Chenjuan Ma


Chenjuan Ma headshot

Chenjuan Ma


Assistant Professor

1 212 992 7173

433 First Avenue
New York, NY 10010
United States

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 research, which focuses on understanding how to optimize nursing care and patient outcomes, particularly in the home healthcare setting, utilizes theories and methodologies from different disciplines, including but not limited to sociology, statistics, medicine, and nursing. Ma also has expertise in large data sets and quantitative methods.

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

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

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)


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

Wang, Y., Ariyo, T., Liu, H., & Ma, C. (2021). Current Psychology. 10.1007/s12144-021-01663-1
The effect of the COVID-19 related stressors on the mental health of both infected patients and the general public has been well established. However, knowledge is limited on how psychosocial support buffers the association. This study aimed to examine this buffering role in the context of China. We utilized cross-sectional data collected online in mid-March 2020, involving 585 respondents. Mental health status was determined through depression symptoms and loneliness. COVID-19 related stressors include three aspects: perceived severity, perceived threat to life and health, and perceived risk of COVID-19 infection. Psychosocial support included family and social supports. Analyses include ordinary linear regression. The finding showed that psychosocial support buffered the negative effect of loneliness in the context of perceived severity of COVID-19, but appeared to intensify the negative effect of depression symptoms in the context of perceived threat to life and health. However, there was no significant buffering effect on depression or loneliness in the context of the perceived risk of infection. The buffering effect of psychosocial support on COVID-19 related stressors is of mixed patterns. This study contributes to the emerging body of literature trying to understand how the COVID-19 impacts the mental health of individuals.

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
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
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
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
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
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.

Non-Medical prescribing policies: A global scoping review

Ecker, S., Joshi, R., Shanthosh, J., Ma, C., & Webster, R. (2020). Health Policy, 124(7), 721-726. 10.1016/j.healthpol.2020.04.015
Background: Authorizing health care providers other than physicians to prescribe medicines (i.e., non-medical prescribing, NMP) has been used to improve access to healthcare in many countries. This paper aimed to identify the scope of policies facilitating NMP worldwide and investigate the relationship of such policies with a country's physician to population ratio and economic status. Methods: A hierarchical search strategy was used. First, we compiled a list of countries and territories (n = 216) based upon World Bank record. Then, we collected relevant information for each country by using country name combined with key terms in PubMed, Google, and World Health Organization (WHO) country pharmaceutical profiles. Countries’ socio-economic status and physician to population ratio were determined using data from the World Bank. Results: Legislation allowing NMP was found for 117 of 216 (54%) countries and territories. The most prevalent policy identified was that of autonomous prescribing authority (59%). Countries with low or high incomes and those with low or high physician to population ratios (<1/1000 or >3/1000) had the highest concentration of policies for NMP rights. Conclusion: Despite the varied scope of relevant policies, NMP has been implemented in countries of varied income levels and physician to population ratios. Future research is warranted to empirically examine its impact on access to care.

Risk factors for infection in home health care: Analysis of national Outcome and Assessment Information Set data

Shang, J., Wang, J., Adams, V., & Ma, C. (2020). Research in Nursing and Health, 43(4), 373-386. 10.1002/nur.22053
Patients in home health care (HHC), a rapidly growing healthcare sector, are at high risk for infections. This study aimed to identify risk factors for infections among HHC patients using the Outcome and Assessment Information Set (OASIS) data. We used a 5% random sample of the 2013 national OASIS data. Infections were identified if records indicated that patients were hospitalized or received emergency care for one of three types of infections (respiratory, wound site, and urinary tract infection). Multivariate logistic regression models were used to identify risk factors for each individual infection type. The final analysis included 128,163 patients from 8,255 HHC agencies nationwide. Approximately 3.2% of the patients developed infections during their HHC stay that led to hospitalization or emergency care treatment. We found that associations between demographics and infection risk are specific to the type of infection. In general, a history of multiple hospitalizations in past 6 months, comorbidity, having a severe condition at HHC admission, and impaired physical functioning increased HHC patients' risk of infections. We also identified that HHC patients with caregivers who needed training in providing medical procedure or treatment are at higher risk for wound-site infections. Our findings suggest that patients with underlying medical conditions and limited physical function status are more likely to develop infection. The caregiver's lack of training in providing needed care at home also places HHC patients at high risk for infection. Education for patients and caregivers should be tailored based on their health literacy level to ensure complete understanding.

Transition-to-U.S. Practice Experiences of Internationally Educated Nurses: An Integrative Review

Ghazal, L. V., Ma, C., Djukic, M., & Squires, A. (2020). Western Journal of Nursing Research, 42(5), 373-392. 10.1177/0193945919860855
Internationally educated nurses (IENs) are an important part of the U.S. nursing workforce. Optimizing their transition-to-practice (TTP) experiences in the United States is crucial for ensuring high-quality patient and IENs’ outcomes. The purpose of this integrative review is to analyze and synthesize the current evidence surrounding IEN TTP experiences in the United States from 2000 to 2018 to inform improvements in TTP. Eighteen studies were included. TTP was defined through IENs’ description of facilitators and barriers of the transition process and presented in seven themes. Two themes were facilitators: support from family and nursing colleagues, and perceptions of self-efficacy. The remaining five themes were barriers: (a) the stigma associated with educational preparation, (b) communication and language, (c) differences in culture, (d) differences in nursing practice, and (e) legal issues. Findings are important for improving TTP programs. Further research focusing on the outcomes of transition programs is needed to inform policymaking surrounding IEN recruitment and retention.