Faculty

Margaret M. McCarthy headshot

Margaret McCarthy

FAHA FNP-BC PhD RN

Assistant Professor

1 212 992 5796

433 First Avenue
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

Managing Diabetes in the Workplace

McCarthy, M., Vorderstrasse, A., Yan, J., Portillo, A., & Vaughan Dickson, V. (2020). Workplace Health and Safety. 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.

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

McCarthy, P. (2019). Nursing Research, 68(6).

The Experience of Partners of Adults with Type 1 Diabetes: an Integrative Review

Whittemore, R., Delvy, R., & McCarthy, M. M. (2018). Current Diabetes Reports, 18(4). 10.1007/s11892-018-0986-4
Abstract
Abstract
Purpose of Review: The purpose of this review was to synthesize the research on the experience of partners living with adults with type 1 diabetes (T1D). Recent Findings: Eleven studies were included in the review. Three themes on the experience of living with a person with T1D were identified: the undercurrent of hypoglycemia, partners’ involvement in diabetes care, and the impact on partners’ lives. Due to considerable fear of hypoglycemia, partners had pervasive and deliberate ways in which they made attempts to minimize hypoglycemia in the person with diabetes and its cascade to a health emergency. As a result, partners of adults with T1D experienced considerable distress and disrupted lives. Partners also expressed a need for more support from family, friends, and health professionals. Summary: Research is needed on the partner experience across the lifespan and the specific supportive services they need in order to optimize their health outcomes.

Type 1 Diabetes Self-Management From Emerging Adulthood Through Older Adulthood

McCarthy, M. M., & Grey, M. (2018). Diabetes Care. 10.2337/dc17-2597
Abstract
Abstract
OBJECTIVE: The purpose of this study of adults with type 1 diabetes was to analyze patterns of diabetes self-management behaviors and predictors of glycemic control across the adult life span.RESEARCH DESIGN AND METHODS: This study was a secondary cross-sectional analysis of data from of 7,153 adults enrolled in the Type 1 Diabetes Exchange clinic registry who were divided into four developmental stages (emerging, young, middle-aged, and older adults). Data were collected by questionnaire and medical record review at enrollment. Statistical analyses compared sociodemographic, clinical, and diabetes-related factors across groups. Logistic regressions were conducted for each group to identify factors associated with hemoglobin A1c ≥7%.RESULTS: The sample was divided according to adult developmental stage: emerging adults, age 18 to <25 years (n = 2,478 [35%]); young adults, age 25 to <45 years (n = 2,274 [32%]); middle-aged adults, age 45 to <65 years (n = 1,868 [26%]; and older adults, age ≥65 years (n = 533 [7%]). Emerging adults had the highest mean hemoglobin A1c level (8.4 ± 1.7% [68 mmol/mol]), whereas older adults had the lowest level (7.3 ± 0.97% [56 mmol/mol]; P < 0.0001). Emerging adults were less likely to use an insulin pump (56%) or a continuous glucose monitor (7%), but were more likely to miss at least one insulin dose per day (3%) and have had an episode of diabetic ketoacidosis in the past year (7%) (all P < 0.0001). Different factors were associated with hemoglobin A1c ≥7% in each age group, but two factors were noted across several groups: the frequency of blood glucose checks and missed insulin doses.CONCLUSIONS: When discussing diabetes self-management, providers may consider a patient's developmental stage, with its competing demands, such as work and family; psychosocial adjustments; and the potential burden of comorbidities.

Arthritis-related limitations predict insufficient physical activity in adults with prediabetes identified in the NHANES 2011-2014

Strauss, S. M., & McCarthy, M. (2017). Diabetes Educator, 43(2), 163-170. 10.1177/0145721717691849
Abstract
Abstract
Purpose The purpose of the study was to determine the extent to which arthritis-related limitations are salient in predicting less than the recommended amount of time for adults with prediabetes to spend on moderate or vigorous physical activity. Methods Data from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) in the United States were used to identify the predictors of insufficient physical activity in a large sample of adults with prediabetes 20 years of age and older (n = 2536). Results When extrapolated to more than 45 million adults in the United States at least 20 years of age with prediabetes, 42.7% had insufficient physical activity. Having arthritis- related functional limitations was a significant predictor of insufficient physical activity, even after accounting for the statistically significant contributions of female sex, older age, lower education level, higher body mass index, and depression. Conclusion When educating and counseling adults with prediabetes, diabetes educators should assess for arthritis-related functional limitations when examining factors that may affect prediabetes progression. Recommendations for physical activity for those with mobility and other limitations need to be individualized within a tailored exercise program to accommodate their specific limitations.

Physical inactivity and cardiac events: An analysis of the Detection of Ischemia in Asymptomatic Diabetics (DIAD) study

McCarthy, M. M., Wackers, F. J., Davey, J., & Chyun, D. A. (2017). Journal of Clinical and Translational Endocrinology, 9, 8-14. 10.1016/j.jcte.2017.05.005
Abstract
Abstract
Aims Diabetes affects 29 million adults, and the majority have type 2 diabetes (T2D). Coronary artery disease (CAD) is the leading cause of death, and physical inactivity is an important risk factor. The aims of this study were to examine the contribution of physical inactivity to CAD events, and to identify the independent predictors of CAD events in a sample of older adults with T2D. Method A secondary data analysis of the prospective randomized screening trial “Detection of Ischemia in Asymptomatic Diabetics (DIAD)” study. Cox proportional hazard modeling was used to examine the outcome of CAD events. Results During the five years of follow-up, the CAD event rate for all subjects (n = 1119) was 8.4% (n = 94). In unadjusted analysis, physical inactivity was significantly associated with development of a CAD event. In the final model, nine baseline variables were significant predictors (p < 0.05) of a CAD: physical inactivity, race, diabetes duration, hemoglobin A1c (HbA1c), peripheral numbness, insulin use, increasing waist-to-hip ratio, family history of premature CAD, and a higher pulse pressure. In men only, there were five predictors (p < 0.05) of a CAD event: diabetes duration, peripheral numbness, HbA1c, increasing waist-to-hip ratio, and higher pulse pressure. The final model in women included three independent predictors (p < 0.05) of a CAD event: diabetes duration, a family history of premature CAD, and higher pulse pressure. Conclusion Several variables predicted CAD events in this sample of older adults with T2D. Understanding baseline characteristics that heighten risk may assist providers in intervening early to prevent its occurrence.

Self-management of physical activity in adults with type 1 diabetes

McCarthy, M. M., Whittemore, R., Gholson, G., & Grey, M. (2017). Applied Nursing Research, 35, 18-23. 10.1016/j.apnr.2017.02.010

Cardiovascular health in adults with type 1 diabetes

McCarthy, M. M., Funk, M., & Grey, M. (2016). Preventive Medicine, 91, 138-143. 10.1016/j.ypmed.2016.08.019
Abstract
Abstract
Adults with type 1 diabetes (T1D) are at risk for cardiovascular (CV) disease. Managing CV risk is an important prevention strategy. The American Heart Association has defined 7 factors for ideal CV health. The purpose of this 2016 secondary analysis was to assess the prevalence of 6 CV health factors in a sample of adults ≥ 18 (n = 7153) in the T1D Exchange Clinic registry. CV health factors include: hemoglobin A1c (HbA1c) < 7%, BMI < 25 kg/m2, blood pressure < 120/80 mm Hg, total cholesterol < 200 mg/dL, non-smoking, and physical activity ≥ 150 min/week. HbA1c < 7% was substituted for the AHA health factor of fasting blood glucose. Frequencies of each factor were tabulated for the total sample and for each gender. Logistic regression examined variables associated with achievement of each CV health factor. The mean age was 37.14 ± 17 years. Mean HbA1c was 7.9 ± 1.5%, and duration was 19.5 ± 13.5 years. The majority (54%) were working full or part-time. Achievement of CV health factors in the whole sample ranged from 27% (HbA1c < 7%) to 94% nonsmoking. Achievement of some factors varied by gender. Common variables associated with several CV health factors included gender, education, employment, and T1D duration. This young sample exhibited low levels of some CV health factors, especially HbA1c and physical activity. Providers need to routinely assess and advise on management of all CV risk factors to prevent this common diabetes complication.

An exercise counseling intervention in minority adults with heart failure

McCarthy, M. M., Dickson, V. V., Katz, S. D., & Chyun, D. A. (2016). Rehabilitation Nursing, 42(3), 146-156. 10.1002/rnj.265
Abstract
Abstract
Purpose: The primary aimof this study was to assess the feasibility of an exercise counseling intervention for adults of diverse race/ ethnicity with heart failure (HF) and to assess its potential for improving overall physical activity, functional capacity, and HF self-care. Design: This study was a quasi-experimental, prospective, longitudinal cohort design. Methods: Twenty adults were enrolled and completed the 6-minute walk and standardized instruments, followed by exercise counseling using motivational interviewing. Each received an accelerometer, hand weights, and a diary to record self-care behaviors. Participants were followed via phone for 12 weeks to collect step-counts, review symptoms, and plan the following week's step goal. Findings: Results indicate that this interventionwas feasible formost participants and resulted in improvements in physical activity, functional capacity, and self-care behaviors. Conclusion/Clinical Relevance: Brief exercise counseling may be an appropriate option to improve outcomes for stable patients with HF and may be tailored to fit different settings.

Physical Activity in Adults With Type 1 Diabetes

McCarthy, M. M., Whittemore, R., & Grey, M. (2016). The Diabetes Educator, 42(1), 108-115. 10.1177/0145721715620021
Abstract
Abstract
Purpose The purpose of this study was to examine sociodemographic, clinical, and psychological factors associated with engaging in regular physical activity (PA) in adults with type 1 diabetes. Secondary cross-sectional analysis based on data from the Type One Diabetes Exchange clinic registry was conducted. Adults ≥18 years old enrolled in the clinic registry who had completed PA self-report data (n = 7153) were included in this study. Mean age was 37.14 ± 17 years, and 54% (n = 3840) were men. Type 1 diabetes duration was 19.5 ± 13.5 years, and mean A1C level was 7.9% ± 1.5% (62 mmol/mol). Twelve percent (n = 848) of the sample reported no PA; 55% (n = 3928) reported PA 1 to 4 days per week; and 33% (n = 2377) reported PA ≥5 days per week. Factors that were associated with increased odds of no PA were older age, less-than-excellent general health, increased body mass index, longer duration of diabetes, and increased depressive symptoms. More blood glucose meter checks per day decreased odds of no PA. Factors associated with lower odds of ≥5 days of PA included minority race/ethnicity, education, less-than-excellent general health, presence of a foot ulcer, increased body mass index, and depressive symptoms. Male sex, less-than-full-time employment, and being single increased the odds of ≥5 days of PA. Several demographic, clinical, diabetes-related, and psychosocial factors were related to PA. Potential interventions may target those with depressive symptoms or self-reported poor general health, or they may be tailored to working adults who may find it harder to be physically active.