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)
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)
Spirit of Hillman Award, Hillman Alumni Network (2014)
Patricia G. Archbold Award, National Hartford Centers for Gerontological Nursing Excellence (2014)
Phi Beta Kappa, Georgetown University
Summa Cum Laude, Georgetown University

Publications

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

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“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. 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

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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

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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.

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
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
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.