- Professional overview
The overarching goal of Dr. Malone’s career is to promote health and prevent cardio-metabolic disease across the lifespan. This goal has been motivated by Dr. Malone’s diverse clinical experiences, including school nursing and outpatient diabetes education. Dr. Malone’s research focuses on bridging research in behavioral, biological, and environmental rhythms to chronotherapeutic interventions that mitigate type 2 diabetes risk and improve overall health. She has studied the relationship between several dimensions of sleep (duration, timing, chronotype, regularity), health behaviors, and body mass index in adolescents. She has also conducted several population based studies examining relationships between these dimensions of sleep and chronic disease in adults, as well as sleep disparities across ethno-racial groups. She is interested in understanding what factors make some people vulnerable and others resilient to sleep loss and disrupted circadian rhythms.
Postdoctoral Fellow, University of PennsylvaniaPhD, University of PennsylvaniaMSN, University of PennsylvaniaBSN, Georgetown University
- Honors and awards
Marion R. Gregory Award for distinguished completed doctoral dissertation, University of Pennsylvania School of Nursing (2015)Heilbrunn Nurse Scholar Award, The Rockefeller University (2014)National Association of School Nurses Annual Conference research poster winner: Intraabdominal adipose tissue and cardio-metabolic disease risk in children and adolescents (2013)Leadership Identification Scholarship, University of Pennsylvania School of Nursing (1985)“Susan Kohl Award”. This award is given annually to a member of the Georgetown University Women’s Swim Team who demonstrates hard work, leadership, and dedication to team efforts.
- Professional membership
Society for Research in Biological RhythmsAmerican Academy of NursingEastern Nursing Research SocietySleep Research SocietyNational Association of School NursesSigma Theta Tau Nursing Honor Society
Characteristics Associated with Sleep Duration, Chronotype, and Social Jet Lag in Adolescents.Malone, S. K., Zemel, B., Compher, C., Souders, M., Chittams, J., Thompson, A. L., & Lipman, T. H. (2016). The Journal of school nursing : the official publication of the National Association of School Nurses 32, (120-31). 10.1177/1059840515603454
Sleep is a complex behavior with numerous health implications. Identifying sociodemographic and behavioral characteristics of sleep is important for determining those at greatest risk for sleep-related health disparities. In this cross-sectional study, general linear models were used to examine sociodemographic and behavioral characteristics associated with sleep duration, chronotype, and social jet lag in adolescents. One hundred and fifteen participants completed Phase I (self-reported sleep measures), and 69 of these participants completed Phase II (actigraphy-estimated sleep measures). Black adolescents had shorter free night sleep than Hispanics. Youth with later chronotypes ate fewer fruits and vegetables, drank more soda, were less physically active, and took more daytime naps. Based on these findings, recommendations for individual support and school policies are provided.
Ethnic differences in sleep duration and morning-evening type in a population sample.Malone, S. K., Patterson, F., Lu, Y., Lozano, A., & Hanlon, A. (2016). Chronobiology international 33, (10-21). 10.3109/07420528.2015.1107729
This cross-sectional population study examined associations of sleep duration and morning-evening type with sociodemographic and cardiometabolic disease in adults participating in the UK Biobank study (N = 439 933). Multivariable Poisson regression models of sleep duration and morning-evening type with a robust error variance were generated to estimate adjusted prevalence ratios and their 95% confidence intervals. All models were adjusted for sex, race, college attendance, employment status and age. Twenty five percent of the sample reported short sleep; 27% were morning, 64% intermediate and 9% evening type. Black ethnicity emerged as most strongly associated with sleep behavior. Short sleep was twice as prevalent, and morning versus intermediate type was 1.4 times more prevalent in Black than White participants. The greater prevalence of short sleep and morning type among Blacks suggests that sleep-based approaches to improving cardiometabolic outcomes may require a more multidimensional approach that encompasses adequate sleep and circadian alignment in this population.
Smoking, Screen-Based Sedentary Behavior, and Diet Associated with Habitual Sleep Duration and Chronotype: Data from the UK BiobankPatterson, F., Malone, S.K., Lozano, A., Grandner, M.A., & Hanlon, A.L. (2016). Annals of Behavioral Medicine 50, (715-726). 10.1007/s12160-016-9797-5 Springer Nature.
Social jet lag, chronotype and body mass index in 14–17-year-old adolescentsMalone, S.K., Zemel, B., Compher, C., Souders, M., Chittams, J., Thompson, A.L., … Lipman, T.H. (2016). Chronobiology International 33, (1255-1266). 10.1080/07420528.2016.1196697 Informa UK Limited.
Measurement and Interpretation of Body Mass Index During Childhood and Adolescence.Malone, S. K., & Zemel, B. S. (2015). The Journal of school nursing : the official publication of the National Association of School Nurses 31, (261-71). 10.1177/1059840514548801
The landscape of childhood health and disease has changed over the past century, and school nurses are now in a unique position to address the conditions that lead to chronic disease, such as obesity. Measuring body mass index (BMI) during childhood and adolescence is the recommended method for screening and/or monitoring obesity in school communities. Yet changes in the size, proportion, and distribution of fat mass and fat-free mass during growth and development introduce challenges to interpreting BMI measurements. Understanding these challenges and ensuring accurate measurement techniques are the foundation for implementing school-based BMI measurement programs. This article will provide an overview of body composition during childhood and adolescence, introduce strategies to improve the accuracy of BMI measurements, and explore the school nurse's role in BMI surveillance and/or screening activities.
Early to bed, early to rise?: an exploration of adolescent sleep hygiene practices.Malone, S. K. (2011). The Journal of school nursing : the official publication of the National Association of School Nurses 27, (348-54). 10.1177/1059840511410434
Cognition, memory, safety, mental health, and weight are all affected by inadequate sleep. Biological studies indicate significant changes in sleep architecture during adolescence, such as changes in melatonin secretion, and a need for greater total sleep time. Yet, social contexts and cultural values impinge on these changing biological sleep needs making adolescents vulnerable to the dangers of insufficient sleep. Sleep hygiene practices are purported as potential mediating factors between biological sleep needs and the sociocultural context of sleep. The purpose of this literature review is to highlight biological and social factors contributing to insufficient sleep in adolescents, to explore the evidence of several recommended sleep hygiene practices, and to stimulate further research about how adolescents negotiate their shifting biological sleep needs amid increasing social demands.
School nurses save lives: can we provide the data?Malone, S. K., & Bergren, M. D. (2010). The Journal of school nursing : the official publication of the National Association of School Nurses 26, (344-51). 10.1177/1059840510376384
Vigilance has been central to nursing practice since Florence Nightingale. Often, the nurse's work of surveillance goes unnoticed and the public never recognizes the value of the nurse's work. The 1999 Institute of Medicine report on hospital deaths due to preventable errors has lifted the veil shrouding professional vigilance. But how to measure vigilance remained elusive, until the concept, failure to rescue (FTR), was proposed. FTR has taken a prominent role in health care since its adoption as a patient safety indicator by the Agency for Healthcare Research and Quality (AHRQ) and as a measure for nursing performance in acute care by the National Quality Forum (NQF). However, its applicability to school nursing has been unexplored. This article provides an initial review of the literature and an analysis of anecdotal stories and media accounts that illustrate professional vigilance in school nursing practice.
Improving the quality of students' dietary intake in the school setting.Malone, S. K. (2005). The Journal of school nursing : the official publication of the National Association of School Nurses 21, (70-6). 10.1177/10598405050210020301
The dramatic increase in our understanding of the brain's development throughout childhood has increased our knowledge of the significance of micronutrients, such as iron and vitamin B-12, for this development. Deficiencies of these micronutrients have been shown to have an impact on students' cognitive development. Regardless of this knowledge, students continue to make unhealthy food choices and develop poor dietary habits. School environments are places where there is an opportunity to practice healthy eating habits. Yet many school policies fail to address the sale of foods of minimal nutritional value in the school setting. School nurses can play a vital role in planning policies at the local and national level that support and encourage healthy food environments, performing assessments of the nutritional status of students, and spearheading the implementation of evidence-based health promotion programs. It is time for school nurses to take the lead in efforts aimed at improving the quality of students' dietary intake in the school setting.
The significance of abdominal obesity in youth.Malone, S. K., & Lipman, T. H. Journal of pediatric nursing 29, (489-90). 10.1016/j.pedn.2014.06.005