIV (PLWH). However, little is known about the factors mediating this relationship. We aimed to examine the mediating role of social isolation and loneliness in the association between perceived discrimination and mental health symptoms among PLWH. A multicenter (Shanghai, Kunming, Nanning, Hengyang, and Changning in China) cross-sectional study was conducted in 2017. Data from 883 PLWH were used for statistical analysis. Perceived discrimination, mental health symptoms, loneliness and social isolation were assessed through self-report questionnaires. Structural equation modeling (SEM) showed a satisfactory model fit (CMIN/DF = 2.676, GFI = 0.998, CFI = 0.997, NFI = 0.995, TLI = 0.985, RMSEA = 0.044 [0.000, 0.090]) and a significant total indirect effect (β = 0.058, SE = 0.009, Z = 6.444, p < 0.01). Both loneliness (β = 0.042, SE = 0.008, Z = −5.250, p < 0.01) and social isolation (β = 0.016, SE = 0.004, Z = −4.000, p < 0.01) were determined to be significant mediators of the association between perceived discrimination and mental health symptoms. Interventions that combat loneliness and social isolation may help ameliorate the adverse consequences of perceived discrimination on mental health.

Perceived Discrimination and Symptoms of Cognitive Dysfuntion among Middle-Age and Older Persons Living with HIV in China: A Multicenter Cross-Sectional Study of the Mediating Role of Mental Health Symptoms and Social Isolation

Han, S., Hu, Y., Wang, L., Pei, Y., Zhu, Z., Qi, X., & Wu, B. (2021). Journal of the Association of Nurses in AIDS Care, 32(4), 442-452. 10.1097/JNC.0000000000000264

Abstract

Abstract

Perceived discrimination is associated with symptoms of cognitive dysfunction (SOCD) among middle-age and older persons living with HIV (PLWH). We aimed to explore how the association between perceived discrimination and SOCD was mediated by mental health symptoms and social isolation. The sample included 321 PLWH, ages 45 years and older, for a multicenter cross-sectional study. Structural equation modeling showed an acceptable model fit and a significant total indirect effect between perceived discrimination and SOCD. All three indirect effect pathways were significant, suggesting that perceived discrimination could influence SOCD through mental health symptoms, through social isolation, or through mental health symptoms and then social isolation. Our study demonstrates that perceived discrimination is a concern for the management of cognitive function among middle-age and older PLWH. Both mental health symptoms and social isolation are critical elements in the design and evaluation of interventions for promoting cognitive health.

Sleep satisfaction and cognitive complaints in Chinese middle-aged and older persons living with HIV: the mediating role of anxiety and fatigue

Han, S., Hu, Y., Pei, Y., Zhu, Z., Qi, X., & Wu, B. (2021). AIDS Care - Psychological and Socio-Medical Aspects of AIDS HIV, 33(7), 929-937. 10.1080/09540121.2020.1844861

Abstract

Abstract

Middle-aged and older persons living with HIV (PLWH) suffer from sleep distress and cognitive disorders due to HIV infection and aging. We aim to explore the relationship between sleep satisfaction and cognitive complaints, and the mediating role of anxiety and fatigue in this relationship among middle-aged and older PLWH. We used data from a multicenter cross-sectional study in China (Shanghai, Kunming, Nanning, Hengyang, and Changning) conducted in 2017. The data analysis included 435 PLWH aged 45 years and over. Multiple linear regression models showed that worse sleep satisfaction was significantly associated with lower cognitive complaints after controlling for anxiety, fatigue, demographic variables, and clinical variables (β = −0.246, p < 0.01). Both anxiety and fatigue were significant partial mediators in the relationship between sleep satisfaction and cognitive complaints. The serial multiple mediation models of sleep satisfaction–anxiety (M1)–fatigue (M2)–cognitive complaints were supported and the alternative model of sleep satisfaction–fatigue (M2)–anxiety (M1)–cognitive complaints were both supported. Our study indicates that it is important to improve sleep quality to promote cognitive function among Chinese middle-aged and older PLWH. Prevention and treatment programs for sleep satisfaction and cognitive function should include the assessment and reduction of fatigue and anxiety.

Urban-Rural Disparities in Dental Services Utilization Among Adults in China’s Megacities

Qi, X., Qu, X., & Wu, B. (2021). Frontiers in Oral Health, 2. 10.3389/froh.2021.673296

Abstract

Abstract

Objective: China’s dental care system is bifurcated between urban and rural areas. However, very few studies have examined the dental services utilization inequities in China’smegacities, particularly in these urban and rural areas. This study aims to examine the urban-rural disparities in dental services utilization among adults living in China’s megacities based on the Andersen dental services utilization model. Methods: This study used data from 4,049 residents aged 18–65 who participated in the “2019 New Era and Living Conditions in Megacities Survey.” Multivariate logistic regressions were employed to examine the associations between place of residence and dental services utilization for individuals from ten megacities in China. Predisposing variables (age, gender, marital status, living arrangement, and education), enabling variables (socioeconomic status, occupational status, income, insurance coverage, health attitude, and health behavior), and need variables (self-rated health, oral health status, gum bleeding) were controlled for. Results: The mean age of the 4,049 adults was 45.2 (standard deviation = 13.0), and 30.4% (n = 1,232) had no dental visits at all. Adults who resided in urban areas were more likely to use dental services [odds ratio (OR) = 1.57, 95% confidence interval (CI) = 1.30 to 1.91] than those residing in rural areas after controlling for key covariates. Factors associated with higher odds of visiting dentists include having a higher income (OR = 1.44, P < 0.001), higher education level (OR = 1.53, P = 0.042), being covered by insurance for urban residents/employees (OR = 1.49, P = 0.031), having a positive attitude toward healthy diets (OR = 1.43, P < 0.001), attending regular physical examination (OR = 1.66, P < 0.001), having more tooth loss (OR = 1.05, P < 0.001), and having frequent gum bleeding (OR = 2.29, P < 0.001). Conclusion: The findings confirm that place of residence is associated with dental services utilization while adjusting for key covariates. Despite rapid economic development in China, many adults had never visited dentists at all. More efforts should be taken to encourage widespread dental care, such as providing more dental coverage and better access to dental care services.

Where Are We and What Shall We Do Next? A Qualitative Study of the Quality of Home Care in Shanghai, China

Tang, X., Chen, X., Wu, B., Ma, C., Ge, S., Sun, H., & Zhou, L. (2021). Journal of Transcultural Nursing, 32(3), 276-285. 10.1177/1043659620911965

Abstract

Abstract

Introduction: With the increasing need for home care in Shanghai, China, it is crucial to ensure its quality. This study aimed to explore quality-related issues of home care in Shanghai, China, and identify strategies for improvement. Method: This is a descriptive qualitative study. Semistructured interviews were conducted among 27 individuals, including home care managers (n = 8), nurses (n = 10), and patients and/or their caregivers (n = 9). Colaizzi’s seven-step analysis method was used to guide data analysis. Results: Three themes emerged regarding the quality of home care in China: unsatisfactory structure quality, unsatisfactory process quality, and imperfect outcome quality evaluation system. Recommended strategies for quality improvement included issuing standards for home care evaluation, refining structure quality and process quality, and establishing an outcome quality evaluation system. Conclusions: Concerns about the quality of home care in China were identified by providers and patients. More research especially studies quantifying the care quality and its influencing factors are needed.

Disparities in dental service utilization among adults in chinese megacities: Do health insurance and city of residence matter?

Qu, X., Qi, X., & Wu, B. (2020). International Journal of Environmental Research and Public Health, 17(18), 1-13. 10.3390/ijerph17186851

Abstract

Abstract

The aims of the study were to present the prevalence of dental service utilization among adults (age between 18 and 65) in Chinese megacities and to examine the associations of health insurance and city of residence with dental visits. This study was a cross-sectional analysis of the 2019 New Era and Living Conditions in Megacities Survey data with a sample of 4835 participants aged 18–65 from 10 different megacities in China. The data including gross domestic product (GDP) per capita of each megacity obtained from the National Bureau of Statistics of China as a city-level characteristic. After adjusting sampling weights, approximately 24.28% of the participants had at least one dental visit per year. Findings from multilevel mixed-effects linear models showed that participants residing in megacities with higher GDP per capita (β = 0.07, p < 0.001) who had Urban Employee Basic Medical Insurance (β = 0.25, p < 0.001) or Urban Resident Basic Medical Insurance (β = 0.19, p < 0.01) had more frequent dental visits after adjusting demographic characteristics, socioeconomic status, health status, health behavior and attitude, and oral health indicators. Margins post-estimation model results demonstrated disparities in the predicted probability of having never visited a dentist by types of health insurance and city of residence. In conclusion, the prevalence of dental visits in China was found to be low. This study highlights socioeconomic inequalities in dental service utilization. There is a great need to develop more dental care programs and services and expand health insurance to cover dental care in China.