Gail D'Eramo Melkus

Gail D’Eramo Melkus, EdD, ANP, FAAN, is Professor Emerita and the former vice dean for research and the Florence and William Downs Professor in Nursing Research at NYU Rory Meyers College of Nursing. Melkus’ sustained interest in eliminating health disparities among vulnerable populations earned her a reputation as a leader in the development and testing of culturally competent models of diabetes care. Her program of intervention research that focuses on physiological and behavioral outcomes of self-management interventions has served as an education and training ground for numerous multidisciplinary scientists.

Melkus currently serves as co-PI and co-investigator or research mentor on numerous funded projects specific to biobehavioral interventions for prevention and management of chronic conditions and related co-morbidities, in mid-life and older adults, including national and international work. Melkus serves as sponsor of K-awards focused on health disparities among vulnerable populations (women with T2D and depression; elderly Blacks at-risk for depression, glycemic control and infection in oncology stem cell recipients, CHD in older adult workers, HIV in adolescents). She is PI for the NINR P20 Center for Precision Health in Diverse Populations.

Before joining the faculty at NYU Meyers, Melkus was the Independence Foundation Professor of Nursing at the Yale University School of Nursing, where, in collaboration with the Diabetes Research Center of Albert Einstein College of Medicine in NY, she developed and implemented the Diabetes Care Specialty for advanced practice nurses.

In recognition of her mentorship, Melkus received the 1st Annual NYU CTSI Mentor Award in May 2011, and in 2015 was inducted into the STTI Nurse Researcher Hall of Fame.

Melkus earned her EdD from Columbia University, MS from Yale University, MS from Connecticut State University, and ASN/BS in Nursing from the University of Bridgeport.

MS - Yale University (2003)

EdD - Columbia University (1987)

MS - Connecticut State University (1978)

ASN/BS, Nursing - University of Bridgeport (1976)

Primary care

Non-communicable disease

Women's health

Immigrants

Adult health

American Academy of Nursing

American Diabetes Association

Council for the Advancement of Nursing Science

CT Nursing Association

Eastern Nursing Research Society

Society for Behavioral Medicine

Eastern Nursing Research Award (2020)

International Nurse Researcher Hall of Fame, Sigma Theta Tau (2015)

STTI Nurse Researcher Hall of Fame Inductee (2015)

Fellow, New York Academy of Medicine (2014)

Affiliated Faculty Appointment, University of Georgia (2014)

Distinguished Alumni Award, University of Bridgeport (2014)

Faculty Scholar Appointment, Universita' Tor Vergata (2014)

Advisory Committee Member, Medicare Evidence Development & Coverage (2013)

1st annual Distinguished Mentor Award, NYU Clinical Translational Science Institute (2011)

Distinguished Scholar Award, New York University College of Nursing (2010)

Distinguished Nurse Researcher Award, New York State Nurse Foundation (2009)

Endowed Chair, New York University (2008)

Endowed Chair of the Independence Foundation, Yale University (2004)

Excellence in Nursing Research Award, Diamond Jubilee Virginia Henderson (2003)

Fellow, American Academy of Nursing (2003)

Cardiovascular disease self-care interventions

Vaughan Dickson, V., Nocella, J., Yoon, H., Hammer, M., Melkus, G. D., & Chyun, D. (2013). Nursing Research and Practice.

Reducing the risks of diabetes complications through diabetes self-management education and support

Kent, D., D’Eramo Melkus, G., Stuart, P. M. W., McKoy, J. M., Urbanski, P., Boren, S. A., Coke, L., Winters, J. E., Horsley, N. L., Sherr, D., & Lipman, R. (2013). Population Health Management, 16(2), 74-81. 10.1089/pop.2012.0020

Abstract

Abstract

People with diabetes are at risk of developing complications that contribute to substantial morbidity and mortality. In 2011, the American Association of Diabetes Educators convened an invitational Reducing Risks Symposium, during which an interdisciplinary panel of 11 thought leaders examined current knowledge about the reduction and prevention of diabetes-related risks and translated evidence into diabetes care and self-management education. Symposium participants reviewed findings from the literature and engaged in a moderated roundtable discussion. This report summarizes the discussion and presents recommendations to incorporate into practice to improve outcomes. The objective of the symposium was to develop practical advice for diabetes educators and other members of the diabetes care team regarding the reduction of diabetes-related risks. Optimal diabetes management requires patients to actively participate in their care, which occurs most effectively with a multidisciplinary team. Diabetes education is an integral part of this team approach because it not only helps the patient understand diabetes, its progression, and possible complications, but also provides guidance and encouragement to the patient to engage in proactive risk-reduction decisions for optimal health. A variety of tools are available to help the diabetes educator develop an individualized, patient-centered plan for risk reduction. More research is needed regarding intervention efficacy, best practices to improve adherence, and quantification of benefits from ongoing diabetes support in risk reduction. Diabetes educators are urged to stay abreast of evolving models of care and to build relationships with health care providers both within and beyond the diabetes care team. (Population Health Management 2013;16:74-81).

Therapeutic options for lowering LDL-C in type 2 diabetes: a nurse practitioner's perspective

Lew, K. N., Kent, D. J., Muñoz, A. A., & Melkus, G. D. (2013). Journal of the American Association of Nurse Practitioners, 25(9), 488-494. 10.1002/2327-6924.12053

Abstract

Abstract

PURPOSE: The majority of patients with type 2 diabetes mellitus (T2DM) have multiple risk factors for cardiovascular disease (CVD). Low-density lipoprotein cholesterol (LDL-C) is a key therapeutic target to reduce CVD risk. This article reviews therapeutic strategies that nurse practitioners (NPs) may use in the management of patients with T2DM requiring lipid management.DATA SOURCES: The evidence used in developing this review included evidence-based reviews, clinical trials, guidelines, and consensus statements. Relevant publications were identified through a search of the literature using PubMed and other search engines.CONCLUSIONS: Lowering LDL-C levels may reduce CVD risk, but achieving goals can be challenging. Lifestyle modifications (including diet, exercise, and smoking cessation) are key components of lipid management and reduction of CVD risk. Statins can be effective to reduce lipids. However, patients may not achieve lipid goals with monotherapy or may experience intolerable adverse effects. Alternative statins or statins along with other lipid-lowering agents remain good options.IMPLICATIONS FOR PRACTICE: Achieving LDL-C goals requires a comprehensive treatment plan that incorporates lifestyle and pharmacologic interventions. Patient commitment in setting goals and self-management is essential. NPs can play an important role in educating patients as well as prescribing appropriate treatments.

Diet, inflammation, and glycemic control in type 2 diabetes: An integrative review of the literature

Nowlin, S. Y., Hammer, M. J., & D’Eramo Melkus, G. (2012). Journal of Nutrition and Metabolism, 2012. 10.1155/2012/542698

Abstract

Abstract

Type 2 diabetes (T2D) is a growing national health problem affecting 35% of adults ≥20 years of age in the United States. Recently, diabetes has been categorized as an inflammatory disease, sharing many of the adverse outcomes as those reported from cardiovascular disease. Medical nutrition therapy is recommended for the treatment of diabetes; however, these recommendations have not been updated to target the inflammatory component, which can be affected by diet and lifestyle. To assess the current state of evidence for which dietary programs contain the most anti-inflammatory and glycemic control properties for patients with T2D, we conducted an integrative review of the literature. A comprehensive search of the PubMed, CINAHL, Scopus, and Web of Science databases from January 2000 to May 2012 yielded 786 articles. The final 16 studies met the selection criteria including randomized control trials, quasiexperimental, or cross-sectional studies that compared varying diets and measured inflammatory markers. The Mediterranean and DASH diets along with several low-fat diets were associated with lower inflammatory markers. The Mediterranean diet demonstrated the most clinically significant reduction in glycosylated hemoglobin (HbA 1c). Information on best dietary guidelines for inflammation and glycemic control in individuals with T2D is lacking. Continued research is warranted.

A continuous glucose monitoring and problem-solving intervention to change physical activity behavior in women with type 2 diabetes: A pilot study

Allen, N., Whittemore, R., & Melkus, G. (2011). Diabetes Technology and Therapeutics, 13(11), 1091-1099. 10.1089/dia.2011.0088

Abstract

Abstract

Background: Diabetes technology has the potential to provide useful data for theory-based behavioral counseling. The aims of this study are to evaluate the feasibility, acceptability, and preliminary efficacy of a continuous glucose monitoring and problem-solving counseling intervention to change physical activity (PA) behavior in women with type 2 diabetes. Methods: Women (n=29) with type 2 diabetes were randomly assigned to one of two treatment conditions: continuous glucose counseling and problem-solving skills or continuous glucose monitoring counseling and general diabetes education. Feasibility data were obtained on intervention dose, implementation, and satisfaction. Preliminary efficacy data were collected at baseline and 12 weeks on the following measures: PA amount and intensity, diet, problem-solving skills, self-efficacy for PA, depression, hemogoloin A1c, weight, and blood pressure. Demographic and implementation variables were described using frequency distributions and summary statistics. Satisfaction data were analyzed using Wilcoxon rank. Differences between groups were analyzed using linear mixed-modeling. Results: Women were mostly white/non-Latina with a mean age of 53 years, a 6.5-year history of diabetes, and suboptimal glycemic control. Continuous glucose monitoring plus problem-solving group participants had significantly greater problem-solving skills and had greater, although not statistically significant, dietary adherence, moderate activity minutes, weight loss, and higher intervention satisfaction pre-to post-intervention than did participants in the continuous glucose monitoring plus education group. Conclusion: A continuous glucose monitoring plus problem-solving intervention was feasible and acceptable, and participants had greater problem-solving skills than continuous glucose monitoring plus education group participants.

A methodological review of faith-based health promotion literature: Advancing the science to expand delivery of diabetes education to black Americans

Newlin, K., Chase, S., Dyess, S., Melkus, G., & Beidler, S. (2011). Journal of Religion and Health, 51(4), 1075-1097.

Physiological and Behavioral Factors Related to Physical Activity in Black Women With Type 2 Diabetes Mellitus

Allen, N. A., Melkus, G. D., & Chyun, D. A. (2011). Journal of Transcultural Nursing, 22(4), 376-385. 10.1177/1043659611414143

Abstract

Abstract

Purpose: To describe relationships among physical activity (PA), physiological factors, and psychological factors in Black women with type 2 diabetes mellitus (T2DM). Methods: A cross-sectional design was used (N = 109). Data were collected on PA (activity/inactivity, TV hours, bed confinement), physiology (blood pressure, lipids, hemoglobin A1c), psychology (anxiety, emotional distress, physical functioning, bodily pain, vitality), and health care provider (HCP) support. Results: Walking was the preferred PA; TV viewing averaged 3.7 hours/day, and 24% reported confinement to bed >1 week in the last year. Inactive women had greater physiological and psychological problems than active women. Women watching TV >2 hours/day had more physiological problems than women watching TV <2 hours/day. Women reporting >1 week of confinement to bed in the last year had more physiological and psychological problems than those confined to bed <1 week. Conclusions: PA interventions in Black women with T2DM should promote walking, address TV viewing time, incorporate HCP's role of PA counseling/support, and address several psychological factors.

Coping as a mediator in the relationships of spiritual well-being to mental health in black women with type 2 diabetes

Newlin, K., Melkus, G. D., Peyrot, M., Koenig, H. G., Allard, E., & Chyun, D. (2010). International Journal of Psychiatry in Medicine, 40(4), 439-459. 10.2190/PM.40.4.g

Abstract

Abstract

Objective: Examine coping as a mediator in the relationships of spiritual well-being to mental health in Black women with type 2 diabetes (T2DM). Methods: Using a cross-sectional design, data were collected from a convenience sample of 45 Black women with T2DM. Measures of coping strategies, spiritual well-being (religious and existential well-being), and mental health, as measured by diabetes-specific distress (DSED), were collected. Bivariate findings informed mediational, trivariate model development. Results: Religious well-being was significantly related to cognitive reframing (CR) coping strategies (p = 0.026) but not DSED (p = 0.751). Existential well-being was significantly related to CR (ß = 0.575, p < 0.001), direct assistance (DA) coping (ß = 0.368, p = 0.006) and DSED (ß = -0.338, p = 0.023). Although CR (ß = -0.305, p = 0.021) and DA (ß = -0.262, p = 0.041) had significant bivariate associations with DSED, the relationships were not significant when existential well-being was controlled. However, the relationship of existential well-being to DSED was mediated by specific CR and DA strategies that were associated with DSED to varying degrees -"I came up with a couple different solutions to the problem" (ß = -0.301, p = 0.049); "I came out of the experience better than I went in" (ß = -0.308, p = 0.061); and "I talked to someone who could do something concrete about the problem" (ß = -0.272, p = 0.078). Conclusion: Findings indicate that diabetes care address spiritual well-being, both its religious and existential components, in Black women with T2DM.

The effect of a diabetes education, coping skills training, and care intervention on physiological and psychosocial outcomes in black women with type 2 diabetes

D’Eramo Melkus, G., Chyun, D., Vorderstrasse, A., Newlin, K., Jefferson, V., & Langerman, S. (2010). Biological Research for Nursing, 12(1), 7-19. 10.1177/1099800410369825

Abstract

Abstract

An 11-week culturally relevant group diabetes self-management training (DSMT), coping skills training (CST), and diabetes care intervention was compared to a 10-week usual diabetes education and diabetes care intervention on physiological and psychosocial outcomes in 109 Black women (aged 48 ± 10 years) with type 2 diabetes in primary care (PC). Strong time effects for hemoglobin A1c improvement were seen in both groups from baseline to 3 months and remained similar at 12 and 24 months (p <. 0001). Systolic blood pressure (p = .01) and low-density lipoprotein cholesterol levels (p = .05) improved in both groups from baseline to 24 months. Baseline quality of life ([QOL]; Medical Outcome Study Short Form-36) was low. Social function, role-emotional, and mental health domains increased initially in both groups then declined slightly, with less decline for the experimental group at 12 months. At 24 months, experimental group scores increased. General health (p = .002), vitality (p = .01), role-physical, and bodily pain (p = .02) domains increased in both groups over time. Perceived provider support for diet (p = .0001) and exercise (p = .0001) increased in both groups over time. Diabetes-related emotional distress decreased in the experimental compared to the control group (group × time, p = .01). Findings suggest that both methods of diabetes education combined with care can improve metabolic control, QOL, and perceptions of provider care. CST may further assist in long-term improvements in health outcomes. Behavioral interventions are needed in addition to routine diabetes care, particularly in PC.

The effect of language preference on prenatal weight gain and postpartum weight retention in urban hispanic women

Hackley, B., Fennie, K., Applebaum, J., Berry, D., & Melkus, G. D. (2010). Ethnicity and Disease, 20(2), 162-168.

Abstract

Abstract

Objective: To describe prenatal weight gain and postpartum loss patterns among Hispanic women receiving prenatal care at an urban community health center by language preference. Methods: Data were abstracted from medical records of prenatal patients seen from 2000-2008. Included were self-identified Hispanic women, English- or Spanish-speaking, aged 16-40 years, with weight measured at ≤13 and at >37 weeks gestation. Women with preexisting diabetes, hypertension, gestational diabetes, pre-eclampsia, multiple gestation, or pretermdelivery were excluded. Bivariate (t-test, chi-square) and multivariate regression (linear, polychotomous logistic) statistics were used in the analysis. Results: Of 259 women who met eligibility criteria, 52 (20.1%) were primarily Spanish speakers. Overall, 43.6% exceeded prenatal weight gain recommendations; 30.8% of Spanish speakers vs 46.9% of English speakers (P=.07). Among normal-weight women, Spanish speakers gained below and English speakers gained above that recommended (P=.03). At late postpartum, 22.9% overall returned to their baseline body mass index (BMI ±0.5 kg/m2); Spanish speakers retained 1.21 vs 1.53 kg/m2 among English speakers, which was not statistically significant. Adjusting for baseline BMI, age, and smoking status, language preference was not associated with prenatal weight gain or postpartum weight retention. In adjusted models, being overweight at baseline was predictive of excessive prenatal weight gain (OR 2.12, 95%CI .99, 4.53; P=.05); older age was protective for postpartum weight retention (OR .90; 95% CI .82, .98; P=.02). Conclusions: Adherence to prenatal weight gain guidelines was poor and few women returned to their baseline weight at late postpartum, regardless of language preference.

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