Haeok Lee's additional information
Haeok Lee, FAAN, PhD, RN, is a professor at NYU Rory Meyers College of Nursing. She is an experienced nurse behavioral scientist with extensive clinical and research experience with populations affected by health disparities. Her research has played a critical role in the national and global recognition of health disparities, especially related to cervical and liver cancers among Asians and Africans. Prof. Lee is currently the site PI on an NIH/NIA-funded grant (R56 AG069130) for the Asian Ancestry Cohort for Alzheimer's Disease Study. Lee is particularly interested in culturally linguistically responsive and theory-based storytelling narrative interventions tailored to targeted racial/ethnic minority populations. Her research, which is noteworthy for its theoretical base, holds considerable promise for the development of practice guidelines and interventions for improving health communication and changing health behaviors to move toward global health equity. She has conducted her studies globally with colleges in several countries.
Before joining the faculty at NYU Meyers, she was a nursing professor at the University of Massachusetts Boston from 2008–2022. She was also on faculty at the University of Colorado Health Sciences Center and Case Western Reserve University. She mentors faculty, postdoctoral scholars, PhD students, and undergraduate students from diverse racial/ethnic backgrounds from diverse disciplines. She has sponsored overseas visiting scholars.
Among her many honors, Lee received the 2022 American Nurses Association, Massachusetts Excellence in Nursing Research Awards. She was honored by Choson University, South Korea as the 2012 Excellent Chosun Alumni for Contributions in Education and Social Justice. She has provided advice to the Korean Nurses Association as a Senior Advisor in Global Health as well as has served on several NIH review panels in the areas of vaccination behavior, HIV/AIDs, and global health.
Lee earned her PhD from the University of California San Francisco, a Master in Nursing Education from Yonsei University, and a BSN from Chosun University. She received a postdoctoral fellowship from the University of California San Francisco, Clinical Cardiology.
Cancer management among older adults living with dementia: A call to action from Asian perspectives
Ethnicity, Social, and Clinical Risk Factors to Tooth Loss among Older Adults in the U.S., NHANES 2011–2018AbstractAbstractBackground. Many older adults suffer from poor oral health, including tooth loss, and disparities among racial/ethnic and socially disadvantaged populations continue to exist. Methods. Data were obtained from the National Health and Nutrition Examination Survey among the adult population in the U.S. The prevalence of edentulism and multiple regression models were conducted on 15,821 adults, including Asians, Blacks, Hispanics, Whites, and others to assess the relationships between tooth loss and their predictors. Results. The prevalence of complete tooth loss increased with age from 0.7% for ages 20–44 to 20.2% for ages 65 and over. There are disparities in complete tooth loss regarding race/ethnicity, with the highest percentages (9%) among Whites and Blacks and the lowest percentages among Asians (3%) and Hispanics (4%). After adjusting for predictors, their impact on tooth loss was not consistent within racial/ethnic groups, as Asians had more tooth loss from Model 1 (β = −1.974, p < 0.0001) to Model 5 (β = −1.1705, p < 0.0001). Conclusion. Tooth loss was significantly higher among older adults and racial/ethnic groups even after controlling for other predictors among a nationally representative sample. The findings point to the fact that subgroup-tailored preventions are necessary.
Examine Race/Ethnicity Disparities in Perception, Intention, and Screening of Dementia in a Community Setting: Scoping ReviewAbstractAbstractBackground: Delayed detection and diagnosis of Alzheimer’s Disease and related dementia (ADRD) can lead to suboptimal care and socioeconomic burdens on individuals, families, and communities. Our objective is to investigate dementia screening behavior focusing on minority older populations and assess whether there are ethnic differences in ADRD screening behavior. Methods: The scoping review method was utilized to examine ADRD screening behavior and contributing factors for missed and delayed screening/diagnosis focusing on race/ethnicity. Results: 2288 papers were identified, of which 21 met the inclusion criteria. We identified six dimensions of ADRD screening behavior: Noticing Symptoms, Recognizing a problem, Accepting Screen, Intending Screen, Action, and Integrating with time. Final findings were organized into study race/ethnicity, theoretical background, the methods of quantitative and qualitative studies, description and measures of ADRD screening behavior, and racial/ethnic differences in ADRD screening behavior. Conclusions: A trend in ethnic disparities in screening for ADRD was observed. Our findings point to the fact that there is a scarcity of studies focusing on describing ethnic-specific ADRD screening behavior as well as a lack of those examining the impact of ethnicity on ADRD screening behavior, especially studies where Asian Americans are almost invisible.
Healthy life of Korean patients with chronic kidney failure undergoing hemodialysis: A situation-specific nursing theoryAbstractAbstractPurpose: This study explored to develop a situation-specific theory explaining the healthy life of Korean patients with chronic kidney failure undergoing hemodialysis. Background: Chronic kidney failure (CKF) patients have to reorganize their lives around their hemodialysis sessions for their survival. Nursing interventions based on specific theories may promote their health-related behaviors and outcomes. However, few theoretical frameworks or theories are available to guide hemodialysis patients on how to construct their lives under various constraints, while considering their experiences and sociocultural contexts. Methods: An integrated approach was used to develop the situation-specific theory based on the network episode model (NEM), a review of related literature, and four of the authors' studies on hemodialysis patients' lives. Results: The major concepts in the proposed theory include sociocultural context, social networks, individual-level factors, illness experiences, health-related behaviors, and health outcomes. Each major concept includes several relevant subconcepts. Conclusions: We used this theory to identify factors involved in shaping the illness experiences, health-related behaviors, and outcomes of Korean CKF patients undergoing hemodialysis. By exploring the links between these factors, we explained the healthy life that considers the uniqueness of Korean patients' sociocultural context, social network, and individual-level factors. Nurse and other healthcare professionals could integrate the proposed situation-specific theory into the development of nursing interventions based on this theory to promote health-related behaviors and outcomes of Korean CKF patients undergoing hemodialysis.
Awareness, knowledge, social norms, and vaccination intentions among Khmer mother–daughter pairsAbstractAbstractCervical cancer is caused by human papillomavirus (HPV) infection, which can be prevented by vaccination. Mothers play an important role in promoting vaccination and health education. However, Cambodian American mothers reported to have challenges to play a role as primary health educators due to lack of health knowledge and language and cultural gaps. Therefore, this study aims to understand the Cambodian American daughters’ and mothers’ awareness, knowledge and social norms of HPV vaccination and their health communication and vaccination decision-making. We conducted a pilot randomized clinical trial to promote HPV vaccination. In this study, we have only reported findings from baseline data examining individual, interpersonal and social determinants of HPV vaccination behavior among 19 dyads of Cambodian American mothers and daughters. Both mothers and daughters demonstrated low levels of awareness and knowledge. A significant relationship was found between the daughters’ HPV vaccine decisions and their perception of their mothers’ intention on HPV vaccination for them. Culturally and linguistically appropriate communication strategies such as storytelling or visual presentation approaches may be more effective than the current practice of using information-based written materials to promote HPV vaccination and health education among Cambodian Americans.
Development of a situation-specific theory of cervical cancer prevention behaviors of Malawian womenAbstractAbstractIn this chapter, the revised Network Episode Model (NEM) as the basis for a situation-specific theory that provides an explanation of how Malawian women come to make a decision about and act to obtain cervical cancer screening. The situation-specific theory takes into account the uniqueness of Malawian women's individual factors, interpersonal relationships factors, and sociocultural factors. The theory emphasizes the need to attend to the unique factors that influence cervical cancer screening behaviors of women in their unique situations.
Overview of human papillomavirus vaccination policy changes and its impact in the United States: Lessons learned and challenges for the futureAbstractAbstractBackground: The HPV vaccination is effective and safe for preventing HPV infection and HPV attributable cancers. Despite this fact, the uptake rate of the vaccination in the United States has remained below the national target of 80%. Health policy focused on allocating resources and creating vaccine-promoting environments can influence HPV vaccination coverage rates. There is a scarcity of information about the HPV vaccination-related health policy and its impact on the outcome of vaccine uptake. Method: We conducted a comprehensive review of HPV vaccination-related health policies at the federal, state, and professional organization levels and examined their impact on population health by reviewing national data on HPV vaccination uptake rates. Results: The review revealed that (a) HPV vaccination recommendations, which serve as the federal-level HPV vaccination policy, have changed frequently in terms of gender, age criteria, and dosing schedule, and (b) the frequent changes of the policy have resulted in low uptake rates among male and young adult populations. Discussion: The uptake rate should be continuously followed to evaluate the impact of recent changes to the federal-level HPV vaccination policy. State-level policies and healthcare professionals, including nurses, are important to the promotion of HPV vaccinations and decreasing HPV vaccination disparities.
Psychometric testing of the korean version of the caring behaviors inventory-24 in clinical nursesAbstractAbstractPurpose: To determine psychometric properties of the Caring Behaviors Inventory-24 (CBI-24) among Korean clinical nurses. Methods: A methodological design was used. Data were collected from 408 clinical nurses. Construct validity analysis was performed, including factorial, convergent, and discriminant validity. Internal consistency was tested by Cronbach's α coefficients, inter-item correlation, and corrected item-total correlation. Results: Exploratory factor analysis produced three factors: 'empathy and supporting', 'knowledge and skills', and 'providing comfort'. In confirmatory factor analysis results, model fit indices were acceptable (x2/df=3.50, RMR=.05, RMSEA=.08, CFI=.90). The values obtained for the AVE ranged from .53 to .68, and for the CR ranged from .53 to .68. Convergent validity coefficients were noticeably greater in magnitude than discriminant validity coefficients: .53 (AVE1 value) and .68 (AVE2 value)≥.45 (r12 2 value) and .68 (AVE2 value) and .63 (AVE3 value)≥.61 (r23 2 value). Internal consistency (Cronbach's α) of CBI-K was .95. Conclusion: The CBI-K was shown to have acceptable construct validity and good internal consistency. Study findings imply that CBI-K could be a useful instrument for clinical administrators and nursing researchers to assess caring behaviors among Korean clinical nurses. Utilization of CBI-K might contribute to the building of empirical knowledge and the understanding of caring behaviors from nurses' perspectives.
Vitamin D deficiency and associated factors in south Korean childbearing women: a cross-sectional studyAbstractAbstractBackground: Adequate levels of vitamin D are important for women of childbearing age as vitamin D helps maintain the pregnancy and ensures proper maternal and fetal bone metabolism and fetal skeletal development. However, vitamin D deficiency is a health problem prevalent in women of all ages, worldwide. This study aimed to determine the current status of serum vitamin D levels and the risk factors for vitamin D deficiency among South Korean nurses of childbearing age. Methods: Serum levels of 25-hydroxyvitamin D (25[OH]D) were measured in 1594 registered nurses aged 20 to 45 years who are participants in an ongoing prospective cohort study of the Korean Nurses’ Health Study initiated in 2013. The participants completed surveys about demographic and occupational characteristics and physical and psychological health. We examined associations with vitamin D deficiency through multivariable logistic regression analysis. Results: The average blood 25(OH) D concentration of the participants was 12.92 ng/mL (4.0–63.4 ng/mL), while the prevalence of vitamin D deficiency (< 20 ng/mL) was 89% (1419/1594). Multivariable logistic regression showed that significant risk factors for vitamin D deficiency included month of sampling (there was a lower level of vitamin D deficiency in winter than in spring, summer, or fall), age (women in their 20s had a lower vitamin D level than those in their 30s and 40s), and stress symptoms. Vitamin D levels were not associated with body mass index, physical activity, and depressive symptoms. Conclusions: This study showed a high prevalence of vitamin D deficiency in Korean female nurses. Serum levels of vitamin D were associated with age and season. Vitamin D deficiency should be recognized as one of the primary health concerns among young women. More proactive actions, such as vitamin D supplements and food fortification, are needed to improve vitamin D deficiency in high-risk groups.
Challenges and lessons learned from a mobile health, web-based human papillomavirus intervention for female korean american college students: feasibility experimental studyAbstractAbstractBackground: Mobile health (mHealth) and Web-based research methods are becoming more commonplace for researchers. However, there is a lack of mHealth and Web-based human papillomavirus (HPV) prevention experimental studies that discuss potential issues that may arise. Objective: This study aimed to assess the feasibility of research procedures and discuss the challenges and lessons learned from an mHealth and Web-based HPV prevention experimental study targeting female Korean American college students in the United States. Methods: A pilot randomized controlled trial (RCT) was conducted in an mHealth and Web-based platform with 104 female Korean American college students aged 18-26 years between September 2016 and December 2016. Participants were randomized to either the experimental group (a storytelling video intervention) or the comparison group (a nonnarrative, information-based intervention). Outcomes included the feasibility of research procedures (recruitment, eligibility, randomization, and retention). Results: From September 2016 to October 2016, we recorded 225 entries in our initial eligibility survey. The eligibility rate was 54.2% (122/225). This study demonstrated a high recruitment rate (95.6%, 111/122) and retention rate (83.7%, 87/104) at the 2-month follow-up. Conclusions: Findings from this study demonstrated sufficient feasibility in terms of research procedures to justify a full-scale RCT. Given the increased possibility of invalid or misrepresentative entries in mHealth and Web-based studies, strategies for detection and prevention are critical.