Tina Sadarangani

Faculty

Tina Sadarangani headshot

Tina Sadarangani

PhD RN ANP-C GNP-BC

Assistant Professor

1 212 992 7183

433 FIRST AVENUE
NEW YORK, NY 10010
United States

Accepting PhD students

Prof. Tina Sadarangani, PhD, RN, FAAN is an NYU Assistant Professor and a board-certified adult and geriatric nurse practitioner. Prof. Sadarangani is an NIH-funded clinician scientist over-seeing a research portfolio focused on improving care for people with Alzheimer’s disease and their families. She has built a growing movement to help families, especially immigrant families, caring for a chronically ill person navigate a complex and fragmented healthcare system. Her work has impacted families and eldercare organizations nationwide.  Prof. Sadarangani’s expertise includes family caregivers, adult day care services, older adult nutrition, age-tech, and addressing the long-term care needs of ethnically diverse older adults.

With support from the National Institutes of Health, Prof. Sadarangani created an award-winning mobile app– CareMobiTM - out of her NYU lab that helps family members caring for a chronically ill loved one, particularly those with dementia, communicate around the day-to-day care of their loved ones. She is also the creator of The Enlightened Caregiver – a social media movement -  that empowers families with practical guidance on how to get optimal, not usual, healthcare for the people they love. 

Her research also innovatively positions adult day centers, which represent a growing but understudied sector of long-term care, as platforms for chronic disease management in underserved communities. A leader in using community-partnered research in adult day centers, her on-going collaborations with the National Adult Day Services Association and the California Association of Adult Day Services, have demonstrated that integrating adult day centers into the healthcare continuum contributes to reductions in avoidable healthcare utilization and person-centered care. She is also the nation's leading researcher focused on evaluating and improving nutrition programs in adult day centers.

Prof. Sadarangani has published extensively in peer-reviewed academic journals, including in the American Journal of Public Health and the Journal of the American Medical Informatics Association. She has been featured in the New York Times, Associated Press, US News and World Report, among several other major media outlets. She has been recognized as a Woman of Distinction/Rising Star in Long-Term Care and recently recognized by Crain’s New York Business as a Notable Leader in Healthcare. She is a Fellow of the American Academy of Nursing, the Gerontological Society of America, and the New York Academy of Medicine.

 

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

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)
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 (2016)
Hillman Alumni Network Innovation Fellowship, Hillman Alumni Network (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

Dementia patient and caregiver relevant outcomes currently being reported by adult day service centers in the United States

Sadarangani, T., Anderson, K., Westmore, M. R., & Zhong, J. (2022). Alzheimer’s and Dementia: Translational Research and Clinical Interventions, 8(1). 10.1002/trc2.12310
Abstract
Abstract
Background: Approximately one third of adults in adult day services (ADS) centers have Alzheimer's disease (AD) and AD-related dementias (ADRD). Understanding of the impact and effectiveness of ADS on persons living with dementia (PLWD) is limited by a lack of patient and caregiver relevant outcomes (PCRO) data. We identified PCROs collected at ADS sites in states that mandate serial data collection and examined the degree to which these data align with established Dementia Care Practice Recommendations (DCPR) and PCROs used in other areas of long-term care. Methods: We conducted an item analysis of regulatory forms used by ADS. Consistent with the methodology used by the Imbedded Pragmatic AD/ADRD Clinical Trials (IMPACT) Collaboratory for PCROs collected in other long-term care settings, we created a matrix informed by DCPR. We matched each item in regulatory forms reflecting a PCRO to one of the seven DCPR domains as well as to the 53 PCROs from other long-term care sectors. Results: Ten states routinely collect outcome data in ADS. Among these, 80% assess cognitive function. All 10 states capture PLWD's ability to complete activities of daily living. Presence and frequency of behavioral symptoms were collected by 80% of states. Very few or, in some cases, none of the 10 states, collected PCROs related to care planning and coordination, education, social support, and/or family caregiver burden and support. Discussion: Lack of standardized collection of PCROs hampers researchers’ understanding of ADS. The vast majority of PCROs collected center on participants’ physical health; conversely, data on socialization, social support, and caregiver well-being, which are purportedly the most impactful services offered by ADS centers, are rarely collected. ADS would be well served to focus on these outcome domains as the resulting data could paint a more complete picture of the holistic impact of ADS on PLWD and their caregivers.

Honoring Asian diversity by collecting Asian subpopulation data in health research

Niles, P. M., Jun, J., Lor, M., Ma, C., Sadarangani, T., Thompson, R., & Squires, A. (2022). Research in Nursing and Health, 45(3), 265-269. 10.1002/nur.22229

International migration and its influence on health

Squires, A., Thompson, R., Sadarangani, T., Amburg, P., Sliwinski, K., Curtis, C., & Wu, B. (2022). Research in Nursing & Health, 45(5), 503-511. 10.1002/nur.22262

Introducing a Clinical Summary Template From the Adult Day Center to Support Decision Making by Primary Care Providers

Zhong, J., Boafo, J., & Sadarangani, T. R. (2022). Journal of Primary Care and Community Health, 13. 10.1177/21501319221144377
Abstract
Abstract
Introduction: CareMOBI (Mhealth for Organizations to Bolster Interconnectedness) is a mobile application designed to facilitate information exchange between primary care providers (PCPs) and adult day centers (ADCs). A key function of CareMOBI is to synthesize information collected outside of the provider’s office (ie,: in the ADC or at home) and distill the most relevant data points into an exportable clinical summary that can help inform clinical decision making by the PCP with information from outside providers who are not formally embedded within health systems. In this study, we used a qualitative approach to understand the acceptability and utility of the clinical summary template within CareMOBI. Methods: Purposive sampling, followed by snowball sampling, was used to recruit PCPs from a variety of primary care practice settings (i.e. home-based, academic). Semi-structured interviews were conducted virtually to elicit feedback on the user-experience after interaction with a prototype template. Interviews were recorded, transcribed, and analyzed using content analysis. Results: Our sample (n = 10) consisted of physicians and nurse practitioners in a variety of settings. Feedback suggested that the summary template facilitates interdisciplinary, bidirectional, succinct, and relevant information exchange across care teams. The summary template effectively integrates observations and assessments from team members, centralizes them, and allows PCPs to hone in on the most salient components to inform clinical decision making for the geriatric patient. The summary gave PCPs “live texture” about what was happening outside the office and represented a significant improvement over other methodologies of information exchange. Prior to implementation into clinical practice, several refinements are necessary based on feedback including integration into the PCP’s workflow. Conclusions: The template was viewed by PCPs as a concise and actionable record, in contrast to current communication which is characterized as “bloated”—containing too many pages on nonessential information. The summary could potentially save PCP’s time in locating and analyzing historical data to enable rapid patient assessment and prompt more ready and informed action.

Multimorbidity patterns in adult day health center clients with dementia: a latent class analysis

Sadarangani, T., Perissinotto, C., Boafo, J., Zhong, J., & Yu, G. (2022). BMC Geriatrics, 22(1). 10.1186/s12877-022-03206-0
Abstract
Abstract
Background: Persons living with dementia (PLWD) in adult day centers (ADCs) represent a complex and vulnerable population whose well-being is at risk based on numerous factors. Greater knowledge of the interaction between dementia, chronic conditions, and social determinants of health would enable ADCs to identify and target the use of their resources to better support clients in need of in-depth intervention. The purpose of this paper is to (a) classify PLWD in ADCs according to their level of medical complexity and (b) identify the demographic, functional, and clinical characteristics of those with the highest degree of medical complexity. Methods: This was a secondary data analysis of 3052 clients with a dementia diagnosis from 53 ADCs across the state of California between 2012 and 2019. The most common diagnosis codes were organized into 28 disease categories to enable a latent class analysis (LCA). Chi-square test, analysis of variance (ANOVA), and Kruskal-Wallis tests were conducted to examine differences among latent classes with respect to clinical and functional characteristics. Results: An optimal 4-class solution was chosen to reflect chronic conditions among PLWD: high medical complexity, moderate medical complexity, low medical complexity, and no medical complexity. Those in the high medical complexity were taking an average of 12.72 (+/− 6.52) medications and attending the ADC an average of 3.98 days (+/− 1.31) per week—values that exceeded any other class. They also experienced hospitalizations more than any other group (19.0%) and met requirements for the nursing facility level of care (77.4%). In addition, the group experienced the greatest frequency of bladder (57.5%) and bowel (15.7%) incontinence. Conclusions: Our results illustrate a high degree of medical complexity among PLWD in ADCs. A majority of PLWD not only have multimorbidity but are socially disadvantaged. Our results demonstrate that a comprehensive multidisciplinary approach that involves community partners such as ADCs is critically needed that addresses functional decline, loneliness, social isolation, and multimorbidity which can negatively impact PLWD.

A National Survey of Data Currently being Collected by Adult Day Service Centers Across the United States.

Sadarangani, T., Anderson, K., Vora, P., Missaelides, L., & Zagorski, W. (2022). Journal of Applied Gerontology, 41, 729-735. 10.1177/07334648211013974
Abstract
Abstract
An understanding of adult day service centers’ (ADC) impacts on clients’ health and well-being has been hampered by a lack of large-scale data. Standardizing data collection is critical to strengthening ADC programs, demonstrating their effectiveness, and enabling them to leverage additional funding streams beyond Medicaid. We distributed an electronic survey on current data collection efforts to ADCs nationally to determine categories of data ADCs are collecting related to clients’ health. In our sample (N = 248), only 32% of ADCs collected patient-level data for research and analysis—most commonly on activities of daily living, cognition, nutrition, and caregiver strain. However, validated assessment tools were used in less than 50% of the cases. ADCs are willing to collect data: More than 70% reported a willingness to participate in future studies. National studies piloting data collection protocols with uniform outcome measures are needed to advance the understanding of ADCs’ capabilities and impacts.

A qualitative analysis of communication workflows between adult day service centers and primary care providers

Zhong, J., Boafo, J., Brody, A. A., Wu, B., & Sadarangani, A. T. (2022). Journal of the American Medical Informatics Association, 29(5), 882-890. 10.1093/jamia/ocab284
Abstract
Abstract
Objectives: Our study documented communication workflows across adult day care centers (ADCs) and primary care providers (PCPs) around complex needs of persons living with dementia (PLWD). We also identified barriers and facilitators to productive communication in clinical decision support and clinical information systems. Materials and Methods: We conducted 6 focus groups with ADC staff (N=33) and individual semistructured interviews with PCPs (N=22) in California. The eHealth Enhanced Chronic Care Model was used to frame the directed qualitative content analysis. Results: Our results captured cumbersome and ineffective workflows currently used to exchange information across PCPs and ADCs. Stakeholders characterized current communication as (1) infrequent, (2) delayed, (3) incomplete, (4) unreliable, (5) irrelevant, and (6) generic. Conversely, communication that was bidirectional, relevant, succinct, and interdisciplinary was needed to elevate the standard of care for PLWD. Discussion and Conclusion: ADCs possess a wealth of information that can support clinical decision-making across community-based providers involved in the care of PLWD, especially PCPs. However, effective information exchange is mired by complicated workflows that rely on antiquated technologies (eg, facsimile) and standard templates. Current information exchange largely focuses on satisfying regulatory guidelines rather than supporting clinical decision-making. Integrating community-based services into the health care continuum is a necessary step in elevating the standard of care for PLWD. In the absence of interoperable electronic health records, which may not be financially viable for ADCs, other options, such as mobile health, should be explored to facilitate productive information exchange of personalized relevant information.

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.