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

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Professional overview

Tina Sadarangani, PhD, RN, ANP-BC, GNP-BC, is an assistant professor at NYU Rory Meyers College of Nursing. Her focus is on improving health outcomes for ethnically diverse older adults with multiple chronic conditions, including dementia, in community-based long-term care settings. She is currently a Fellow of the Hartford Institute of Geriatric Nursing at NYU and an Aging Incubator Senior Fellow. Sadarangani is also a board-certified adult/gerontological primary care nurse practitioner with experience in both primary care and specialty settings.   

Sadarangani’s program of research specifically explores the capacity of adult day service centers to integrate health and social services for persons with dementia in order to reduce avoidable healthcare utilization. She is currently examining the impact of COVID-19 on frail older adults in community-based long-term care settings.

Sadarangani is a leading member of the National Adult Day Services Association Research Committee. She was selected for her expertise by the Camden Coalition to serve on the Complex Care Core Competencies Working Group. She will join a group of 15 practitioners, educators, and consumers across the country in a year-long process to develop an initial set of statements that define the knowledge, skills, and attitudes needed to effectively deliver care for people with complex health and social needs. She is committed to the use of community-based participatory action research methods to enhance stakeholder engagement in the research process and maintains strong community partnerships with both the adult day centers across the United States.

Sadarangani's work has received significant funding from the National Hartford Centers for Gerontological Nursing Excellence and the Hillman Family Foundation. She was recognized as a Patricia G. Archbold Scholar by the National Hartford Centers for Gerontological Nursing Excellence from 2014-2016. Most recently, she was awarded $30,000 as part of the NYU Center for the Study of Asian American Health's Pilot Program for Alzheimer's Disease and its Related Dementias.

Education

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

Specialties

Gerontology
Immigrants
Policy
Chronic disease
Underserved populations
Vulnerable & marginalized populations

Professional membership

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

Honors and awards

Faculty Honors Awards

Provost’s Postdoctoral Fellowship Program, New York University (2019)
Provost’s Postdoctoral Fellowship Program, New York University (2018)
Hermann Biggs Health Policy Scholar, Josiah Macy Jr. Foundation (2017)
Provost’s Postdoctoral Fellowship Program, New York University (2017)
Valedictorian, New York University (2017)
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)
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 (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

Publications

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
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.

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. (2020). Journal of Applied Gerontology. 10.1177/0733464820910030
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.

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
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
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
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.

Racial Disparities in Nutritional Risk among Community-Dwelling Older Adults in Adult Day Health Care

Sadarangani, T., Missaelides, L., Yu, G., Trinh, C., & Brody, A. (2019). Journal of Nutrition in Gerontology and Geriatrics.
Abstract
Information regarding nutritional risk among users of American adult day health centers (ADHCs), 60% of whom are racial minorities, is scant. This study examined nutritional risk and associated factors in a diverse sample ADHC users aged 50+ using secondary cross-sectional analysis of data collected between 2013 and 2017. Risk was assessed using the DETERMINE checklist, and results were stratified by race. The majority of the sample (N = 188) was at moderate (45.2%) or high (38.5%) nutritional risk, with statistically significant racial differences. Blacks were at greater risk than any other group: 65% had high nutritional risk; 76.5% ate <5 servings of fruits, vegetables, or milk daily; 21% ate <2 meals daily, 48.5% reported involuntary weight loss/gain, and 41.2% had tooth loss/mouth pain. Older adults in ADHCs are at elevated risk of malnutrition, disproportionately so amongst blacks. Both routine nutrition screening and population-specific approaches are needed to attenuate risk.

Strategies for overcoming language barriers in research

Squires, A., Sadarangani, T., & Jones, S. (2019). Journal of Advanced Nursing, 76(2), 706-714. 10.1111/jan.14007
Abstract
Aim: This paper seeks to describe best practices for conducting cross-language research with individuals who have a language barrier. Design: Discussion paper. Data Sources: Research methods papers addressing cross-language research issues published between 2000–2017. Implications for Nursing: Rigorous cross-language research involves the appropriate use of interpreters during the research process, systematic planning for how to address the language barrier between participant and researcher and the use of reliably and validly translated survey instruments (when applicable). Biases rooted in those who enter data into “big data” systems may influence data quality and analytic approaches in large observational studies focused on linking patient language preference to health outcomes. Conclusion: Cross-language research methods can help ensure that those individuals with language barriers have their voices contributing to the evidence informing healthcare practice and policies that shape health services implementation and financing. Understanding the inherent conscious and unconscious biases of those conducting research with this population and how this may emerge in research studies is also an important part of producing rigorous, reliable, and valid cross-language research. Impact: This study synthesized methodological recommendations for cross-language research studies with the goal to improve the quality of future research and expand the evidence-base for clinical practice. Clear methodological recommendations were generated that can improve research rigor and quality of cross-language qualitative and quantitative studies. The recommendations generated here have the potential to have an impact on the health and well-being of migrants around the world.

Cardiovascular disease risk among older immigrants in the United States

Sadarangani, T. R., Chyun, D., Trinh-Shevrin, C., Yu, G., & Kovner, C. (2018). Journal of Cardiovascular Nursing, 33(6), 544-550. 10.1097/JCN.0000000000000498
Abstract
Background: In the United States, 16 million immigrants are 50 years and older, but little is known about their cardiometabolic health and how to best assess their cardiovascular disease (CVD) risk. Aging immigrants may therefore not be benefitting from advances in CVD prevention. Objective: In this study, we estimate and compare CVD risk in a nationally representative sample of aging immigrants using 3 different measures. Methods: This was a cross-sectional analysis using National Health and Nutrition Examination Survey data. Immigrants 50 years and older with no history of CVD were eligible. The Framingham Risk Score (FRS), the American College of Cardiology/American Heart Association Pooled Cohort Risk Equation, and presence of metabolic syndrome (MetS) were used to estimate risk. Bivariate statistics were analyzed using SPSS version 23.0 Complex Survey module to account for National Health and Nutrition Examination Survey unique weighting scheme. Results: The mean age of the sample was 61.3 years; 40% had hypertension, 17% had diabetes, 10% were smokers, and 95% did not meet the recommended physical activity guidelines. Proportions at an elevated CVD risk were as follows: American College of Cardiology/American Heart Association, 42% female and 76% male; FRS, 17.4% female and 76% male; and MetS, 22% female and 24% male. Conclusions: Immigrants had a lower overall risk using MetS and the American College of Cardiology/American Heart Association equation than has been found using these tools in similarly aged samples. The opposite was true for the FRS. The discrepancy between the proportion at risk and those being treated may reflect healthcare access gaps that warrant further investigation. A more holistic approach to risk measurement is needed that accounts for determinants of health that disproportionately affect immigrants, including language and socioeconomic status.

Service use, participation, experiences, and outcomes among older adult immigrants in american adult day service centers: An integrative review of the literature

Sadarangani, T. R., & Murali, K. P. (2018). Research in Gerontological Nursing, 11(6), 317-328. 10.3928/19404921-20180629-01
Abstract
Older adult immigrants are often socially isolated and vulnerable to poor health. Adult day service (ADS) centers could potentially facilitate social integration and address their long-term health care needs. The current review (a) identifies barriers to and facilitators of ADS use among immigrants, (b) explores how ADS programs impact older adult immigrants’ health and well-being, and (c) isolates the most effective culturally based components of ADS programs. An integrative review was conducted using Whittemore and Knafl’s methodology. Four databases were searched. Articles were critically appraised and data were organized within an ADS-specific framework. Functional impairment, race, gender, and degree of loneliness were all predictors of ADS use. ADS enhanced immigrants’ quality of life and provided fulfillment. Transportation, bilingual nurses, peer support, and cultural activities were deemed essential by participants. ADS can provide support to older adult immigrants by adding cultural elements to existing services and using nurses as cultural liaisons. More research is needed to assess the impact of ADS on disease outcomes, including dementia, and on immigrants in multi-ethnic settings.

Prognostic utility of the braden scale and the morse fall scale in hospitalized patients with heart failure

Carazo, M., Sadarangani, T., Natarajan, S., Katz, S. D., Blaum, C., & Dickson, V. V. (2017). Western Journal of Nursing Research, 39(4), 507-523. 10.1177/0193945916664077
Abstract
Geriatric syndromes are common in hospitalized elders with heart failure (HF), but association with clinical outcomes is not well characterized. The purpose of this study (N = 289) was to assess presence of geriatric syndromes using Joint Commission-mandated measures, the Braden Scale (BS) and Morse Fall Scale (MFS), and to explore prognostic utility in hospitalized HF patients. Data extracted from the electronic medical record included sociodemographics, medications, clinical data, comorbid conditions, and the BS and MFS. The primary outcome of mortality was assessed using Social Security Death Master File. Statistical analysis included Cox proportional hazards models to assess association between BS and MFS scores and allcause mortality with adjustment for known clinical prognostic factors. Higher risk BS and MFS scores were common in hospitalized HF patients, but were not independent predictors of survival. Further study of the clinical utility of these scores and other measures of geriatric syndromes in HF is warranted.