Tina Sadarangani

Faculty

Tina Sadarangani headshot

Tina Sadarangani

ANP-C GNP-BC PhD RN

Assistant Professor

1 212 992 7183

433 First Avenue
New York, NY 10010
United States

Tina Sadarangani's additional information

Tina Sadarangani is an early career NIH-funded Principal Investigator and board certified primary care nurse practitioner deeply committed to advancing the health of vulnerable older adults by leveraging the strengths of community-based adult day health care centers to target health disparities. In the last three years, she has expanded her program of research to focus, specifically, on identifying and addressing the healthcare needs of cognitively impaired older immigrants, by using the adult day health center as a platform for the delivery of culturally and linguistically congruent care.  Having previously collaborated with the California Association of Adult Day Services to evaluate their Community Based Health Home, a program designed to improve care coordination and reduce social isolation among ethnically diverse, low-income, frail adults with limited English proficiency through intensive support from registered nurse navigator (RN-N). Her findings affirmed that adult day centers can serve as a health home and RN-Ns facilitate improved communication between centers and health care providers that contributed to reductions in healthcare utilization. However, widespread implementation has been limited by the cost of the RN-N.

Sadarangani’s latest work focuses on improving communication between adult day centers and primary care providers using low-cost mobile technology. She recently received an R21 from the National Institute on Aging entitled “Bridging Communication Gaps between Primary Care Providers and Adult Day Service Centers to Reduce Emergency Department Use and Hospitalizations among Persons with Dementia.” She also received a Career Development Award from the National Institute on Aging IMPACT Collaboratory through which she will benefit from the expertise of an experienced interdisciplinary mentorship team to acquire training in using both (1) stakeholder engaged approaches to developing mhealth technology and (2) pilot embedded pragmatic clinical trials (ePCTs) and ePCTs patient centered reported outcomes. 

PhD - New York University
MS - University of Pennsylvania
BSN - New York University
BA - Georgetown University

Gerontology
Immigrants
Health Policy
Chronic disease
Underserved populations
Vulnerable & marginalized populations
Health Services Research

American Gerontological Society
American Heart Association
National Gerontological Nurses Association
Sigma Theta Tau Nursing Honor Society

Faculty Honors Awards

Provost’s Postdoctoral Fellowship Program, New York University (2019)
Provost’s Postdoctoral Fellowship Program, New York University (2018)
Provost’s Postdoctoral Fellowship Program, New York University (2017)
Valedictorian, New York University (2017)
Hermann Biggs Health Policy Scholar, Josiah Macy Jr. Foundation (2017)
Doctoral Audience Choice Winner, New York University (2016)
Research Podium Presentation Award, Gerontology Advanced Practice Nurses Association (2016)
Patricia G. Archbold Award, National Hartford Centers for Gerontological Nursing Excellence (2016)
Hillman Alumni Network Innovation Fellowship, Hillman Alumni Network (2016)
Hermann Biggs Health Policy Scholar, Josiah Macy Jr. Foundation (2016)
Patricia G. Archbold Award, National Hartford Centers for Gerontological Nursing Excellence (2015)
Patricia G. Archbold Award, National Hartford Centers for Gerontological Nursing Excellence (2014)
Spirit of Hillman Award, Hillman Alumni Network (2014)
Phi Beta Kappa, Georgetown University
Summa Cum Laude, Georgetown University

Publications

Engaging Nursing Assistants to Enhance Receptivity to the Coronavirus Disease 2019 Vaccine

Sadarangani, T. R., David, D., & Travers, J. (2021). Journal of the American Medical Directors Association, 22(6), 1125-1127. 10.1016/j.jamda.2021.03.016

Identifying research priorities in adult day centers to support evidence-based care of vulnerable older adults

Sadarangani, T., Zagorski, W., Parker, L., & Missaelides, L. (2021). Progress in Community Health Partnerships: Research, Education, and Action, 15(1), 127-131. 10.1353/cpr.2021.0012
Abstract
Abstract
Adult day centers (ADCs) are essential community resources that allow frail older adults to remain in their communities. Research demonstrates that ADC staff have the capacity to leverage their culturally and socially congruent relation-ships with clients and caregivers, to deliver evidence-based interventions that improve health outcomes. Yet, they remain a largely overlooked neighborhood resource for older adults with complex health care needs. The National Adult Day Services Association (NADSA) created a multistakeholder work group to identify priority areas for research to enhance the quality of services offered in ADCs and the delivery of evidence-based practices to clients. This perspective piece, which presents the workgroup’s findings in the form of key research priorities, is intended as practical guide for researchers seeking to align their research questions with the needs of ADCs and those they serve. In addition to identifying areas of further exploration, we discuss current studies being undertaken within the ADC setting.

A Qualitative Analysis of the Delivery of Person-Centered Nutrition to Asian Americans With Dementia in the Adult Day Health Care Setting

Sadarangani, T., Chong, S., Park, S., Missaelides, L., Johnson, J., Trinh-Shevrin, C., & Brody, A. (2021). Journal of Applied Gerontology, 40(2), 179-188. 10.1177/0733464820910030
Abstract
Abstract
Adult day service centers (ADSCs) provide community-based long-term care, including meals, to racially diverse older adults, 47% of whom have dementia and consequently experience elevated nutritional risk. We examine nutritional behaviors for Chinese and Vietnamese persons living with dementia (PLWD) in ADSCs and evaluate the extent to which ADSCs provide person-centered nutritional care. Multi-stakeholder interviews were conducted. Data were coded using Dedoose and analyzed using Braun and Clarke’s six-step method. The Model for the Provision of Good Nutritional Care in Dementia guided analysis. Barriers to food intake included distracting meal environment, rigid mealtimes, and excessively restrictive diets. Conversely, peer relationships, culturally tailored meals and celebrations, and consistent staff assisting with feeding benefited PLWD. ADSCs can support healthy nutritional behaviors and quality of life among PLWD through person-centered nutritional care. To optimize nutritional services, further exploration is needed with respect to the ADSC environment, users’ culture and ethnicity, and liberalized diets for PLWD.

“Advocating Every Single Day” so as Not to be Forgotten: Factors Supporting Resiliency in Adult Day Service Centers Amidst COVID-19-Related Closures

Sadarangani, T., Zhong, J., Vora, P., & Missaelides, L. (2021). Journal of Gerontological Social Work, 64(3), 291-302. 10.1080/01634372.2021.1879339
Abstract
Abstract
Adult day centers (ADCs) are nonresidential settings that support the health and social needs of vulnerable older adults. Due to ADCs’ congregate nature and participants’ compromised health status, many ADCs have been forced to close during the COVID-19 pandemic. It is unknown how closures have impacted service delivery at ADCs. Guided by the Resiliency Activation Framework, we (a) identified consequences resulting from closures of ADCs during the COVID-19 pandemic and (b) described factors that have enabled the ADC community to remain resilient in the wake of challenges brought on by the pandemic. We conducted 2 focus groups in California (n = 12), and individual interviews with ADC staff members (n = 8) in 7 other states. The results of a directed content analysis revealed perceived declines in physical, cognitive, and mental health of ADC users and increased caregiver strain. Access to human, social, economic, and political capital were essential for supporting ADCs in buffering the impacts of the pandemic on the older adults they serve but were not consistently available. Research is urgently needed that quantifies the impacts of the pandemic on ADC users and their caregivers to inform policy and advocacy efforts in the wake of the pandemic.

Enriching Nutrition Programs to Better Serve the Needs of a Diversifying Aging Population

Sadarangani, T. R., Beasley, J. M., Yi, S. S., & Chodosh, J. (2020). Family and Community Health, 43(2), 100-105. 10.1097/FCH.0000000000000250
Abstract
Abstract
Racial minorities experience a high burden of food insecurity relative to non-Hispanic whites. Government-subsidized nutrition programs can positively impact food insecurity and nutritional risk among older adults. Yet, in New York City, where nearly 60% of people over 65 years are non-white, older minorities participate in government nutrition programs at very low rates. In this commentary, we focus on 2 programs: the Child and Adult Care Food Program and Older Americans Act Nutrition Services Programs. We identify opportunities for strengthening these programs to improve their reach and engagement with diverse older adults in New York City and similarly diverse urban communities.

Family- And person-centered interdisciplinary telehealth: Policy and practice implications following onset of the COVID-19 pandemic

Brody, A. A., Sadarangani, T., Jones, T. M., Convery, K., Groom, L., Bristol, A. A., & David, D. (2020). Journal of Gerontological Nursing, 46(9), 9-13. 10.3928/00989134-20200811-03
Abstract
Abstract
With the onset of the COVID-19 pandemic, telehealth was thrust to the forefront, becoming one of the most predominant forms of care almost overnight. Despite years of research, practice, and policymaking, tenets for providing telehealth in an interdisciplinary, family- and person-centered fashion, and across a wide breadth of settings remain underdeveloped. In addition, although telehealth has the potential to increase equity in care, it can also further exacerbate disparities. The current article discusses the opening created by the pandemic and provides recommendations for how to make permanent changes in telehealth policy and practice to allow for interdisciplinary, person- and family-centered care while also taking care to address issues of equity and ethics and privacy issues related to telehealth and remote monitoring. [Journal of Gerontological Nursing, 46(9), 9-13.]

The nurse's role in promoting health equity and improving racial justice in older adults through elimination of unconscious bias

Sadarangani, T. R. (2020). Geriatric Nursing, 41(6), 1025-1027. 10.1016/j.gerinurse.2020.10.011

Using the social ecological model to identify drivers of nutrition risk in adult day settings serving east Asian older adults

Sadarangani, T. R., Johnson, J. J., Chong, S. K., Brody, A., & Trinh-Shevrin, C. (2020). Research in Gerontological Nursing, 13(3), 146-157. 10.3928/19404921-20191210-02
Abstract
Abstract
Adult day care (ADC) centers provide community-based care (including meals) to frail, ethnically diverse older adults, many of whom are at risk for malnutrition. To support the development of interventions to benefit ADC users, the authors aimed to identify barriers and facilitators of healthy nutrition among ADC users born in Vietnam and China. Semi-structured qualitative interviews were conducted among ADC stakeholders to identify barriers and facilitators. Data were analyzed using Braun and Clarke’s six-step method and organized within the framework of the Social Ecological Model. Facilitators of good nutrition included adherence to traditional diet at the ADC center, peer networks, and access to ethnic grocers. Poor health, family dynamics, and loneliness all contributed to poor nutrition, as did the restrictive nature of nutrition programs serving ADC users in the United States. Individual, relationship, organizational, community, and policy level factors play a role in ADC users’ nutritional status. Targeted nutrition interventions should leverage culturally congruent relationships between ADC users and staff and include advocacy for enhancement of federal programs to support this population. [Research in Gerontological Nursing, 13(3), 146-157.].

Cardiovascular Risk in Middle-Aged and Older Immigrants: Exploring Residency Period and Health Insurance Coverage

Sadarangani, T. R., Trinh-Shevrin, C., Chyun, D., Yu, G., & Kovner, C. (2019). Journal of Nursing Scholarship, 51(3), 326-336. 10.1111/jnu.12465
Abstract
Abstract
Purpose: It is reported that while immigrants are, initially, healthier than the native-born upon resettlement, this advantage erodes over time. In the United States, uninsured aging immigrants are increasingly experiencing severe complications of cardiovascular disease (CVD). The purpose of this study was to compare overall CVD risk and explore the importance of health insurance coverage on CVD risk relative to other health access barriers, from 2007 to 2012, in recent and long-term immigrants >50 years of age. Methods: This study was based on secondary cross-sectional analysis of the National Health and Nutrition Examination Survey (N = 1,920). The primary outcome, CVD risk category (high or low), was determined using the American College of Cardiology and American Heart Association Pooled Cohort equation. Differences between immigrant groups were examined using independent-samples t tests and chi-square analysis. The association between insurance and CVD risk was explored using a hierarchical block logistic regression model, in which variables were entered in a predetermined order. Changes in pseudo R 2 measured whether health insurance explained variance in cardiac risk beyond other variables. Results: Recent immigrants had lower overall CVD risk than long-term immigrants but were twice as likely to be uninsured and had higher serum glucose and lipid levels. Based on regression models, being uninsured contributed to CVD risk beyond other health access determinants, and CVD risk was pronounced among recent immigrants who were uninsured. Conclusions: Health insurance coverage plays an essential part in a comprehensive approach to mitigating CVD risk for aging immigrants, particularly recent immigrants whose cardiovascular health is susceptible to deterioration. Clinical Relevance: Nurses are tasked with recognizing the unique social and physical vulnerabilities of aging immigrants and accounting for these in care plans. In addition to helping them access healthcare coverage and affordable medication, nurses and clinicians should prioritize low-cost lifestyle interventions that reduce CVD risk, especially diet and exercise programs.

A Mixed-Methods Evaluation of a Nurse-Led Community-Based Health Home for Ethnically Diverse Older Adults With Multimorbidity in the Adult Day Health Setting

Sadarangani, T., Missaelides, L., Eilertsen, E., Jaganathan, H., & Wu, B. (2019). Policy, Politics, and Nursing Practice. 10.1177/1527154419864301
Abstract
Abstract
Multimorbidity affects 75% of older adults (aged 65 years and older) in the United States and increases risk of poor medical outcomes, especially among the poor and underserved. The creation of a Medicaid option allowing states to establish health homes under the Affordable Care Act was intended to enhance coordinated care for Medicaid beneficiaries with multimorbidity. The Community-Based Health Home (CBHH) model uses the infrastructure of the Adult Day Health Center (ADHC) to serve as a health home to improve outcomes for medically complex vulnerable adults. Between 2017 and 2018, we used a sequential explanatory mixed-methods approach to (a) quantitatively examine changes in depression, fall risk, loneliness, cognitive function, nutritional risk, pain classification, and health care utilization over the course of 12 months in the program and (b) qualitatively explore the perspectives of key stakeholders (registered nurse navigators, participants, ADHC administrators, and caregivers) to identify the most effective components of CBHH. Using data integration techniques, we identified components of CBHH that were most likely driving outcomes. After 12 months in CBHH, our racially diverse sample (N = 126), experienced statistically significant (p < .05) reductions in loneliness, depression, nutritional risk, poorly controlled pain, and emergency department utilization. Stakeholders who were interviewed (n = 40) attributed positive changes to early clinical intervention by the registered nurse navigators, communication with providers across settings, and a focus on social determinants of health, in conjunction with social stimulation and engagement provided by the ADHC. CBHH positions the ADHC as the locus of an effective health home site and is associated with favorable results. CBHH also demonstrates the unique capacity and skill of registered nurses in integrating health and social services across community settings. Continued exploration of CBHH among diverse populations with multimorbidity is warranted.