Chenjuan Ma

Faculty

Chenjuan Ma headshot

Chenjuan Ma

PhD

Assistant Professor

1 212 992 7173
Accepting PhD students

Chenjuan Ma's additional information

Chenjuan Ma is an assistant professor and health services researcher at NYU Rory Meyers College of Nursing. Her program of research focuses on understanding how to optimize nursing care and patient safety and outcomes across settings with a particular focus of home healthcare and vulnerable populations (e.g., persons with dementia and minorities). Her research utilizes theories and methodologies from various disciplines, including but not limited to nursing, sociology, medicine, statistics and data science. Ma also has expertise in large data and quantitative methods. She is currently working on a project with the National Institute on Aging titled Racial/Ethnic Disparities in Home Health Care for Persons with Alzheimer’s Disease and Related Dementias.

Prior to joining the NYU Rory Meyers faculty, Prof. Ma was a postdoctoral fellow in the National Database of Nursing Quality Indicators at the University of Kansas.

Prof. Ma holds a PhD from University of Pennsylvania and MSN and BSN from Xi'an Jiaotong University, China.

PhD - University of Pennsylvania (2012)
MSN - Xi'an Jiaotong University, China (2008)
BSN - Xi'an Jiaotong University, China (2005)

Nursing workforce
Home care
Health Policy
Research methods
Health Services Research

AcademyHealth
American Nurses Association (ANA)
Eastern Nursing Research Society (ENRS)
Sigma Theta Tau International Honor Society of Nursing (STTI)

Faculty Honors Awards

Vivian G. Prins Global Scholar, New York University (2021)
Vivian G. Prins Global Scholar, New York University (2020)
New Investigator Award, Interdisciplinary Research Group of Nursing Issues (IRGNI), Academy Health (2020)
Scholarship, Columbia University Epidemiology and Population Health (2019)
Fellowship, NYU CTSI Mentor Development Program (2018)
Rising Star, Sigma Theta Tau International Honor Society of Nursing Xi Chapter (2011)
President Gutmann Leadership Award for Travel, University of Pennsylvania (2011)
ThinkSwiss Award, University of Basel, Switzerland (2011)

Publications

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.

Continuity of Nursing Care in Home Health: Impact on Rehospitalization among Older Adults with Dementia

Ma, C., McDonald, M. V., Feldman, P. H., Miner, S., Jones, S., & Squires, A. (2021). Medical Care, 59(10), 913-920. 10.1097/MLR.0000000000001599
Abstract
Abstract
Background: Home health care (HHC) is a leading form of home and community-based services for persons with dementia (PWD). Nurses are the primary providers of HHC; however, little is known of nursing care delivery and quality. Objective: The objective of this study was to examine the association between continuity of nursing care in HHC and rehospitalization among PWD. Research Design: This is a retrospective cohort study using multiple years (2010-2015) of HHC assessment, administrative, and human resources data from a large urban not-for-profit home health agency. Subjects: This study included 23,886 PWD receiving HHC following a hospitalization. Measures: Continuity of nursing care was calculated using the Bice and Boxerman method, which considered the number of total visits, nurses, and visits from each nurse during an HHC episode. The outcome was all-cause rehospitalization during HHC. Risk-Adjusted logistic regression was used for analysis. Results: Approximately 24% of PWD were rehospitalized. The mean continuity of nursing care score was 0.56 (SD=0.33). Eight percent of PWD received each nursing visit from a different nurse (no continuity), and 26% received all visits from one nurse during an HHC episode (full continuity). Compared with those receiving high continuity of nursing care (third tertile), PWD receiving low (first tertile) or moderate (second tertile) continuity of nursing care had an adjusted odds ratio of 1.33 (95% confidence interval: 1.25-1.46) and 1.30 (95% confidence interval: 1.22-1.43), respectively, for being rehospitalized. Conclusions: Wide variations exist in continuity of nursing care to PWD. Consistency in nurse staff when providing HHC visits to PWD is critical for preventing rehospitalizations.

Does psychosocial support buffer the effect of COVID-19 related stressors on mental health among Chinese during quarantine?

Failed retrieving data.

Effect of social participation on the development of physical frailty: Do type, frequency and diversity matter?

Failed retrieving data.

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.

Prevalence and risk factors of the co-occurrence of physical frailty and cognitive impairment in Chinese community-dwelling older adults

Xie, B., Ma, C., Chen, Y., & Wang, J. (2021). Health and Social Care in the Community, 29(1), 294-303. 10.1111/hsc.13092
Abstract
Abstract
This cross-sectional study aimed to determine the prevalence of the co-occurrence of physical frailty and cognitive impairment and to identify its associated demographic, psychosocial and behavioural factors. Participants were recruited from 32 neighbourhoods using multistage sampling method in Xuhui District, Shanghai, China. A total of 1585 older adults were included who lived in community, were 75 years or older and without a clinical diagnosis of dementia. Based on the presences of frailty (using the modified frailty phenotype criteria) and/or cognitive impairment (using Chinese version Mini-Mental Status Examination stratified by educational level), the participants were classified into four groups: normal, cognitive impairment alone, frailty alone and co-occurrence. Multinomial logistic regression analyses were conducted to identify the demographic, psychosocial (depression, social participation and social support) and behavioural (sedentary lifestyle and sleep problems) characteristics associated with the co-occurrence of physical frailty and cognitive impairment. The prevalence of frailty alone, cognitive impairment alone and the co-occurrence of physical frailty and cognitive impairment in the study sample were 7%, 26.94% and 7.19% respectively. The results of multinomial logistic regression show the following characteristics significantly associated with the co-occurrence of physical frailty and cognitive impairment: advanced age (81–85 years old, Odds Ratio, OR = 1.99, 95% CI = 1.10–3.59; 86 years or older, OR = 6.43, 95% CI = 3.66–11.29), number of co-morbidities (OR = 1.34, 95% CI = 1.01–1.77), depression (OR = 3.88, 95% CI = 2.39–6.29), social participation (OR = 0.61, 95% CI = 0.39–0.96), sedentary lifestyle (OR = 2.69, 95% CI = 1.66–4.34) and sleep problems (insomnia occasionally, OR = 1.84, 95% CI = 1.07–3.17; insomnia every day, OR = 2.38, 95% CI = 1.33–4.26). The co-occurrence of physical frailty and cognitive impairment is a prevalent health issue in oldest old community-dwelling older adults. Advanced age, co-morbidity, depression, sedentary lifestyle and sleep problems are risk factors for cognitive frailty while good social participation may have a protective effect on it.

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.

Extended afternoon naps are associated with hypertension in women but not in men

Yang, Y., Liu, W., Ji, X., Ma, C., Wang, X., Li, K., & Li, J. (2020). Heart and Lung, 49(1), 2-9. 10.1016/j.hrtlng.2019.09.002
Abstract
Abstract
Background: The impact of afternoon napping duration on the risk of hypertension has not been well established, particularly with regards to sex and age differences. Objective: To examine the association between afternoon napping duration and hypertension stratified by sex and age among Chinese adults over 45 years of age. Methods: The 2011–2012 survey of the China Health and Retirement Longitudinal Study (CHARLS) was used, including 7,980 participants. We conducted logistic regression models in the overall sample, and then stratified by sex and age groups. Results: Middle-aged and older women who napped over 90 min were 39% and 54% more likely to have hypertension, respectively; however, the associations were not significant in middle-aged and older men. Conclusion: Extended afternoon napping (≥90 min) was associated with hypertension in both the middle-aged women and older women but not in men. Future studies are needed to further examine the association and possible mechanisms.

Factors Associated with Timely Initiation and Intensity of Home Health Care Following Hospital Discharge

Ma, C., Thorpe, L., Han, B., Yi, S. S., Kwon, S. C., & Squires, A. (2020). Nursing Research.

Independent and combined relationships of perceived neighborhood social cohesion and physical frailty on functional disability in community-dwelling older adults

Xie, B., Ma, C., & Wang, J. (2020). International Journal of Environmental Research and Public Health, 17(16), 1-12. 10.3390/ijerph17165912
Abstract
Abstract
Functional disability and physical frailty (PF) are debilitating geriatric conditions. Previous studies have suggested both perceived neighborhood social cohesion (PNSC) and PF can influence functional disability and may have an interactive effect too. This cross-sectional study aims to examine the independent and combined relationships of PF and PNSC on functional disability in community-dwelling older adults in Shanghai, China. A total of 1616 older adults aged 75 years were recruited using multistage sampling. Results showed that prefrailty, frailty (using the modified frailty phenotype criteria), and low PNSC (measured by the Neighborhood Cohesion Scale) were independently associated with increased likelihood of functional disability after adjustment of covariates. To evaluate the combined relationships of PF and PNSC, participants were classified into six groups based on their levels of PF and PNSC. The probability of frail older adults with low PNSC having functional disability stood out compared with the robust older adults with high PNSC. Our findings suggest the importance of high PNSC as a protective factor of maintaining functional ability. Future longitudinal studies are needed to identify the role of PNSC in the development of functional disability among frail older adults.