Margaret McCarthy

Faculty

Margaret M. McCarthy headshot

Margaret McCarthy

FAHA FNP-BC PhD RN

Assistant Professor

1 212 992 5796

433 First Ave
Room 404
New York, NY 10010
United States

Accepting PhD students

Margaret McCarthy's additional information

Margaret McCarthy, PhD, RN, FNP-BC, FAHA, is an assistant professor at NYU Rory Meyers College of Nursing. She is a family nurse practitioner and an exercise physiologist. Her research focuses on promoting exercise in populations at risk for cardiovascular disease. She has conducted research in adults with both type 1 and type 2 diabetes. Her future research goal is to develop interventions to promote exercise in these populations, focusing on the use of technology in clinical settings. 

McCarthy received her PhD from New York University, MS in family nursing from Pace University, MA in exercise physiology from Adelphi University, and BSN from Binghamton University. She completed post-doctoral training in nursing at Yale University.

Post-doctoral training, Nursing - Yale
PhD - New York University
MS, Family Nursing Practitioner - Pace University
MA, Exercise Physiology - Adelphi University
BSN - Binghamton University

Non-communicable disease
Diabetes
Cardiology
Adult health

American Association of Nurse Practitioners
American Heart Association
Eastern Nursing Research Society
Society of Behavioral Medicine

Faculty Honors Awards

Fellow, New York Academy of Medicine (2018)
Fellow, American Heart Association (2017)
Overall Distinguished Student, NYU College of Nursing (2013)

Publications

Associations of insomnia symptoms with sociodemographic, clinical, and lifestyle factors in persons with HF: Health and retirement study

Gharzeddine, R., McCarthy, M. M., Yu, G., & Dickson, V. V. (2022). Research in Nursing and Health, 45(3), 364-379. 10.1002/nur.22211
Abstract
Abstract
Insomnia symptoms are very common in persons with heart failure (HF). However, many of the correlates and predictors of insomnia symptoms in this population remain unclear. The purpose of this study is to investigate the associations of sociodemographic, clinical, and lifestyle factors with insomnia symptoms in persons with HF. A theoretical framework was adapted from the neurocognitive model of chronic insomnia to guide the study. Data from the health and retirement study were used for the analysis. Parametric and nonparametric bivariate and multivariate analyses were conducted to investigate these associations. Age, depressive symptoms, comorbidity, dyspnea, pain, and smoking had significant bivariate associations with all insomnia symptoms. Race, Hispanic ethnicity, marital status, household income, poverty, and physical activity were associated with difficulty initiating sleep (DIS) and early morning awakening (EMA). Female sex, education, and alcohol consumption had a significant bivariate association with DIS. Sleep-disordered breathing and body mass index were significantly associated with EMA. Multivariate analysis suggested that depressive symptoms, comorbidity, dyspnea, and pain had independent associations with each insomnia symptom. Age explained DIS and difficulty maintaining sleep, and significant interaction effects between age and physical activity on DIS and EMA were revealed. Results suggest that insomnia symptoms are associated with several sociodemographic, clinical, and lifestyle factors. Age below 70 years, depressive symptoms, comorbidity, dyspnea, and pain might be considered as a phenotype to identify persons with HF who are at increased risk for insomnia symptoms.

Cardiovascular health in emerging adults with type 1 diabetes

McCarthy, M., Yan, J., Jared, M. C., You, E., Ilkowitz, J., Gallagher, M. P., & Vaughan Dickson, V. (2022). European Journal of Cardiovascular Nursing, 21(3), 213-219. 10.1093/eurjcn/zvab062
Abstract
Abstract
Aims: Individuals with type 1 diabetes (T1D) face increased risk for cardiovascular disease (CVD). Controlling individual cardiovascular risk factors can prevent or slow the onset of CVD. Ideal cardiovascular health is associated with a lower incidence of CVD. Identifying areas of suboptimal cardiovascular health can help guide CVD prevention interventions. To assess cardiovascular health and explore the barriers and facilitators to achieving ideal cardiovascular health in a sample of young adults with T1D. Methods and results: We used a sequential mixed-method design to assess the seven factors of cardiovascular health according to American Heart Association. Qualitative interviews, guided by Pender's Health Promotion Model, were used to discuss participant's cardiovascular health results and the barriers and facilitators to achieving ideal cardiovascular health. We assessed the frequency of ideal levels of each factor. The qualitative data were analysed using content analysis. Qualitative and quantitative data were integrated in the final analysis phase. The sample (n = 50) was majority female (70%), White (86%), with a mean age of 22 ± 2.4 and diabetes duration of 10.7 ± 5.5 years. Achievement of the seven factors of cardiovascular health were: non-smoking (96%); cholesterol <200 mg/dL (76%); body mass index <25 kg/m2 (54%); blood pressure <120/<80 mmHg (46%); meeting physical activity guidelines (38%); haemoglobin A1c <7% (40%); and healthy diet (14%). Emerging qualitative themes related to the perceived benefits of action, interpersonal influences on their diabetes self-management, and perceived self-efficacy. Conclusion: We found areas of needed improvement for cardiovascular health. However, these young adults expressed a strong interest in healthy habits which can be supported by their healthcare providers.

Associations of Insomnia Symptoms With Cognition in Persons With Heart Failure

Gharzeddine, R., Yu, G., McCarthy, M. M., & Dickson, V. V. (2021). Western Journal of Nursing Research, 43(12), 1105-1117. 10.1177/0193945920988840
Abstract
Abstract
Although cognitive impairment is common among persons with heart failure and negatively impacts self-care, hospitalization, and mortality, the associations between cognitive impairment and insomnia symptoms are not clearly understood. The purpose of this study was to explore these associations and examine if they are maintained after adjusting for relevant sociodemographic, clinical, and lifestyle factors. Guided by the Neurocognitive model of insomnia and sleep and the self-care conceptual model, a cross-sectional data analysis using parametric testing was conducted on the Health and Retirement Study wave 2016. Difficulty initiating sleep and early morning awakening, but not difficulty maintaining sleep were significantly associated with poorer cognitive performance in the bivariate and multivariate analysis. Our results are suggestive of different phenotypes of insomnia symptoms that may have different associations with cognition in persons with heart failure. Further research using objective measurements of insomnia symptoms and detailed neuropsychiatric testing of cognition is needed to confirm this conclusion.

Factors associated with work ability in adults with diabetes

McCarthy, M., Yan, J., & Dickson, V. V. (2021). Applied Nursing Research, 61. 10.1016/j.apnr.2021.151478
Abstract
Abstract
Aims: The aims of this study were to explore associations between clinical and diabetes-related factors with work ability in a sample of working adults with diabetes. Background: Adults with diabetes may face challenges in the workplace, including managing their diabetes and overall physical and mental health. Methods: This was a cross-sectional design with a sample of 101 working adults. Subjects completed valid and reliable surveys assessing depressive symptoms, diabetes self-care, fear of hypoglycemia, diabetes distress, cardiovascular health using American Heart Association's Life's Simple 7 (range 0–7) and work ability. Factors significantly associated with work ability at bivariate level were included in linear and logistic regression. Results: The majority of the sample was female (65%) (mean age 54.1 ± 10.5), White (74%), non-Hispanic (93%), worked full-time (65%) and had type 2 diabetes (87%) (mean duration 12.4 ± 9.5 years). The majority (55%) had low diabetes distress, but 24% had high distress and 28% had depressive symptoms. The sample achieved 2.5 ± 1.4 ideal AHA heart health indices and 33% rated their work ability as excellent. In linear regression higher depressive scores were associated with lower work ability scores (b = −0.45, p = .002). In logistic regression, scores on heart health (OR = 1.4; 95%CI:1.0–1.9, p = .03) and diabetes distress (OR = 0.6, 95%CI:0.4–0.9, p = .048) were significantly associated with work ability at its best. Conclusion: Both cardiovascular and psychological health may impact work ability in adults with diabetes. Routinely screening for diabetes distress and depression while also promoting ideal cardiovascular health may improve overall health and work ability in this population.

Implementing the physical activity vital sign in an academic preventive cardiology clinic

McCarthy, M. M., Fletcher, J., Heffron, S., Szerencsy, A., Mann, D., & Vorderstrasse, A. (2021). Preventive Medicine Reports, 23. 10.1016/j.pmedr.2021.101435
Abstract
Abstract
The aims were to implement physical activity (PA) screening as part of the electronic kiosk check-in process in an adult preventive cardiology clinic and assess factors related to patients’ self-reported PA. The 3-question physical activity vital sign (PAVS) was embedded in the Epic electronic medical record and included how many days, minutes and intensity (light, moderate, vigorous) of PA patients conducted on average. This is a data analysis of PAVS data over a 60-day period. We conducted multivariable logistic regression to identify factors associated with not meeting current PA recommendations. Over 60 days, a total of 1322 patients checked into the clinic using the kiosk and 72% (n = 951) completed the PAVS at the kiosk. The majority of those patients were male (58%) and White (71%) with a mean age of 64 ± 15 years. Of the 951 patients completing the PAVS, 10% reported no PA, 55% reported some PA, and 35% reported achieving at least 150 min moderate or 75 min vigorous PA/week. In the logistic model, females (AOR = 1.4, 95%CI: 1.002–1.8, p =.049) vs. males, being Black (AOR = 2.0, 95%CI: 1.04–3.7, p =.038) or ‘Other’ race (AOR = 1.5, 95%CI: 1.02–2.3, p =.035) vs. White, unknown or other types of relationships (AOR = 0.0.26, 95%CI: 0.10–0.68, p =.006) vs. being married/partnered, and those who were retired (AOR = 1.9, 95% CI: 1.4–2.8, p <.001) or unemployed (AOR = 2.2, 95%CI: 1.3–3.7, p =.002) vs. full-time workers were associated with not achieving recommended levels of PA. The PAVS is a feasible electronic tool for quickly assessing PA and may prompt providers to counsel on this CVD risk factor.

Insomnia and Insomnia Symptoms in Persons with Heart Failure: An Integrative Review

Gharzeddine, R., McCarthy, M. M., Yu, G., & Vaughan Dickson, V. (2021). Journal of Cardiovascular Nursing, 36(4), 374-384. 10.1097/JCN.0000000000000719
Abstract
Abstract
Background/Objective Insomnia and insomnia symptoms are highly prevalent in persons with heart failure (HF), and they are associated with several untoward outcomes. The purpose of this integrative review is to describe the correlates, predictors, and outcomes of insomnia and insomnia symptoms in persons with HF. Methods Using integrative review methods, an extensive electronic search of 5 databases was conducted for the period of 2000-2019. Sixteen studies were identified that met the inclusion criteria for review and investigated insomnia or insomnia symptoms in HF. Results Various sociodemographic factors, chronic comorbidities, clinical factors, and cognitive-behavioral factors are correlates and predictors of insomnia and insomnia symptoms in persons with HF. Depression, fatigue, daytime sleepiness, poor self-reported physical functioning, decreased exercise capacity, cardiac events, and poor health-related quality of life are significant outcomes of insomnia and insomnia symptoms in persons with HF. The associations of insomnia and insomnia symptoms with age, sex, sleep-disordered breathing, and cognition were not consistent across all studies. Conclusion Larger studies with diverse age and race groups as well as longitudinal studies and designs that test mediation effects are needed to disentangle complex relationships between insomnia and insomnia symptoms and several of their potential predictors and correlates in HF.

An Integrated Review of Hypertrophic Cardiomyopathy in Black Populations Underrecognized and Understudied

Arabadjian, M., McCarthy, M., & Dickson, V. V. (2021). Journal of Cardiovascular Nursing, 36(2), 104-115. 10.1097/JCN.0000000000000718
Abstract
Abstract
Background: Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disorder globally, affecting 0.2% to 0.5% of individuals. Existing clinical HCM guidelines do not address diverse populations, specifically minority groups who often experience health disparities. Objective: The aim of this study was to describe the state of the science of HCM in black populations. Methods: This integrated review guided by Whittemore and Knafl's methodology included literature search of multiple databases, data evaluation, and analysis. Publications between 2000 and 2020 were included if they addressed HCM cardiac anatomic manifestations, disease course, symptoms, quality of life, or outcomes in black populations. Results: Six articles met the inclusion criteria. Overall, blacks are underrepresented in HCM research. Certain HCM structural phenotypes are more commonly exhibited in blacks, and physiology drives HCM treatment. Sudden death events and all-cause mortality do not differ between blacks and whites with HCM. Fewer blacks with HCM undergo genetic testing than whites with HCM. The lack of diversity in general genomic databases has resulted in reclassification of several genetic variants identified as more common in blacks. Conclusions: Blacks are underrepresented in HCM research, even those focused on elucidating HCM manifestations, disease course, and outcomes in black populations. This may be due in part to HCM research that is largely generated from specialty centers that can require patients to navigate complex healthcare systems to reach expert HCM care. Longitudinal studies with large samples of blacks with HCM are necessary to elucidate how HCM affects this population.

Managing Diabetes in the Workplace

McCarthy, M., Vorderstrasse, A., Yan, J., Portillo, A., & Dickson, V. V. (2021). Workplace Health and Safety, 69(5), 216-223. 10.1177/2165079920965538
Abstract
Abstract
Background: Although many adults with diabetes are productive members of the workforce, loss of work productivity has been associated with diabetes. The purpose of this study was to explore the interrelationship between work-related factors and current work ability in adults with type 1 diabetes (T1D) and type 2 diabetes (T2D). Methods: This study used a convergent mixed-method design. We assessed the relationship between work-related factors and work ability using bivariate statistics and logistic regression. Work ability was measured using the Work Ability Index and Karasek’s Job Content Questionnaire (JCQ) was employed to measure job demands. Qualitative interviews (n = 30) explored the relationship between diabetes and work. Findings: The sample (n =101) was mostly female (65%) and White (74%). Most worked full-time (65%), had T2D (87%), an elevated glycated hemoglobin A1c ≥ 7% (56%), and were overweight (22%) or obese (68%). Only 33% of subjects self-reported their work ability as excellent. Four of the JCQ subscales (skill discretion, psychological demands, supervisor support, and coworker support), and work–life balance were significantly associated with work ability (all p <.05). In adjusted models, better coworker support (OR = 1.4; 95% CI = [1.04, 1.9]) and better work–life balance (OR = 1.3; 95% CI = [1.1, 1.5]) were associated with excellent work ability. Many stated their diabetes impacted them at work and spoke of the effects of stress. Few engaged in workplace wellness programs. Conclusion/Application to Practice: Social support and work–life balance were associated with excellent work ability. Engaging workers with diabetes in workplace educational programs may take strategic efforts by occupational health staff.

Telemedicine and Telehealth in Nursing Homes: An Integrative Review

Groom, L. L., McCarthy, M. M., Stimpfel, A. W., & Brody, A. A. (2021). Journal of the American Medical Directors Association, 22(9), 1784-1801.e7. 10.1016/j.jamda.2021.02.037
Abstract
Abstract
Objectives: Telemedicine and telehealth are increasingly used in nursing homes (NHs). Their use was accelerated further by the COVID-19 pandemic, but their impact on patients and outcomes has not been adequately investigated. These technologies offer promising avenues to detect clinical deterioration early, increasing clinician's ability to treat patients in place. A review of literature was executed to further explore the modalities' ability to maximize access to specialty care, modernize care models, and improve patient outcomes. Design: Whittemore and Knafl's integrative review methodology was used to analyze quantitative and qualitative studies. Setting and Participants: Primary research conducted in NH settings or focused on NH residents was included. Participants included clinicians, NH residents, subacute patients, and families. Methods: PubMed, Web of Science, CINAHL, Embase, PsycNET, and JSTOR were searched, yielding 16 studies exploring telemedicine and telehealth in NH settings between 2014 and 2020. Results: Measurable impacts such as reduced emergency and hospital admissions, financial savings, reduced physical restraints, and improved vital signs were found along with process improvements, such as expedient access to specialists. Clinician, resident, and family perspectives were also discovered to be roundly positive. Studies showed wide methodologic heterogeneity and low generalizability owing to small sample sizes and incomplete study designs. Conclusions and Implications: Preliminary evidence was found to support geriatrician, psychiatric, and palliative care consults through telemedicine. Financial and clinical incentives such as Medicare savings and reduced admissions to hospitals were also supported. NHs are met with increased challenges as a result of the COVID-19 pandemic, which telemedicine and telehealth may help to mitigate. Additional research is needed to explore resident and family opinions of telemedicine and telehealth use in nursing homes, as well as remote monitoring costs and workflow changes incurred with its use.

Diabetes Distress, Depressive Symptoms, and Cardiovascular Health in Adults with Type 1 Diabetes

McCarthy, P. (2019). Nursing Research, 68(6), 445-452.
Abstract
Abstract
BACKGROUND: The prevalence of adults with Type 1 diabetes (T1D) is increasing, and their risk of cardiovascular disease is high. Comorbid diabetes distress and depressive symptoms may affect their cardiovascular health. OBJECTIVES: The purpose of this study was to describe the relationship between diabetes distress and depressive symptoms with cardiovascular health factors. METHODS: This was a cross-sectional survey of a sample of adults with T1D. Valid and reliable instruments were used to collect the data on sociodemographics, diabetes-related complications, psychological factors, and cardiovascular health factors. Independent-sample t tests, analysis of variance, chi-square analyses, and linear regression were used to compare the cardiovascular health factors among the three levels of diabetes distress scores and the two levels of depressive symptom scores. RESULTS: Our sample included 83 adults with a mean age of 45.2 years and a mean duration of T1D of 20 years. The majority scored low in the Diabetes Distress Scale, whereas 18% scored moderate and 18% scored high. Twenty-two percent had increased levels of depressive symptoms. There were significant correlations between diabetes distress and fear of hypoglycemia, depressive symptom scores, hemoglobin A1c, and total cholesterol. Depressive symptom scores were significantly correlated with hemoglobin A1c. Hemoglobin A1c and total cholesterol were significantly higher in those with higher levels of diabetes distress. There were no significant differences in cardiovascular health between those who scored below or above the cut point for depressive symptoms, but there was a finding toward higher mean body mass index, hemoglobin A1c, and a lower weekly step count in those who had elevated depressive symptoms. In the linear regression, only diabetes distress was significantly associated with hemoglobin A1c. DISCUSSION: This is a sample with elevated diabetes distress and depressive symptoms, both of which may affect their risk of cardiovascular disease.