CTAC, who has been working since 2020 to rally faith leaders in this effort, is a Washington, D.C.-based nonprofit whose mission is to be a voice and improve lives for the 12 million people impacted by serious illness, including their families and caregivers.

Effort tackles health care barriers

With CTAC support, the Trager Institute’s Louisville Community of Care Project – Community Health Worker Initiative to Promote Health Equity (LCCP-CHWPHE) was launched earlier this year with funding from the Foundation for a Healthy Kentucky to address health disparities in this vulnerable 40203 zip code.

“LCCP is a collaborative effort of more than 15 community partners assembling their collective resources,” said Barbara Gordon, director of community engagement at the Trager Institute. “The church, major hospitals, and community resources are joining forces for the greater good of the people.”

This pilot program employs a dedicated neighborhood community health worker whose aim is to enhance the quality of life for residents through care navigation and community-based support. LCCP’s goal is to enroll 100 residents into the program by the end of 2025. So far, the initiative has offered health screenings and fairs to offer information and resources for 40203 residents.

Connecting the public to resources

Selected for her new role in June 2024 from her paraprofessional community health worker apprenticeship program at Trager Institute, LCCP coordinator Charlie Bell works as a liaison and advocate to improve access to primary care, support early diagnosis, reduce ER visits and address social determinants of health for clients.

With neighborhood input, factors like food, transportation and housing were identified as the most pressing hurdles to health care access and other quality of life issues. LCCP has gathered health care, business and nonprofit partners who can span the spectrum of social services.Ìę

As the point of contact and liaison to connect patients to resources, Bell explained there needs to be more “warm handoffs.”

“We may do a referral through an electronic medical record like MyChart but if it’s someone who doesn’t have an internet connection or doesn’t know how to use the computer, it’s a huge barrier. If we didn’t have the community of care project, then this would never be brought to light.”

Faith leaders fill the trust gap

Historically, one of the biggest challenges for community outreach efforts has been residents’ distrust of health care providers, according to Bell, but leveraging the community’s established relationships with faith leaders is helping to mitigate that factor.

Bell is working with Elder Angela Overton and faith project leads Rev. Dr. Angela Johnson, Rev. Lance West and Pastor Alma Wooley to keep 40203 residents from falling through the cracks of health care and social services access.

Overton, community engagement director for LCCP, and senior advisor and director of Faith Community Partnerships for CTAC said they hand-picked local faith leaders already working beyond the church walls in the local community. “No matter what your religion or if you have a religion, if you are struggling to navigate life with illness or chronic disease, we want to help you.”

The challenge of health inequities

An important overall framework for LCCP identifies stress and health inequities among African Americans, a key demographic of the 40203-zip code. Bell uses this context to address the social determinants of health while working to dismantle structural barriers that perpetuate health disparities.

“We’re still dealing with access to health care issues, mistrust in medical staff and discrimination like we did in the ‘60s and ‘70s,” said Bell. “It’s surprising that these things are still happening in 2025.”

As a strategic planner, Overton works at the intersection of health care, spiritual care and clinical care, and said she has been shocked at the apathy she has seen in some community settings. “The system does not work for everyone, and the disheartening message I hear in boardrooms and executive meetings is that is just how it is,” said Overton. “But this project from the beginning has made profound impacts on this community.” ÌęIncreasing a neighborhood’s access to health care changes lives, adds Bell.

“What may seem like a simple fix or a few phone calls can change the world for a client. Getting an electric wheelchair to someone who was bedridden for three years changed the mobility for one client. She told me, ‘You saved my life, thank you for saving my life’ – you can’t get any higher than that,” Bell said.

LCCP community partners include:

AARP, Accessia Health, Archangels, CenterWell, Chrysalis Ventures, Gilda’s Club, KIPDA, Norton Healthcare, University of Louisville, University of Louisville Trager Institute.

UofL News talked with fourth-year UofL medical student Sierra Shockley about her commitment to addressing health disparities as a Health and Social Justice Scholar (HSJS). Recently selected by the American Lung Association to represent the organization at Respiratory Advocacy Day in Washington, D.C., Shockley met with legislators to address disparities in lung health. Her ongoing advocacy work as a HSJS gave her the chance to not only represent the American Lung Association, but also the University of Louisville.

UofL News: Tell us about your involvement with the Health and Social Justice Scholar (HSJS) program.

Shockley: The mission of this program focuses on addressing health care disparities and promoting equity within underserved populations, which aligns perfectly with my deep-rooted commitment to give back to every community I have the privilege of serving.

What truly excites me about this program is its emphasis on interdisciplinary collaboration, fostering partnerships between students from various professional and doctoral programs, all working together to tackle the most pressing health inequities. Participating in this program has also challenged me to reflect on my role as a future physician, not just in treating patients but in advocating for systemic change.

UofL News: Why is it so important to address health disparities?

Shockley: ÌęHealth disparities are not just medical problems—they are societal and reflect deep-rooted inequalities that need to be confronted if we are to create a more just and equitable health care system. It’s about making sure that healthcare is fair and accessible to all, no matter where people live or who they are.

It’s a stark reality that something as simple as a zip code can determine a person’s health outcomes, with life expectancy sometimes varying by more than ten years within just a 20-30-mile locational difference. This geographic inequality is just one example of how pervasive and alarming health disparities are. For instance, people of certain racial or ethnic backgrounds are more likely to face higher rates of morbidity and mortality for conditions such as diabetes, hypertension, and asthma, simply because of the systemic barriers that exist in their communities.

UofL Health: How can health equity be advanced through community participatory research?

Shockley: Community-based participatory research (CBPR) involves engaging the communities affected by health disparities in every step of the process, from identifying the problems to developing solutions. CBPR allows for a more inclusive and comprehensive approach to tackling disparities, creating interventions that are both culturally relevant and practically applicable. This approach also helps ensure that the research is actionable, impactful, and sustainable while fostering a sense of trust and ownership within the community as they see that their voices and lived experiences are being valued in the research process.

UofL News: Tell me about your experience in Washington D.C. What was your biggest takeaway?

Shockley: My experience standing for the University of Louisville in Washington D.C. was both inspiring and transformative. The biggest takeaway was the profound impact that storytelling and personal narratives can have when advocating for change. While data and research are crucial, it’s often the emotional and human aspects of a story that resonate most with lawmakers.

This experience also highlighted the power of collaboration—whether it’s with fellow advocates, policymakers, or health care professionals. By working together, we were able to amplify our voices and drive home the importance of lung health on a broader scale.

UofL News: How do you plan to use your research/knowledge about health disparities in your medical career/practice?

Shockley: I am fortunate to be working with Dr. Scott Bickel and Dr. Rose Hawkins on a project analyzing the impact of urban greening on asthma exacerbations and related health outcomes. By studying how urban green spaces can mitigate asthma symptoms and improve respiratory health, I am gaining valuable insight into how environmental justice is tied to health equity, and this knowledge will undoubtedly influence how I approach patient care.

As a future surgeon, knowing many underserved communities face significant barriers to accessing surgical care, I hope to focus part of my career on bridging that gap. Whether through global health initiatives, public health programs, or working with underserved populations locally, I aim to be an advocate for systemic change, ensuring that the communities I serve have access to the resources and infrastructure necessary to lead healthier lives.

Professor Oluwaferanmi Okanlami encouraged attendees to ask that question at the 2024 health equity keynote: “Disabusing Disability: Demonstrating that Disability Doesn’t Mean Inability.” Okanlami, whose mission is to close the gap among the diverse members of our society to create a more equitable and promising future for all, highlighted shortcomings in how most of society views disabilities and what must change.

Born in Nigeria before immigrating to the U.S. at a young age, Okanlami attended high school at Deerfield Academy and went on to Stanford University where he also ran track & field, serving as captain his last two seasons and achieving Academic All-American recognition.ÌęOkanlami earned his medical degree from the University of Michigan before matching into orthopedic surgery residency at Yale University. At the beginning of his thirdÌęyear of residency, he experienced a spinal cord injury, paralyzing him from the chest down. After two surgeries and intense rehabilitation, he recovered some motor function and navigates the world as a proud wheelchair user.

Today, Okanlami is director of student accessibility and accommodation services at the University of Michigan, where he oversees the Office of Services for Students with Disabilities, two Testing Accommodation Centers and the Adaptive Sports & Fitness Program. He also is an assistant professor of family medicine, physical medicine & rehabilitation and urology at Michigan Medicine and an adjunct assistant professor of orthopedic surgery at David Geffen School of Medicine at UCLA. In addition, he earned a master’s in engineering, science and technology entrepreneurship from the University of Notre Dame and completed his family medicine residency at Memorial Hospital in South Bend, Indiana.

As an accomplished athlete, he is passionate about adaptive sports and fitness and champions access to physical fitness and inclusive recreational and competitive sports for all.

At Research!Louisville, Okanlami’s topic provided insight into creating a health system which is accessible to and inclusive of both patients and providers with disabilities, as well as providing provisions necessary for students and employees with disabilities in higher education.

The Americans with Disabilities Act defines a person with a disability as an individual who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment or a person who is perceived by others as having such an impairment. Okanlami’s work emphasizes that disabilities do not fairly identify individuals, but more than likely perceptions of disabilities can lead to artificially placing limits on people who have just as much or more to contribute to society.

As a disabled, Black, Nigerian, immigrant, cis-gender heterosexual, male, physician and athlete, Okanlami doesn’t just speak from an acquired knowledge-based perspective. He has experienced firsthand the difficulties of being identified in a culture that does not understand his main message that “disability does not mean inability.”

In his talk, Okanlami illustrated how each individual with a disability has unique needs for accommodations.

“When you have met one person with a disability, you have met one person with a disability,” he said.

Okanlami said that everyone must recognize that we live in an ableist world and we need to provide reasonable and appropriate accommodation for people that identify has having disabilities, whether those disabilities are visible or invisible.

“The health care system is ableist by definition. The medical model of disability teaches us that disability is pathology. It is something that is broken that should be fixed, prevented or cured,” Okanlami said. “The social model of disability does not see the problem living in the individual, it sees the system we are in as being inaccessible. If someone is born without the ability to walk, that shouldn’t be a problem if we have access to the resource they need to be able to navigate.”

But he encouraged everyone to take action.

“What is it we can do to make someone’s tomorrow better than their yesterday?” Okanlami said. “There is something that each of you can do, even if it is a tiny little bite, but the impact that little bite can have could be something that makes a profound impact on someone else’s life.”

Okanlami’s Research!Louisville presentation on Sept. 19 at the University of Louisville Health Sciences Center was led by the HSC Office of Health Equity and Engagement and the School of Medicine Office of Community Engagement and Diversity. To watch his entire keynote discussion, visit the .

Betty Coffman contributed to this story.

Black patients have been shown to receive coronary artery calcium scoring (CAC) tests eight times less frequently than white patients. The test reveals whether people at moderate risk for developing heart disease have calcium deposits in their heart arteries and physicians should recommend preventative medications for them, such as statins.

This summer, second-year medical students Brown and Ballenger created a video and questionnaire to help physicians understand and overcome potential barriers Black patients have experienced in obtaining the CAC test. With the help of Dinesh Kalra, chief of cardiology, and other physicians in the , the video and survey were sent to physicians in the UofL Department of Medicine and other UofL providers.

“It reminds physicians about when this preventive test should be ordered, much like screening for blood glucose, cholesterol or cancers. Hopefully after that, we will be able to show that the gap we were seeing in African Americans getting tested less often will be eliminated,” Kalra said.

The survey revealed that the study increased physicians’ confidence in CAC testing and understanding of its role in predicting the risk of future heart attacks. After providers watched the educational video and reviewed guidelines for the test, they reported a greater willingness to order the test and understanding of implicit bias in medicine, which may drive such disparities in health care between Blacks and whites. Kalra’s team hopes to apply these findings in other diseases affected by such disparities, such as heart failure or blood pressure control.

Brown and Ballinger worked on the study as part of the UofL cohort of the national . Winn CIPP offers a six-week summer service-learning experience for medical students who are underrepresented in medicine and committed to a career path that addresses diversity, equity, and inclusion in clinical trial studies.

Brown and Ballinger both have a personal or family history of heart disease, so they understand the need for preventative care delivered through the calcium scoring test. They see this summer’s project as a chance to improve their research skills to benefit their future patients.

“As medical students, we don’t get a lot of instruction on research in our classes,” Brown said. “This program has provided a great opportunity for me to learn as much as I can about research and how to ask questions and how to think and how to analyze data.”

Ballinger believes her experience in Winn CIPP will help her increase trust in research among Black and other underrepresented patients.

“The community aspect of reaching back and providing education and offering education to the community and creating trust in clinical research in general is really important to us moving forward in our career,” Ballinger said.

Seven medical students participated in four mentored projects with , five of whom are UofL students. UofL first hosted the Winn CIPP program in 2023 and is one of nine sites for 2024.

Cardarelli is currently senior associate provost for academic affairs at the University of Kentucky. In her ten years at UK, she has served as associate dean, college diversity officer, department chair and assistant/senior assistant provost for faculty affairs. Her research focuses on community-engaged approaches to enhancing health equity, and she has served as principal investigator on more than $10 million in grants funded by the National Institutes of Health, Centers for Disease Control and Prevention, United States Department of Agriculture and other sponsors.

A professor of health, behavior and society, Cardarelli received her Master of Public Health degree at University of North Texas School of Public Health Fort Worth. She went on to earn a doctorate in epidemiology at University of Texas School of Public Health Houston and completed the Executive Leadership in Academic Medicine fellowship at Drexel University.

Cardarelli is a member of the Association of Schools and Programs of Public Health’s Inclusive Excellence through an Anti-Racism Lens expert panel.ÌęHer commitment to advancing women and faculty of color in the academy is reflected in a two-year term as State Chair for the Kentucky chapter of the American Council on łÉÈËֱȄ Women’s Network, where she grew institutional membership and professional development programming.

“Dr. Katie Cardarelli is an accomplished leader, researcher, and dedicated advocate for diversity and inclusion in academia. Her distinguished background and extensive academic experience have led to multifaceted contributions, spanning administrative leadership, impactful research, excellence in teaching, and commitment to equity, making her a formidable force in shaping the landscape of public health,”Ìęsaid Interim Provost Gerry Bradley.

Cardarelli said the impressive track record of SPHIS faculty, staff, and students in advancing health equity in the Commonwealth and beyond was a key factor in her decision. “My passion for social justice was instilled in me from an early age by my mother, who was a nurse,” she said. “Public health strives to assure that all individuals have an opportunity to live a healthy life. I am excited to build upon the accomplishments of the school and build a vision for the next chapter.”

“Social justice is at the foundation of why I pursued medicine,” Mian said. “I believe that health care is a human right and that people of all cultures and backgrounds deserve to be treated with equitable, high-quality care.”

This belief has motivated her throughout medical school and inspired her to apply for a master’s degree in public eye care in order to directly impact the health care conditions of impoverished populations locally and abroad. Mian realized her passion for ophthalmology when she shadowed a doctor who provided free eye surgeries and training. Inspired by how a simple surgery to cure blindness could empower someone to get an education, live independently without a disability and pursue their dreams, Mian was dedicated to becoming an ophthalmologist.

In May, Mian was awarded a $50,000 Rotary Global Grant Scholarship to attend the London School of Hygiene and Tropical Medicine. The scholarship is designed for students pursuing a career in an area of great humanitarian need and have a long-term commitment to measurable and sustainable change. Students must be sponsored by a local Rotary club in their place of permanent residence or full-time study.

“The rotary club has a long history of service and humanitarian work, and I found that I shared similar goals with the organization,” Mian said. “As a public eye care master’s candidate, I believe I can gain valuable knowledge and experience to be a successful social justice leader, physician, and policy maker.”

As a future ophthalmologist, Mian hopes to create an equitable health care system for diverse populations. She believes her experience at the London School of Hygiene and Tropical Medicine will widen her cultural competence and knowledge in research and epidemiology and allow the opportunity to work intensely in preventing detrimental ocular disease.

Mian attributes her award to the support of her faculty mentors at the School of Medicine, Bethany Smith and Susan Sawning, as well as her community involvement during her first years of medical school. During her time as a medical student, she has been extensively involved with the American Medical Association creating health policy. She is the co-founder of Grow502, a professional student-led nonprofit organization aiming to address health care disparities in the Louisville community, and also the co-founder of Physicians for Human Rights. These experiences have led her to live a life of service.

Kentucky has a severe shortage of health care providers, with at least some portion of 113 of the state’s 120 counties designated as Health Professional Shortage Areas, including parts of Jefferson County. Recent projections rank Kentucky lowest among the states in meeting the need for primary care physicians by 2025.

To attract and train medical students with an interest in practicing primary care in medically underserved communities, the School of Medicine will enhance existing programs that train students in the underserved rural environments, assist individuals from other careers who want to prepare for medical school, create a new program to train medical students in an urban environment and provide scholarships to support students financially in all of these programs.

“The UofL School of Medicine is honored to have been selected as a recipient of the HRSA grant and is committed to creating pathways that support workforce development for primary care careers in medically underserved regions,” said Jeffrey Bumpous, interim dean for the UofL School of Medicine and vice president of medical affairs. “University leaders recognize the projects and programs supported by this funding are critical to the institutional mission of both the university and the School of Medicine and aim to sustain the efforts beyond the four-year term.”

UofL has a long history of preparing physicians for practice in rural and smaller communities through the , started in 1998 with the goal of increasing the number of physicians practicing in rural areas, and in existing UofL family medicine residencies in Glasgow and Owensboro.

“Students tend to practice what they are taught and where they learn it. Our idea is to enhance our training programs with a focus on improving their educational experience in primary care, particularly in underserved communities,” said Kelli Bullard Dunn, vice dean of community engagement and diversity for the UofL School of Medicine, who leads the project. “At the UofL School of Medicine, we are in a unique position in that not only do we serve rural parts of the state, but we have an urban, underserved core right in our backyard. We would like to take what we have learned from the Trover Campus and replicate part or all of that in the urban environment here in West Louisville and other underserved areas.”

Medical students in the complete their final two years of medical school at Trover Campus, located in Madisonville, Kentucky, hosted by Baptist Health Deaconess Madisonville. Of the 170 physicians who have graduated from the Trover Rural Track so far, 75% practice primary care and 43% practice in rural communities.

“The Trover Campus has been successful because we are able to get more rural students into medical school and then into rural practice by supporting them all the way through the process, starting with high school,” said William J. Crump, associate dean of the UofL School of Medicine Trover Campus. “This grant holds the promise of enlarging our campus, but most importantly building an urban underserved counterpart.”

Three programs to achieve the grant goals

The grant project focuses on three programs aimed at increasing the number of physicians who choose primary care specialties of family medicine, general internal medicine, pediatrics and internal medicine-pediatrics and encouraging them to practice in underserved communities.

First, UofL will increase participation opportunities for students in the Trover Rural Track and expand primary care clinical training for students in conjunction with the UofL family medicine residency programs at Glasgow and Owensboro.

Second, a new urban training program will be created, modeled on the Trover program, that provides medical students opportunities to train in medical facilities in West Louisville and other communities that provide care for underserved populations. This project will involve partnerships with community health systems such as UofL Health, Family Health Centers and others.

In addition, the project calls for enhancement of the UofL , which prepares individuals who have a bachelor’s degree in another field to enter medical school. Of the 114 students who have completed the Postbaccalaureate Premedical Program since it began in 2009, 98% have been accepted into a medical school and 36% of those who have completed residency programs now practice in primary care fields.

The new funding will allow this program to recruit more students from medically underserved communities who are interested in practicing in those areas after completing residency training and to improve access to medical school for them with scholarships and additional academic support.

“This new grant allows us to help even more people fulfill their dream of becoming a physician. A lot of the postbaccalaureate premedical students have come from underserved populations or underserved areas, including rural areas. Having more folks from rural areas and underserved communities going into medicine is a great thing for Kentucky,” said V. Faye Jones, UofL Health Sciences Center associate vice president for health affairs and diversity initiatives and co-lead for the grant project.

Students in each of the three programs will receive academic and financial support with coaching and scholarships to help ensure their success in applying to and completing medical school.

“Everyone deserves the best quality health care we can provide, and that means having the best quality of talent in the medical school pipeline,” said Rep. Morgan McGarvey, who supported the grant proposal. “I’m excited for UofL and for the future of Kentucky health care with this HRSA Medical Student łÉÈËֱȄ Program grant to address the primary care provider shortage. We need to be doing everything we can to ensure we are supporting the primary care providers of tomorrow, and I’m proud UofL is leading the way.”

See photos on from the Oct. 9 press conference announcing the new funding.Ìę

The University of Louisville and partners have launched a new $1.5 million innovation challenge centered on tackling pressing problems in health equity, with 15 winners each receiving $100,000 to further their ideas.Ìę

This new Reconstruct Challenge is led by the , in partnership with an innovation studio, with funding from the Kentucky Department for Public Health’s Office of Health Equity and the private operating foundation, .

Together, they will select five winners for each of the following categories: 1) food access, 2) maternal and child health and 3) non-emergency medical transportation (NEMT) and access in the Louisville region.Ìę

“By bringing together the lived experiences of community members, academic expertise, industry knowledge and entrepreneurs, the goal is to create solutions in partnership with the people experiencing these health inequities every day,” said Ben Reno-Weber, challenge lead and deputy director of HEIH within UofL’s HEIH is an innovative partnership among UofL, and the focused on solving important health equity challenges through research, innovation and talent pipeline development.

Render is the executing partner of this grant and will launch the national call for innovations and the evaluation process. Each of the 15 winners will be awarded $100,000 in development funding and will participate in a 12- to 18-month proof-of-concept phase where they will work with community partners and UofL researchers to pilot their innovations in the Louisville region.Ìę

“Addressing inequities in our communities is vital work because we know we are only as strong as our most vulnerable populations,” said Kentucky Public Health Deputy Commissioner for Clinical Affairs and Interim Director of the Office of Health Equity Connie White. “We need to work together to elevate all of us. The Kentucky Department for Public Health is happy to be a contributing partner.”ÌęÌę

Applications are now open on the Reconstruct Challenge , and an will be held July 27. After the initial pilot period, successful innovations will have the opportunity to receive additional funding to further scale.Ìę

This innovation program builds on UofL’s track record as a research powerhouse and the prior successes of the two previous Reconstruct Challenges launched by Access Ventures in 2019 and 2022 addressing housing and barriers to employment, respectively. This Reconstruct Challenge series is funded by the Kentucky Cabinet for Health and Family Services and Access Ventures.Ìę

“Poverty and its related challenges are cyclical and complex, and there are no silver bullet solutions,” said Access Ventures Managing Director Bryce Butler, who spearheaded the first two Reconstruct Challenges in 2019 and 2022. “We believe that if we work together, we can enact meaningful change and increase health equity in Louisville and Southern Indiana, which is why I’m so excited to expand Reconstruct with the help of new partners.”Ìę

The inaugural Ìęin 2019, founded by Access Ventures, focused on finding creative solutions to the affordable housing gap in the United States and granted six innovations of $300,000 each. Winners included Padsplit, Working Your Way Home, Urban Institute, Nesterly, Haven Connect and mRelief, of which the latter three received $350,000 (mRelief), $100,000 (Nesterly), $100,000 (Haven Connect) in follow-on capital to further scale. Through the first program iteration alone, 71,725 lives have been impacted, over $51 million unlocked for families already, and a 22-fold return on impact realized through these six innovative solutions.

A second in 2022 focused on finding creative approaches to making employment more equitable, and $100,000 was awarded to each of five innovative solutions to deploy in Louisville and Southern Indiana.ÌęÌę

This set of Reconstruct Challenges is open to anyone in the United States as long as the beta test of the innovation takes place in the Louisville region.ÌęImportant dates for applicants:Ìę

UofL News: Please describe some of the health disparities that directly impact the older adult population.Ìę

Harrington: Ageism is a collective result of stereotypes, prejudice and discrimination based solely on age. This is a relevant barrier to health care equity and patient safety. Our mindset of ageism must change. Human life means growing older across the life span without self-exclusion. The burden of preventable disease, mistreatment and inequity in access to and the provision of quality health care impedes opportunities to achieve optimal health. Optimal aging begins in early life and continues across the lifespan.

UofL News: What are some ways to overcome these challenges?Ìę

Harrington: We must take a collaborative all-hands-on-deck approach. There is a strong body of research showing patient outcomes are best when inter-professional teams work together. Our patients are begging for access to high-quality health care.

UofL News: Louisville is home to multiple aging care businesses and city leaders hope we can be innovators for improving quality of life for the growing population of older adults throughout the United States. How do you see your work (both in research and teaching) contributing to this effort?Ìę

Harrington: Ensuring that all our primary care nurse practitioner graduates acquire the knowledge and skill to care for our older adults in the community and long-term care settings is my highest priority as a nursing educator. Disseminating content for student and practicing nurse practitioners on the most complex medical conditions will hopefully help them improve their patients’ outcomes.

I and my medical and computer science and engineering colleagues also are working to change the most confounding social problems affecting older adults with Alzheimer’s disease and their caregivers using artificial intelligence and innovative product design. This exciting research has substantial social and policy implications.

UofL News: As someone with decades of geriatric nursing experience, explain how your research has helped improve the health and well-being of family caregivers of those withÌęAlzheimer’s disease/Alzheimer’s disease-related dementias (ADRD).Ìę

Harrington: From the 30,000-foot perspective, the gaps are vast in every area of aging. Fifteen million family caregivers of those with ADRD and 12 million ADRD care recipients are potentially impacted by research and innovative practice models adopted by health care professionals. It is difficult to separate research in aging into disease-based categories because they are all interconnected. My defined program of nursing scholarship and creative activity focuses on older adults’ and their caregivers’ health disparities and power inequity in the context of heart failure, Alzheimer’s disease and Alzheimer’s disease related dementias, and ageism.

UofL News: What are some of your significant areas of geriatric research?ÌęÌęDescribe for us some of the outcomes.

Harrington: Yes, in the context of the fellowship with the academy, there are several:

• 5 million individuals who reside in long-term care have heart failure. My innovative heart failure evidence-based guideline remains the only nurse-driven practice guideline of its kind since 2006, and has received national and international recognition through citations and inclusion of content. I created the ACE (Assess, Collaborate, Engage) Delirium Superimposed on Dementia practice model to improve how we approach delirium superimposed on dementia that impacts 20 million hospitalized older adults with ADRD yearly. That research recently published in .
• I believe education for quality health care for older adults requires a multi-prong approach that reaches health science students, health science professionals and families in the community. The possibilities for nursing innovation are infinite with inter-professional collaboration and begin with identifying the problems in care provision or care delivery. Redesigning the Medicare Annual Visit process for a 45 office Federally Qualified Health Centers (FQHC), prompted leading an inter-professional team in the development and production of an innovative desktop application for comprehensive geriatric assessment with custom reporting capabilities for FQHCs.
• The outcome of the first population-based study of 1,500 older adults in eastern North Carolina identified family caregivers’ need and desire for the knowledge and skill to be optimal caregivers for those with Alzheimer’s disease. We also realized how unrealistic it is to expect farmers to lose critical daylight hours to seek preventive health care, so we connected them to AgriSafe nursing services who visited them on their farms. The population-based community research led to delivering person-in-context dementia simulation to caregivers as an educational method to improve their understanding of dementia and their family members’ daily challenges and multiple educational workshops in collaboration with area agencies on aging.
• Between 2015 and 2017, I conducted two research studies that successfully eliminated academic silos in inter-professional geriatric education. The outcomes were an innovative and sustained Two-As-One Preceptor Model and the Troika InterProfessional (TIP) Gerontology łÉÈËֱȄ Model impacting over 300 third-year medical, primary care nurse practitioner and physician assistant students. The TIP outcome model was designed for a student team of three primary care professionals who learn and apply gerontology knowledge in a virtual clinic environment. All faculty reported students maintained proficiency in the content over time. These skills impact approximately 8 million older adults these individuals will serve when extrapolated over a 20-year career.

UofL News: What is the future of geriatric health care?Ìę

Harrington: We currently have approximately 680,000 adults over the age of 65 in Kentucky. The majority of the state’s counties, 81 of 120, are medically underserved. This void is compounded by many primary care physicians who are approaching retirement. Nurse practitioners are critical to the care quality of our older adult population and will remain critical for at least the next 30 years. Enacting legislation to remove the practice barriers and allowing nurse practitioner to practice collaboratively at the full scope of our educations, experience and training is growing more so each year. This is imperative to our ability to impact the wide-range of health disparities our older adults experience.