Jasmine Travers

Faculty

Jasmine Travers Headshot

Jasmine Travers

AGPCNP-BC CCRN PhD RN

Assistant Professor

1 212 992 7147
Accepting PhD students

Jasmine Travers's additional information

Jasmine L. Travers is an assistant professor of nursing at NYU Rory Meyers College of Nursing. Her career is dedicated to designing and conducting research to improve health outcomes and reduce health disparities in vulnerable older adult groups using both quantitative and qualitative approaches. Her current work focuses on mitigating disparities in appropriate access and use of in-home and facility-based long-term care for older adults (i.e., home & community-based settings, nursing homes, and assisted living). Currently, Travers is the principal investigator of a Robert Wood Johnson Foundation four-year Career Development Award through the Harold Amos Medical Faculty Development Program which she is examining the association of neighborhood disadvantage with nursing home outcomes using large-scale nursing home data and a Paul B. Beeson Emerging Leader five-year K76 Award through the National Institute on Aging which in this mixed-method study she will develop a survey instrument aimed to identify unmet needs that are disproportionately driving avoidable nursing home placements. Most recently, Travers served on the National Academies of Science Engineering and Medicine Committee on the Quality of Care in Nursing Homes which on April 6, 2022, released the widely anticipated report titled, The National Imperative to Improve Nursing Home Quality.

Travers has published widely on the topics of aging, long-term care, health disparities and inequities, workforce diversity and workforce issues, vaccinations, and infections. She has presented her work at regional and national health services research, gerontological, nursing, and public health conferences.

Prior to joining the faculty at NYU, Travers completed a postdoctoral fellowship with the National Clinician Scholars Program at Yale University and a T32-funded postdoctoral fellowship at the New Courtland Center for Transitions and Health at the University of Pennsylvania School of Nursing.

Travers received her Ph.D. at Columbia University School of Nursing, MHS at Yale University, MSN in Adult-Gerontological Health at Stony Brook University, and BSN at Adelphi University.

PhD, Columbia University
MSN, Stony Brook University
MHS, Yale University
BSN, Adelphi University

Gerontology
Underserved populations

Eastern Nursing Research Society
American Geriatrics Society
Gerontological Society of America
Academy Health

Faculty Honors Awards

Rising Star Research Award, Eastern Nursing Research Society (2022)
Health in Aging Foundation New Investigator Award, American Geriatrics Society (2022)
Committee Member, Committee on the Quality of Care in Nursing Homes, The National Academies of Sciences, Engineering, and Medicine (2020)
Scholar, National Clinician Scholars Program, Yale University (2020)
Early Career Alumni Award: Emerging Nurse Leader, Columbia University (2020)
Jonas Policy Scholar, American Academy of Nursing, Jonas Center for Nursing and Veterans Healthcare (2019)
Douglas Holmes Emerging Scholar Paper Award, Gerontological Society of America (2018)
Dean’s Distinguished Postdoctoral Fellow, University of Pennsylvania Vice Provost Office (2018)
Associate Fellow, Leonard Davis Institute of Health Economics, University of Pennsylvania (2018)
Awardee, 10 Under 10 Young Alumni Recognition, Adelphi University (2018)
Jonas Nurse Leader Scholar, Jonas Center for Nursing and Veterans Healthcare (2016)
Pre-Dissertation Student Research Award, The Behavioral & Social Sciences Section of The Gerontological Society of America (2016)

Publications

Antimicrobial Stewardship Interventions to Optimize Treatment of Infections in Nursing Home Residents: A Systematic Review and Meta-Analysis

Aliyu, S., Travers, J. L., Heimlich, S. L., Ifill, J., & Smaldone, A. (2022). Journal of Applied Gerontology, 41(3), 892-901. 10.1177/07334648211018299
Abstract
Abstract
Effects of antibiotic stewardship program (ASP) interventions to optimize antibiotic use for infections in nursing home (NH) residents remain unclear. The aim of this systematic review and meta-analysis was to assess ASPs in NHs and their effects on antibiotic use, multi-drug-resistant organisms, antibiotic prescribing practices, and resident mortality. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we conducted a systematic review and meta-analysis using five databases (1988–2020). Nineteen articles were included, 10 met the criteria for quantitative synthesis. Inappropriate antibiotic use decreased following ASP intervention in eight studies with a pooled decrease of 13.8% (95% confidence interval [CI]: [4.7, 23.0]; Cochran’s Q = 166,837.8, p <.001, I2 = 99.9%) across studies. Decrease in inappropriate antibiotic use was highest in studies that examined antibiotic use for urinary tract infection (UTI). Education and antibiotic stewardship algorithms for UTI were the most effective interventions. Evidence surrounding ASPs in NH is weak, with recommendations suited for UTIs.

Diversity equity and Inclusion: To advance infection prevention and control efforts, nursing assistants need to be given the opportunity to dance

Travers, J. L. (2022). American Journal of Infection Control, 50(7), 717-718. 10.1016/j.ajic.2022.04.001

Evidence for Action: Addressing Systemic Racism Across Long-Term Services and Supports

Shippee, T. P., Fabius, C. D., Fashaw-Walters, S., Bowblis, J. R., Nkimbeng, M., Bucy, T. I., Duan, Y., Ng, W., Akosionu, O., & Travers, J. L. (2022). Journal of the American Medical Directors Association, 23(2), 214-219. 10.1016/j.jamda.2021.12.018
Abstract
Abstract
Long-term services and supports (LTSS), including care received at home and in residential settings such as nursing homes, are highly racially segregated; Black, Indigenous, and persons of color (BIPOC) users have less access to quality care and report poorer quality of life compared to their White counterparts. Systemic racism lies at the root of these disparities, manifesting via racially segregated care, low Medicaid reimbursement, and lack of livable wages for staff, along with other policies and processes that exacerbate disparities. We reviewed Medicaid reimbursement, pay-for-performance, public reporting of quality of care, and culture change in nursing homes and integrated home- and community-based service (HCBS) programs as possible mechanisms for addressing racial and ethnic disparities. We developed a set of recommendations for LTSS based on existing evidence, including (1) increase Medicaid and Medicare reimbursement rates, especially for providers serving high proportions of Medicaid-eligible and BIPOC older adults; (2) reconsider the design of pay-for-performance programs as they relate to providers who serve underserved groups; (3) include culturally sensitive measures, such as quality of life, in public reporting of quality of care, and develop and report health equity measures in outcomes of care for BIPOC individuals; (4) implement culture change so services are more person-centered and homelike, alongside improvements in staff wages and benefits in high-proportion BIPOC nursing homes; (5) expand access to Medicaid-waivered HCBS services; (6) adopt culturally appropriate HCBS practices, with special attention to family caregivers; (7) and increase promotion of integrated HCBS programs that can be targeted to BIPOC consumers, and implement models that value community health workers. Multipronged solutions may help diminish the role of systemic racism in existing racial disparities in LTSS, and these recommendations provide steps for action that are needed to reimagine how long-term care is delivered, especially for BIPOC populations.

Functional Limitations and Access to Long-Term Services and Supports Among Sexual Minority Older Adults

Travers, J. L., Shippee, T. P., Flatt, J. D., & Caceres, B. A. (2022). Journal of Applied Gerontology, 41(9), 2056-2062. 10.1177/07334648221099006
Abstract
Abstract
Objective: Little is known about sexual minority (SM) older adults’ activities of daily living (ADL) and instrumental activities of daily living (IADL) limitations and their subsequent access to long-term services and supports (LTSS). Methods: We analyzed cross-sectional data from the 2016 Health and Retirement Study limited to individuals ≥50 years old. Bivariate analyses were performed to examine 1) sexual identity differences in the prevalence of ADL/IADL limitations and 2) associations of sexual identity with having ADL/IADL limitations and having access to help with ADL/IADL limitations. Results: Our sample consisted of 3833 older adults, 6% (n = 213) were SM. Compared to heterosexual participants, bisexual older adults had greater reports of ADL/IADL limitations (20.9% vs. 35.9%, p = 0.013). Among those who reported having ADL/IADL limitations (n = 803), there were no sexual identity differences in accessing help for ADL/IADL limitations (p =.901). Discussion: Our findings contribute to the limited research on LTSS access among SM older adults.

Minority Older Adults’ Access to and Use of Programs of All-Inclusive Care for the Elderly

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Older Adults’ Goals and Expectations When Using Long-Term Services and Supports

Travers, J. L., Hirschman, K. B., & Naylor, M. D. (2022). Journal of Applied Gerontology, 41(3), 709-717. 10.1177/07334648211033671
Abstract
Abstract
Objective: Despite recent research focused on aging well, little is known regarding the goals and expectations from long-term services and supports (LTSS) use among older adults. Methods: To address this knowledge gap, interviewer-guided surveys with older adults newly receiving LTSS in home and community-based, assisted living, and nursing home settings in Philadelphia, New Jersey, and New York were conducted. Results: Twelve subthemes regarding the goals and expectations of 464 older adults receiving LTSS and in the context of Aging Well emerged from our analysis: maintaining function, optimizing health and circumstances, maintaining the status quo, transitioning back to the previous state, achieving independence, preserving cognitive function and capacity for psychosocial and emotional health, achieving purpose, increasing quality of life, receiving social support, increasing engagement, relieving burden, and feeling a sense of security/safety. Discussion: This in-depth analysis of qualitative data provides context for LTSS use among older adults.

A Profile of Black and Latino Older Adults Receiving Care in Nursing Homes: 2011–2017

Travers, J. L., Dick, A. W., Wu, B., Grabowski, D. C., Robison, J., Agarwal, M., Perera, G. U., & Stone, P. W. (2022). Journal of the American Medical Directors Association. 10.1016/j.jamda.2022.04.010
Abstract
Abstract
Objective: To identify if disparate trends in the access and use of nursing home (NH) services among Black and Latino older adults compared with White older adults persist. Access was operationalized as the NHs that served Black, Latino, and White residents. Use was operationalized as the utilization of NH services by Black, Latino, and White residents. Design: This was an observational study analyzing facility-level data from LTCfocus for 2011 to 2017. Setting and Participants: All NH residents present in US NHs participating in the Centers for Medicare and Medicaid Services program on the first Thursday in April in the years 2011 to 2017. NHs with fewer than 4500 bed-days per year are excluded in the LCTfocus dataset. Black, Latino, and White were the racial/ethnic groups of interest. Methods: We calculated the mean percentage of each racial/ethnic group in NHs (Black, Latino, White) annually along with the number of NHs that provided care for these groups. We conducted a simple trend analysis using ordinary least squares to estimate the change in NH access and use by racial/ethnic group over time. Results: Our NH sample ranged from 15,564 in 2011 to 14,956 in 2017. Latino residents' use of NHs increased by 20.47% and Black residents increased by 11.42%, whereas there was a 1.36% decrease in White residents’ use of NHs. In this 7-year span, there was a 4.44% and 6.41% decline in the number of NHs that serve any Black and Latino older adults, respectively, compared with a 2.26% decline in NHs that serve only White older adults (access). Conclusions and Implications: Our findings reveal a continued disproportionate rise in Black and Latino older adults’ use of NHs while the number of NHs that serve this population have declined. This work can inform federal and state policies to ensure access to long-term care services and supports in the community for all older adults and prevent inappropriate NH closures.

Severe neighborhood deprivation and nursing home staffing in the United States

Falvey, J. R., Hade, E. M., Friedman, S., Deng, R., Jabbour, J., Stone, R. I., & Travers, J. L. (2022). Journal of the American Geriatrics Society. 10.1111/jgs.17990
Abstract
Abstract
Background: Low nursing home staffing in the United States is a growing safety concern. Socioeconomic deprivation in the local areas surrounding a nursing home may be a barrier to improving staffing rates but has been poorly studied. Thus, the objective of this paper was to assess the relationship between neighborhood deprivation and nursing home staffing in the United States. Methods: This cross-sectional study used 2018 daily payroll-based staffing records and address data for 12,609 nursing homes in the United States linked with resident assessment data. Our primary exposure of interest was severe economic deprivation at the census block group (neighborhood) level, defined as an area deprivation index score ≥85/100. The primary outcome was hours worked per resident-day among nursing home employees providing direct resident care. Marginal linear regression models and generalized estimating equations with robust sandwich-type standard errors were used to estimate associations between severe neighborhood deprivation and staffing rates. Results: Compared to less deprived neighborhoods, unadjusted staffing rates in facilities located within severely deprived neighborhoods were 38% lower for physical and occupational therapists, 30% lower for registered nurses (RNs), and 5% lower for certified nursing assistants. No disparities in licensed practical nurse (LPN) staffing were observed. In models with state-level and rurality fixed effects and clustered on the county, a similar pattern of disparities was observed. Specifically, RN staffing per 100 resident-days was significantly lower in facilities located within severely deprived neighborhoods as compared to those in less deprived areas (mean difference: 5.6 fewer hours, 95% confidence interval [CI] 4.2–6.9). Disparities of lower magnitude were observed for other clinical disciplines except for LPNs. Conclusions: Significant staffing disparities were observed within facilities located in severely deprived neighborhoods. Targeted interventions, including workforce recruitment and retention efforts, may be needed to improve staffing levels for nursing homes in deprived neighborhoods.

Taking the Long View: Understanding the Rate of Second Job Holding Among Long-Term Care Workers

Dill, J., Frogner, B., & Travers, J. (2022). Medical Care Research and Review. 10.1177/10775587221089414
Abstract
Abstract
We analyze the 2004, 2008, and 2014 longitudinal panels of the Survey of Income and Program Participation (SIPP) to compare the percentage of long-term care (LTC) workers who held a second job in an LTC setting or in any industry at the first panel observation versus over a longer time period. We find that around 5% to 7% of LTC workers held a second job in another LTC setting in their first panel observation. However, we found that 20% to 30% of LTC workers held a second job in LTC during the survey period of 3 to 4 years, and 30% to 40% of LTC workers held a second job in any industry during the survey period. Our findings suggest that second job holding is widespread among LTC workers. Future research should focus on how facilities and organizations can reduce the spread of infectious disease among workers who are working in multiple settings.

Assessment of Coronavirus Disease 2019 Infection and Mortality Rates Among Nursing Homes With Different Proportions of Black Residents

Travers, J. L., Agarwal, M., Estrada, L. V., Dick, A. W., Gracner, T., Wu, B., & Stone, P. W. (2021). Journal of the American Medical Directors Association, 22(4), 893-898.e2. 10.1016/j.jamda.2021.02.014
Abstract
Abstract
Objective: Coronavirus disease 2019 (COVID-19) has disproportionately impacted nursing homes (NHs) with large shares of Black residents. We examined the associations between the proportion of Black residents in NHs and COVID-19 infections and deaths, accounting for structural bias (operationalized as county-level factors) and stratifying by urbanicity/rurality. Design: This was a cross-sectional observational cohort study using publicly available data from the LTCfocus, Centers for Disease Control and Prevention Long-Term Care Facility COVID-19 Module, and the NYTimes county-level COVID-19 database. Four multivariable linear regression models omitting and including facility characteristics, COVID-19 burden, and county-level fixed effects were estimated. Setting and Participants: In total, 11,587 US NHs that reported data on COVID-19 to the Centers for Disease Control and Prevention and had data in LTCfocus and NYTimes from January 20, 2020 through July 19, 2020. Measures: Proportion of Black residents in NHs (exposure); COVID-19 infections and deaths (main outcomes). Results: The proportion of Black residents in NHs were as follows: none= 3639 (31.4%), <20% = 1020 (8.8%), 20%-49.9% = 1586 (13.7%), ≥50% = 681 (5.9%), not reported = 4661 (40.2%). NHs with any Black residents showed significantly more COVID-19 infections and deaths than NHs with no Black residents. There were 13.6 percentage points more infections and 3.5 percentage points more deaths in NHs with ≥50% Black residents than in NHs with no Black residents (P <.001). Although facility characteristics explained some of the differences found in multivariable analyses, county-level factors and rurality explained more of the differences. Conclusions and Implications: It is likely that attributes of place, such as resources, services, and providers, important to equitable care and health outcomes are not readily available to counties where NHs have greater proportions of Black residents. Structural bias may underlie these inequities. It is imperative that support be provided to NHs that serve greater proportions of Black residents while considering the rurality of the NH setting.