Gail D'Eramo Melkus

Gail D’Eramo Melkus, EdD, ANP, FAAN, is Professor Emerita and the former vice dean for research and the Florence and William Downs Professor in Nursing Research at NYU Rory Meyers College of Nursing. Melkus’ sustained interest in eliminating health disparities among vulnerable populations earned her a reputation as a leader in the development and testing of culturally competent models of diabetes care. Her program of intervention research that focuses on physiological and behavioral outcomes of self-management interventions has served as an education and training ground for numerous multidisciplinary scientists.

Melkus currently serves as co-PI and co-investigator or research mentor on numerous funded projects specific to biobehavioral interventions for prevention and management of chronic conditions and related co-morbidities, in mid-life and older adults, including national and international work. Melkus serves as sponsor of K-awards focused on health disparities among vulnerable populations (women with T2D and depression; elderly Blacks at-risk for depression, glycemic control and infection in oncology stem cell recipients, CHD in older adult workers, HIV in adolescents). She is PI for the NINR P20 Center for Precision Health in Diverse Populations.

Before joining the faculty at NYU Meyers, Melkus was the Independence Foundation Professor of Nursing at the Yale University School of Nursing, where, in collaboration with the Diabetes Research Center of Albert Einstein College of Medicine in NY, she developed and implemented the Diabetes Care Specialty for advanced practice nurses.

In recognition of her mentorship, Melkus received the 1st Annual NYU CTSI Mentor Award in May 2011, and in 2015 was inducted into the STTI Nurse Researcher Hall of Fame.

Melkus earned her EdD from Columbia University, MS from Yale University, MS from Connecticut State University, and ASN/BS in Nursing from the University of Bridgeport.

MS - Yale University (2003)

EdD - Columbia University (1987)

MS - Connecticut State University (1978)

ASN/BS, Nursing - University of Bridgeport (1976)

Primary care

Non-communicable disease

Women's health

Immigrants

Adult health

American Academy of Nursing

American Diabetes Association

Council for the Advancement of Nursing Science

CT Nursing Association

Eastern Nursing Research Society

Society for Behavioral Medicine

Eastern Nursing Research Award (2020)

International Nurse Researcher Hall of Fame, Sigma Theta Tau (2015)

STTI Nurse Researcher Hall of Fame Inductee (2015)

Fellow, New York Academy of Medicine (2014)

Affiliated Faculty Appointment, University of Georgia (2014)

Distinguished Alumni Award, University of Bridgeport (2014)

Faculty Scholar Appointment, Universita' Tor Vergata (2014)

Advisory Committee Member, Medicare Evidence Development & Coverage (2013)

1st annual Distinguished Mentor Award, NYU Clinical Translational Science Institute (2011)

Distinguished Scholar Award, New York University College of Nursing (2010)

Distinguished Nurse Researcher Award, New York State Nurse Foundation (2009)

Endowed Chair, New York University (2008)

Endowed Chair of the Independence Foundation, Yale University (2004)

Excellence in Nursing Research Award, Diamond Jubilee Virginia Henderson (2003)

Fellow, American Academy of Nursing (2003)

Implementation of a lifestyle program in primary care by nurse practitioners

Whittemore, R., Melkus, G. D., Alexander, N., Zibel, S., Visone, E., Muench, U., Magenheimer, E., & Wilborne, S. (2010). Journal of the American Academy of Nurse Practitioners, 22(12), 684-693. 10.1111/j.1745-7599.2010.00562.x

Abstract

Abstract

Purpose: The purpose of this study is to describe the implementation process and participant satisfaction with a lifestyle program provided by nurse practitioners (NPs) in primary care to adults at risk for type 2 diabetes (T2D) compared to enhanced standard care. Data sources: A mixed-method clinical trial design was used (n= 58). NPs were interviewed prior to beginning the program, at 3 months, and at completion of the program. NPs also completed a questionnaire on lifestyle counseling at baseline. Process data were collected on attendance, attrition, and intervention fidelity. Participants completed a satisfaction survey at completion of the program and a sub-sample were interviewed at the end of the program. Conclusions: NPs reported that they felt well-prepared and moderately effective in providing lifestyle change counseling. Participant attendance was high and in-person sessions were implemented with good success. Participants in the lifestyle program were more satisfied with the program, reporting that the program was a good experience. Implications for practice: Implementation of a lifestyle program to prevent T2D in primary care is feasible and acceptable to NPs and participants. Developing a structured program may improve health outcomes.

Religion and spirituality among black Americans

Newlin, K., & Melkus, G. (2010). Practical Diabetology, 29(4), 26-30.

Scheduled and unscheduled hospital readmissions among patients with diabetes

Kim, H., Ross, J. S., Melkus, G. D., Zhao, Z., & Boockvar, K. (2010). American Journal of Managed Care, 16(10), 760-767.

Abstract

Abstract

Objectives: To describe rates of scheduled and unscheduled readmissions among midlife and older patients with diabetes and to examine associated socioeconomic and clinical factors. Study Design: Population-based data set study. Methods: Using the 2006 California State Inpatient Dataset, we identified 124,967 patients 50 years or older with diabetes who were discharged from acute care hospitals between April and September 2006 and examined readmissions in the 3 months following their index hospitalizations. Results: About 26.3% of patients were readmitted within the 3-month period following their index hospitalizations, 87.2% of which were unscheduled readmissions. Patients with unscheduled readmissions were more likely to have a higher comorbidity burden, be members of racial/ethnic minority groups with public insurance, and live in lower-income neighborhoods. Having a history of hospitalization in the 3 months preceding the index hospitalization was also a strong predictor of unscheduled readmissions. Almost one-fifth of unscheduled readmissions (constituting approximately 27,500 inpatient days and costing almost $72.7 million) were potentially preventable based on definitions of Prevention Quality Indicators by the Agency for Healthcare Research and Quality. Scheduled readmissions were less likely to occur among patients 80 years or older, the uninsured, and those with an unscheduled index hospitalization. Conclusions: The predictors of scheduled and unscheduled readmissions are different. Transition care to prevent unscheduled readmissions in acutely ill patients with diabetes may help reduce rates, improving care. Further studies are needed on potential disparities in scheduled readmissions.

Depression, depression treatment, and insulin sensitivity in adults at risk for type 2 diabetes

Wagner, J., Allen, N. A., Swalley, L. M., Melkus, G. D., & Whittemore, R. (2009). Diabetes Research and Clinical Practice, 86(2), 96-103. 10.1016/j.diabres.2009.06.024

Abstract

Abstract

Aims: To compare insulin sensitivity (Si) in adults at risk for type 2 diabetes (T2DM) who were categorized as non-depressed, treated for depression and untreated depression after controlling for physical activity (PA). Methods: Baseline data was analyzed from individuals enrolled in a diabetes prevention program (n = 56). Si was calculated using the whole-body insulin sensitivity method. The Centers for Epidemiologic Studies Depression Scale (CESD) was used to assess depressive symptoms and depressed cases were identified using a cutoff of ≥16. Depression treatment was identified using a self-report form validated by medical chart review. The PA subscale of the Health Promoting Lifestyle Profile was used to determine PA levels. Results: One third of participants had elevated depressive symptoms; 19% were taking antidepressant medication. Mean Si was 3.1 (±1.9). In ANOVA, depressed individuals showed significantly lower Si (M = 1.8 ± 0.9) than non-depressed individuals (M = 3.4 ± 1.8). However, individuals taking antidepressant medications had Si similar to non-depressed individuals (M = 3.7 ± 2.3: p = .63). In ANCOVA this association remained after controlling for PA. Conclusions: These data suggest that in adults at high risk for T2DM, depression treatment may improve insulin resistance observed in depression. Healthcare practitioners are encouraged to screen, treat, or refer their patients with depression for treatment.

Translating the Diabetes Prevention Program to Primary Care A Pilot Study

Whittemore, R., Melkus, G., Wagner, J., Dziura, J., Northrup, V., & Grey, M. (2009). Nursing Research, 58(1), 2-12. 10.1097/NNR.0b013e31818fcef3

Abstract

Abstract

Background: Research on the translation of efficacious lifestyle change programs to prevent type 2 diabetes into community or clinical settings is needed. Objective: The objective of this study was to examine the reach, implementation, and efficacy of a 6-month lifestyle program implemented in primary care by nurse practitioners (NPs) for adults at risk of type 2 diabetes. Methods: The NP sites (n = 4) were randomized to an enhanced standard care program (one NP and one nutrition session) or a lifestyle program (enhanced standard care and six NP sessions). These NPs recruited adults at risk of diabetes from their practice (n = 58), with an acceptance rate of 70%. Results: The program reached a diverse, obese, and moderately tow income sample. The NPs were able to successfully implement the protocols. The average length of the program was 9.3 months. Attendance was high (98%), and attrition was low (12%). The NPs were able to adopt the educational, behavioral, and psychosocial strategies of the intervention easily. Motivational interviewing was more difficult for NPs. Mixedmodel repeated-measures analysis indicated significant trends or improvement in both groups for nutrition and exercise behavior. Participants of the lifestyle program demonstrated trends for better high-density lipoprotein (HDL) and exercise behavior compared with the enhanced standard care participants. Twenty-five percent of lifestyle participants met treatment goals of 5% weight loss compared with 11 % of standard care participants. Discussion: A lifestyle program can be implemented in primary care by NPs, reach the targeted population, and be modestly successful. Further research is indicated.

Type 2 diabetes in urban black and rural white women

Melkus, G. D., Whittemore, R., & Mitchell, J. (2009). Diabetes Educator, 35(2), 293-301. 10.1177/0145721708327532

Abstract

Abstract

Purpose The purpose of this secondary analysis was to describe and compare physiological, psychosocial, and self-management characteristics of urban black and rural white women with type 2 diabetes (T2D) in the northeast United States. Methods A descriptive, cross-sectional secondary analysis was conducted with baseline data from 2 independent study samples: rural white women and urban black women. Results Results revealed the sample were on average educated, working, low-income, mid-life women with poor glycemic and blood pressure control, despite having a usual source of primary care. When compared, black women were younger, had lower income levels, worked more, and were often single and/or divorced. They had worse glycemic control, significantly higher levels of diabetes-related emotional distress, and less support than white women. Conclusion Despite differences in geography and study findings, both groups had suboptimal physiological and psychosocial levels that impede self-management. These findings serve to aid in the understanding of health disparities, emphasizing the importance of developing and evaluating effective interventions of diabetes care for women with T2D.

Designing a research study

Whittemore, R., & Melkus, G. D. (2008). Diabetes Educator, 34(2), 201-216. 10.1177/0145721708315678

Abstract

Abstract

Diabetes educators and advanced-practice nurses in diabetes care often participate in clinical research. The purpose of this article is to provide a broad overview of important decisions in planning a research study. The research process is reviewed, including the conceptual phase, the design and planning phase, the empirical phase, the analytic phase, and the dissemination phase. Issues unique to diabetes education research are highlighted.

Factors contributing to integrating lifestyle in Thai women with type 2 diabetes

Siripitayakunkit, A., Hanucharurnkl, S., Melkus, G., Vorapongsathon, O., Rattarasarn, C., & Apanantikul, M. (2008). Thai Journal of Nursing Research, 12(3), 166-177.

Grandparenthood status and health outcomes in midlife African American women with type 2 diabetes

Balukonis, J., Melkus, G. D., & Chyun, D. (2008). Ethnicity and Disease, 18(2), 141-146.

Abstract

Abstract

Objective: To describe grandparenthood status and determine the relationship between grandparenthood status, metabolic control, and psychosocial factors in African American women with type 2 diabetes. Methods: A secondary, descriptive, exploratory analysis was conducted to examine the relationship between grandparenting status, physiologic indices related to metabolic control (body mass index, hemoglobin A1c, systolic blood pressure, low-density lipoprotein cholesterol) and psychosocial factors (emotional distress and quality of life) in a sample of 109 urban midlife African American women with type 2 diabetes. Results: Grandmothers made up 60% of the sample and were stratified into three groups on the basis of caretaking status. Grandmothers who cared for but did not live with grandchildren had the highest body mass index, hemoglobin A1c, low-density lipoprotein cholesterol, and systolic blood pressure. Caregiving grandmothers also had higher diabetes-related emotional distress scores but had better quality of life scores than did the non-caretaking grandmothers. Non-grandmothers had the lowest quality of life scores. Conclusions: These findings suggest relationships between grandmother caretaking status and metabolic and psychosocial factors. Research is needed to further examine these relationships and implications on practice and policy decisions.

Relationships of religion and spirituality to glycemic control in black women with type 2 diabetes

Newlin, K., Melkus, G. D., Tappen, R., Chyun, D., & Koenig, H. G. (2008). Nursing Research, 57(5), 331-339. 10.1097/01.NNR.0000313497.10154.66

Abstract

Abstract

▶ Background: Although religion and spirituality are prominent in the lives of Black women with type 2 diabetes (T2DM), there is little research on the relationships of religion and spirituality to glycemic control (GC) in this population. ▶ Objective: To examine the relations of religion and spirituality to GC. ▶ Methods: Using a cross-sectional, descriptive, correlational design, a convenience sample of 109 Black women with T2DM was recruited. Measures of demographic (age, income, and education), clinical (body mass index and use of diabetes medications), psychosocial (emotional distress and social support), religion and spirituality (religious and existential well-being), and GC (hemoglobin A1c) factors were collected. A theoretical model, based on the work of Koenig, McCullough, and Larson (2001), informed linear regression analyses to examine the relations of religion and spirituality to GC, with psychosocial factors as putative mediators. ▶ Results: With age (β = -.133, SE = .020, p = .145), income (β =.020, SE = .139, p = .853), education (β = -.221, SE = .204, p = .040), body mass index (β= - .237, SE = .031, p = .011), and diabetes medications (β = .338, SE = .216, p < .001) held constant, religion and spirituality demonstrated significant relations with GC (β = .289, SE = .032, p = .028 and β = -.358, SE = .030, p = .006, respectively). Evidence of emotional distress and social support as mediators in the relationships of religion and spirituality to GC was lacking. ▶ Discussion: Religion and spirituality were related to GC, with evidence of psychosocial mediation lacking, thereby forcing revision of the model for the study population. Research is warranted to validate the findings, with further examination of theoretical mediators linking religion and spirituality to GC. Findings suggest that religion and spirituality be addressed in diabetes care to improve GC in Black women with T2DM.

Faculty