Victoria Vaughan Dickson

Faculty

Victoria Vaughan Dickson

Victoria Vaughan Dickson

FAAN FAHA FHFSA PhD RN

Dr. John W. Rowe Professor in Successful Aging
Assistant Dean, Research Innovation
Director, Pless Center for Research

1 212 992 9426

Victoria Vaughan Dickson, PhD, RN, FAHA, FHFSA, FAAN, is an associate professor in the Rory Meyers College of Nursing and director of the NYU Meyers Pless Center for Nursing Research. With extensive clinical and research experience in cardiovascular and occupational health nursing, her research program focuses on investigating the bio-behavioral influences on self-care in patients with cardiovascular disease risk,  coronary heart disease, heart failure, and multiple comorbidities. Her work has led to an improved understanding of the sociocultural influences of self-care among vulnerable populations, including ethnic minority groups, women, and older workers; and the development of innovative theory-based interventions. Dickson is recognized as an international expert in qualitative research techniques and mixed methods research and has conducted training for interdisciplinary teams locally, nationally, and internationally. 

Prof. Dickson is dedicated to building research capacity across disciplines and advancing nursing science that impacts policy and clinical care Currently, Dickson serves as PI and program director of the NIOSH-funded doctoral training program in occupational and environmental health nursing, PI of the NHLBI- funded Research Education in Cardiovascular Conditions program, co-PI of the NINR-funded NYU Meyers P20 Exploratory Center for Precision Health in Diverse Populations and KL2 co-director and co-investigator of the NCATS-funded NYU CTSI. In addition, she is a co-investigator on several team science initiatives focused on multiple chronic conditions. 

Prof. Dickson’s has been recognized with numerous awards for her research and leadership including the STTI Nurse Researcher Hall of Fame (2019), HFSA Nursing Research Leadership award (2021), and ENRS Leadership Award (2020). She is a fellow in the American Academy of Nursing (2014), American Heart Association (2011), Heart Failure Society of America (2016), and New York Academy of Medicine (2018). Dickson is the co-editor of the Journal of Cardiovascular Nursing.  

Prof. Dickson holds a clinical appointment as an advanced practice nurse in the division of cardiology at NYU Langone Health and the Bellevue Hospital. She earned her PhD and MSN from the University of Pennsylvania and BSN from Temple University.
 

PhD - University of Pennsylvania
MSN - University of Pennsylvania
BSN - Temple University

Non-communicable disease
Cardiology
Gerontology

American Academy of Nurse Practitioners
American Academy of Nursing
American Association of Occupational Health Nurses
American Heart Association
American Nurses Association
Council on the Advancement of Nursing
Eastern Nursing Research Society
European Society of Cardiology
Gerontological Society of America
Heart Failure Society of America
New York Academy of Medicine
New York Nurse Practitioners Association
Sigma Theta Tau, XI Chapter
Sigma Theta Tua International Honor Society

Nursing Research Leadership Award, HFSA (2021)
Leadership Award, ENRS (2021)
Nurse Researcher Hall of Fame, STTI (2019)
President-Elect, Eastern Nursing Research Society (2018)
Associate Editor, Cardiovascular Nursing (2018)
Fellow, New York Academy of Medicine (2018)
Spirit of Nursing Award, University of Massachusetts (2017)
President-Elect, Eastern Nursing Research Society (2017)
Associate Editor to Circulation, Cardiovascular Quality & Outcomes (2016)
Fellow, Heart Failure Society of America (2016)
President-Elect, Eastern Nursing Research Society (2016)
PhD Faculty Excellence Award, NYU (2014)
Springer Publishing Company Award (2014)
Fellow, American Academy of Nursing (2014)
Research Award, ENRS Rising Star (2012)
Fellow, American Heart Association Fuchs-Schoeck Research (2012)
Fellow, American Heart Association (2011)
Minority Aging Research and Community Health Scholar, University of Pennsylvania (2011)
Nursing and Allied Health Professional Award, European Society of Cardiology (2011)
Fellow, Brookdale Foundation Leadership in Aging (2010)
Reviewer of the Year, Journal of Cardiovascular Nursing (2009)
Student Award, University of Pennsylvania (2007)
Nursing Research Award, Heart Failure Society of America (2007)
Martha Hill New Investigator Award, American Heart Association (2007)
Research Award, American Association of Occupational Health Nurses (2006)

Acculturation, Discrimination and 24-h Activity in Asian American Immigrant Women

Park, C., Larsen, B., Kwon, S., Xia, Y., Dickson, V. V., Kim, S. S., Garcia-Dia, M. J., Reynolds, H. R., & Spruill, T. M. (2022). Journal of Immigrant and Minority Health, 24(4), 1005-1012. 10.1007/s10903-022-01361-5
Abstract
Abstract
Asian American immigrant (AAI) women may have suboptimal 24-h activity patterns due to traditional gender role and caregiving responsibilities. However, little is known about their objectively-measured activity. We measured AAI women’s 24-h activity patterns using accelerometry and examined cultural correlates of time in sedentary behavior (SB), light intensity physical activity (LIPA), moderate-to-vigorous physical activity (MVPA) and sleep. Seventy-five AAI women completed surveys on acculturation (years of U.S. residency and English proficiency), discrimination, and sleep quality, and 7 days of wrist- and hip-accelerometer monitoring. Linear regression was conducted controlling for age, BMI, and education. We also compared activity patterns across Asian subgroups (East, Southeast, South Asians). On average, AAI women had 33 min of MVPA, 6.1 h of LIPA, 10 h of SB, and 5.3 h of sleep per day. South Asian women had the longest SB and the shortest sleep and MVPA hours. English proficiency was negatively related to MVPA (p = 0.03) and LIPA (p < 0.01). Years of U.S. residency was positively related to SB (p = 0.07). Discrimination was related to shorter (p = 0.03) and poorer quality sleep (p = 0.06). Culturally-tailored programs targeting SB and sleep and integrating coping strategies against discrimination could help optimize AAI women’s 24-h activity patterns.

Addressing Challenges in Recruiting Diverse Populations for Research: Practical Experience from a P20 Center

Wright, F., Malone, S. K., Wong, A., Melkus, G. D., & Dickson, V. V. (2022). Nursing Research, 71(3), 218-226. 10.1097/NNR.0000000000000577
Abstract
Abstract
Background Improving the recruitment and retention of underrepresented groups in all research areas is essential for health equity. However, achieving and retaining diverse samples is challenging. Barriers to recruitment and retention of diverse participants include socioeconomic and cultural factors and practical challenges (e.g., time and travel commitments). Objectives The purpose of this article is to describe the successful recruitment and retention strategies used by two related studies within a P20 center funded by the National Institute of Nursing Research focused on precision health research in diverse populations with multiple chronic conditions, including metabolic syndrome. Methods To address the complexity, biodiversity, and effect of metabolic syndrome and multiple chronic conditions, we developed culturally appropriate, multipronged recruitment and retention strategies for a pilot intervention study and a longitudinal observational pilot study within our P20 center. The following are the underlying principles that guided the recruitment and retention strategies: (a) flexibility, (b) active listening and bidirectional conversations, and (c) innovative problem solving. Results The intervention study (Pilot 1) enrolled 49 participants. The longitudinal observational study (Pilot 2) enrolled 45 participants. Women and racial/ethnic minorities were significantly represented in both. In Pilot 1, most of the participants completed the intervention and all phases of data collection. In Pilot 2, most participants completed all phases of data collection and chose to provide biorepository specimens. Discussion We developed a recruitment and retention plan building on standard strategies for a general medical population. Our real-world experiences informed the adaption of these strategies to facilitate the participation of individuals who often do not participate in research - specifically, women and racial/ethnic populations. Our experience across two pilot studies suggests that recruiting diverse populations should build flexibility in the research plan at the outset.

Associations of insomnia symptoms with sociodemographic, clinical, and lifestyle factors in persons with HF: Health and retirement study

Gharzeddine, R., McCarthy, M. M., Yu, G., & Dickson, V. V. (2022). Research in Nursing and Health, 45(3), 364-379. 10.1002/nur.22211
Abstract
Abstract
Insomnia symptoms are very common in persons with heart failure (HF). However, many of the correlates and predictors of insomnia symptoms in this population remain unclear. The purpose of this study is to investigate the associations of sociodemographic, clinical, and lifestyle factors with insomnia symptoms in persons with HF. A theoretical framework was adapted from the neurocognitive model of chronic insomnia to guide the study. Data from the health and retirement study were used for the analysis. Parametric and nonparametric bivariate and multivariate analyses were conducted to investigate these associations. Age, depressive symptoms, comorbidity, dyspnea, pain, and smoking had significant bivariate associations with all insomnia symptoms. Race, Hispanic ethnicity, marital status, household income, poverty, and physical activity were associated with difficulty initiating sleep (DIS) and early morning awakening (EMA). Female sex, education, and alcohol consumption had a significant bivariate association with DIS. Sleep-disordered breathing and body mass index were significantly associated with EMA. Multivariate analysis suggested that depressive symptoms, comorbidity, dyspnea, and pain had independent associations with each insomnia symptom. Age explained DIS and difficulty maintaining sleep, and significant interaction effects between age and physical activity on DIS and EMA were revealed. Results suggest that insomnia symptoms are associated with several sociodemographic, clinical, and lifestyle factors. Age below 70 years, depressive symptoms, comorbidity, dyspnea, and pain might be considered as a phenotype to identify persons with HF who are at increased risk for insomnia symptoms.

Cardiovascular health in emerging adults with type 1 diabetes

McCarthy, M., Yan, J., Jared, M. C., You, E., Ilkowitz, J., Gallagher, M. P., & Vaughan Dickson, V. (2022). European Journal of Cardiovascular Nursing, 21(3), 213-219. 10.1093/eurjcn/zvab062
Abstract
Abstract
Aims: Individuals with type 1 diabetes (T1D) face increased risk for cardiovascular disease (CVD). Controlling individual cardiovascular risk factors can prevent or slow the onset of CVD. Ideal cardiovascular health is associated with a lower incidence of CVD. Identifying areas of suboptimal cardiovascular health can help guide CVD prevention interventions. To assess cardiovascular health and explore the barriers and facilitators to achieving ideal cardiovascular health in a sample of young adults with T1D. Methods and results: We used a sequential mixed-method design to assess the seven factors of cardiovascular health according to American Heart Association. Qualitative interviews, guided by Pender's Health Promotion Model, were used to discuss participant's cardiovascular health results and the barriers and facilitators to achieving ideal cardiovascular health. We assessed the frequency of ideal levels of each factor. The qualitative data were analysed using content analysis. Qualitative and quantitative data were integrated in the final analysis phase. The sample (n = 50) was majority female (70%), White (86%), with a mean age of 22 ± 2.4 and diabetes duration of 10.7 ± 5.5 years. Achievement of the seven factors of cardiovascular health were: non-smoking (96%); cholesterol <200 mg/dL (76%); body mass index <25 kg/m2 (54%); blood pressure <120/<80 mmHg (46%); meeting physical activity guidelines (38%); haemoglobin A1c <7% (40%); and healthy diet (14%). Emerging qualitative themes related to the perceived benefits of action, interpersonal influences on their diabetes self-management, and perceived self-efficacy. Conclusion: We found areas of needed improvement for cardiovascular health. However, these young adults expressed a strong interest in healthy habits which can be supported by their healthcare providers.

The Effect of Psychosocial Factors and Functional Independence on Poststroke Depressive Symptoms: A Cross-Sectional Study

Babkair, L. A., Chyun, D., Dickson, V. V., & Almekhlafi, M. A. (2022). The Journal of Nursing Research : JNR, 30(1), E189. 10.1097/JNR.0000000000000464
Abstract
Abstract
Background Stroke is the second leading cause of death and a major cause of serious, long-term disability worldwide. The approximately 15 million people each year who experience stroke are at risk of developing depression. Poststroke depressive symptoms affect one third of survivors of stroke. Patients who develop poststroke depressive symptoms experience decreased functional independence, poor cognitive recovery, decreased quality of life, and increased mortality. Survivors of stroke use social support to deal with stress and defend against the adverse effects of negative stroke outcomes. Purpose This study was designed to examine the influence of perceived social support (emotional and informational, tangible, affectionate, and positive social interaction), stress level, and functional independence on depressive symptoms in survivors of stroke. Methods A cross-sectional observational study design in outpatient settings and rehabilitation centers was conducted. A convenience sample of 135 survivors of stroke completed the psychometrically valid instruments. Results Most of the sample had mild or moderate depressive symptoms (26% and 29%, respectively). The mean score for perceived social support was 77.53 (SD = 21.44) on the Medical Outcomes Study Social Support Survey. A negative association was found between depressive symptoms and the social support total score (r = -.65, p <.01). All of the social support subcategories were negatively associated with depressive symptoms. Hierarchical multiple linear regression showed that social support, stress level, and literacy were associated with depressive symptoms (β = -.31, p <.001; β =.45, p <.001; and β =.16, p =.01, respectively) and partially mediated the association between depressive symptoms and functional independence. Conclusions/Implications for Practice Poststroke depressive symptoms are common among survivors of stroke. Social support may improve health by protecting these individuals from the negative outcomes of stroke and enhance their recovery. Future research is required to examine how related interventions improve social support in caregivers and reduce depressive symptoms in stroke survivors.

Exercise and Self‑Management in Adults with Type 1 Diabetes

McCarthy, M. M., Ilkowitz, J. R., Zheng, Y., & Vaughan Dickson, V. (2022). Current Cardiology Reports, 24(7), 861-868. 10.1007/s11886-022-01707-3
Abstract
Abstract
Purpose of Review: The purpose of this review paper is to examine the most recent evidence of exercise-related self-management in adults with type 1 diabetes (T1D). Recent Findings: This paper reviews the benefits and barriers to exercise, diabetes self-management education, the role of the healthcare provider in assessment and counseling, the use of technology, and concerns for special populations with T1D. Summary: Adults with T1D may not exercise at sufficient levels. Assessing current levels of exercise, counseling during a clinical visit, and the use of technology may improve exercise in this population.

Factors Associated With Cognitive Impairment in Heart Failure With Preserved Ejection Fraction

Faulkner, K. M., Dickson, V. V., Fletcher, J., Katz, S. D., Chang, P. P., Gottesman, R. F., Witt, L. S., Shah, A. M., & D’Eramo Melkus, G. (2022). The Journal of Cardiovascular Nursing, 37(1), 17-30. 10.1097/JCN.0000000000000711
Abstract
Abstract
BACKGROUND: Cognitive impairment is prevalent in heart failure and is associated with higher mortality rates. The mechanism behind cognitive impairment in heart failure with preserved ejection fraction (HFpEF) has not been established. OBJECTIVE: The aim of this study was to evaluate associations between abnormal cardiac hemodynamics and cognitive impairment in individuals with HFpEF. METHODS: A secondary analysis of Atherosclerosis Risk in Communities (Atherosclerosis Risk in Communities) study data was performed. Participants free of stroke or dementia who completed in-person assessments at visit 5 were included. Neurocognitive test scores among participants with HFpEF, heart failure with reduced ejection fraction (HFrEF), and no heart failure were compared. Sociodemographics, comorbid illnesses, medications, and echocardiographic measures of cardiac function that demonstrated significant (P < .10) bivariate associations with neurocognitive test scores were included in multivariate models to identify predictors of neurocognitive test scores among those with HFpEF. Multiple imputation by chained equations was used to account for missing values. RESULTS: Scores on tests of attention, language, executive function, and global cognitive function were worse among individuals with HFpEF than those with no heart failure. Neurocognitive test scores were not significantly different among participants with HFpEF and HFrEF. Worse diastolic function was weakly associated with worse performance in memory, attention, and language. Higher cardiac index was associated with worse performance on 1 test of attention. CONCLUSIONS: Cognitive impairment is prevalent in HFpEF and affects several cognitive domains. The current study supports the importance of cognitive screening in patients with heart failure. An association between abnormal cardiac hemodynamics and cognitive impairment was observed, but other factors are likely involved.

Identifying Patients with Hypoglycemia Using Natural Language Processing: Systematic Literature Review

Zheng, Y., Dickson, V. V., Blecker, S., Ng, J. M., Rice, B. C., Melkus, G. D., Shenkar, L., Mortejo, M. C. R., & Johnson, S. B. (2022). JMIR Diabetes, 7(2). 10.2196/34681
Abstract
Abstract
Background: Accurately identifying patients with hypoglycemia is key to preventing adverse events and mortality. Natural language processing (NLP), a form of artificial intelligence, uses computational algorithms to extract information from text data. NLP is a scalable, efficient, and quick method to extract hypoglycemia-related information when using electronic health record data sources from a large population. Objective: The objective of this systematic review was to synthesize the literature on the application of NLP to extract hypoglycemia from electronic health record clinical notes. Methods: Literature searches were conducted electronically in PubMed, Web of Science Core Collection, CINAHL (EBSCO), PsycINFO (Ovid), IEEE Xplore, Google Scholar, and ACL Anthology. Keywords included hypoglycemia, low blood glucose, NLP, and machine learning. Inclusion criteria included studies that applied NLP to identify hypoglycemia, reported the outcomes related to hypoglycemia, and were published in English as full papers. Results: This review (n=8 studies) revealed heterogeneity of the reported results related to hypoglycemia. Of the 8 included studies, 4 (50%) reported that the prevalence rate of any level of hypoglycemia was 3.4% to 46.2%. The use of NLP to analyze clinical notes improved the capture of undocumented or missed hypoglycemic events using International Classification of Diseases, Ninth Revision (ICD-9), and International Classification of Diseases, Tenth Revision (ICD-10), and laboratory testing. The combination of NLP and ICD-9 or ICD-10 codes significantly increased the identification of hypoglycemic events compared with individual methods; for example, the prevalence rates of hypoglycemia were 12.4% for International Classification of Diseases codes, 25.1% for an NLP algorithm, and 32.2% for combined algorithms. All the reviewed studies applied rule-based NLP algorithms to identify hypoglycemia. Conclusions: The findings provided evidence that the application of NLP to analyze clinical notes improved the capture of hypoglycemic events, particularly when combined with the ICD-9 or ICD-10 codes and laboratory testing.

Individual and Work Factors Associated with Psychosocial Health of Registered Nurses During the Covid-19 Pandemic: A Mixed Methods Study

Witkoski Stimpfel, A., Ghazal, L., Goldsamt, L., & Vaughan Dickson, V. (2022). Journal of Occupational and Environmental Medicine, 64(6), 515-524. 10.1097/JOM.0000000000002495
Abstract
Abstract
OBJECTIVE: To describe the initial influence of the Covid-19 pandemic on U.S. nurses' psychosocial health, and to identify factors associated with poor psychosocial health outcomes. METHODS: We conducted a convergent (QUAN+qual) mixed methods study. From June to August 2020, we administered surveys (N = 629) and conducted semi-structured interviews (N = 34) among nurses working across healthcare settings in 18 states. We developed separate multivariable logistic regression models for three psychosocial outcomes (anxiety, depressive symptoms, insomnia). We used content analysis to process and analyze qualitative data, and integrated results in the final analysis step. RESULTS: Nurses reported high rates of depressive symptoms (22%), anxiety (52%), and insomnia (55%). Disturbances to sleep were both a contributing factor to, and an outcome of, poor psychosocial health. CONCLUSIONS: Evidence-based interventions addressing work stress and sleep, and proactive monitoring of nurses' psychosocial health by employers are urgently needed.

The intellectual capital supporting nurse practice in a post-emergency state: A case study

Ridge, L. J., Liebermann, E. J., Stimpfel, A. W., Klar, R. T., Dickson, V. V., & Squires, A. P. (2022). Journal of Advanced Nursing, 78(9), 3000-3011. 10.1111/jan.15282
Abstract
Abstract
Aim: To explore the resources supporting current nurse practice in the post-emergency country of Liberia, using the nursing intellectual capital framework, as nurses work to meet the targets set by Government of Liberia's Essential Package of Health Services. Design: Case study. Methods: Data were collected in Liberia February–June 2019. Direct observation, semi-structured interviews and photographs were used to investigate how nurse practice is supported. Field notes, transcripts and photographs were coded using both directed and conventional content analysis. Reports were then generated by code to triangulate the data. Results: Thirty-seven nurses at 12 health facilities participated. The intellectual capital supporting inpatient and outpatient nurse practice differs in important ways. Inpatient nurse practice is more likely to be supported by facility-based protocols and trainings, whereas outpatient nurse practice is more likely to be supported by external protocols and trainings, often developed by the Liberian government or non-governmental organizations. This can lead to uneven provision of inpatient protocols and trainings, often favouring private facilities. Similarly, inpatient nurses rely primarily on other nurses at their facilities for clinical support while outpatient nurses often have external professional relationships that provided them with clinical guidance. Conclusion: Much has been accomplished to enable outpatient nurses to provide the primary- and secondary-care target services in the Essential Package of Health Services. However, as the Liberian government and its partners continue to work towards providing certain tertiary care services, developing analogous protocols, trainings and clinical mentorship networks for inpatient nurses will likely be fruitful, and will decrease the burden on individual facilities. Impact: Nurses are often expected to meet new service provision targets in post-emergency states. Further research into how best to support nurses as they work to meet those targets has the potential to strengthen health systems.