Abstract
Title: 2021 Distinguished Contribution to Research Award
First, I want to thank the Midwest Nursing Research Society leadership and committee members for this prestigious award. MNRS has been the most important professional organization to which I belong. MNRS colleagues, networks and meetings supported my growth and development as a nurse scientist since I joined in 1983 as a first-year PhD student. I will never forget being awed when meeting famous nurse researchers whose work had influenced my thinking. I am still in awe of the impressive number of distinguished MNRS researchers who have made outstanding scientific contributions.
My own journey as a scientist was more than a bit unconventional. My interest in research started early with a science project in 8th grade. Health concerns about hexachlorophene, a product commonly used in shampoos, skin cleansers, and baby products back in the 1970s, were emerging in the news. I decided to test the effects of hexachlorophene on the brain by injecting a small dose into 3 mice, a larger dose into 3 other mice, and keep 3 others as a control group. I was so excited and carefully administered subcutaneous injections into mice. Now that I understand AUCAC and IRB regulations, I shudder to think what requirements I may have violated, but I did my very best to take really good care of them.
During my outstanding nursing education at the University of Illinois at Chicago where I earned my BSN, MS and PhD degrees, I was exposed to nursing research from basic science to clinical studies. My undergraduate research course was taught by a brilliant postdoctoral fellow who taught us not only research methods but also what it meant to be a postdoc. I pursued my master’s degree after a few years of clinical practice as an ICU nurse and conducted an observational study of the nurses’ role in patient education in an academic health center setting. This project got me hooked on research and I applied to the PhD program where I was taught and mentored by stellar faculty researchers.
After completing my PhD coursework, I took a position at a comprehensive university where research and service were expected but excellent teaching was required. I was able to hone my teaching and administrative skills, complete my dissertation, and launch my first randomized trial of an advanced practice nursing intervention (with generous internal funding). This project taught me a great deal – including how little I knew about conducting a clinical trial in the real world (resources needed, time, effort, etc.). After earning promotion to Associate Professor and tenure, my family made the decision to relocate to Indianapolis.
This move presented an opportunity to carefully consider what I wanted for my next position. Indiana University was a premiere research university and I loved research so I decided I would take this opportunity to obtain additional research training through a postdoctoral fellowship at IU (after 7 years as a faculty member). Some colleagues thought I was crazy to give up a tenured position for a postdoc but I was committed to focusing 100% on research and learning as much as possible. I never regretted that decision (except briefly when going through P & T for the second time). When I came to IU in 1996, Dr. Victoria Champion gave me the opportunity to manage a randomized trial of a nurse-led intervention to improve outcomes for patients undergoing chemotherapy. The exciting thing about this project was that it was the first collaboration between Drs. Champion and Barbara and Bill Given. I got three world famous scientific mentors instead of one and learned a tremendous amount about intervention development, randomized trials, and obtaining funding.
I was fortunate to have access to foundation funding to support several of my initial, mostly descriptive, studies that were focused on understanding people’s knowledge, attitudes and behaviors related to colorectal cancer screening. While my mentor had been developing and testing interventions to increase mammography, I saw the potential to build upon her research methods and apply them to colorectal cancer screening. In the mid-90s, colon cancer was not on many people’s radars despite being preventable. I was excited about launching a program of research in this new area where screening could actually prevent cancer, that was relevant to both men and women, and offered complexity (requiring tailored interventions) in the number of screening tests available.
Strong preliminary work led to my first NIH funding including an R15 funded by NINR in 2002 and an R21 funded by NCI in 2003. In 2006, I will never forget sitting in a meeting and, during a break, reading the email that my first R01 had been funded by NCI. I jumped out of my seat and startled people around me who were certain something was wrong. My most recent project was funded by the Patient Centered Outcomes Research Institute (PCORI) which is committed to patient engagement in research. When PCORI was first established in 2010, it was a natural funder of my work since I had never developed an intervention or conducted a trial without invaluable assistance from members of the target audience (patients and community members).
Clinical trials are hard work and I learned early on that launching each project is similar to starting a small business. Establishing the infrastructure, developing study documents, getting all the regulatory approvals, building interventions, hiring competent and reliable staff, training and supervising them are just a few of the tasks to be accomplished. Having served as a project manager taught me a very important lesson – having a competent, qualified project manager can make or break a study. When I started with small funding, I could only afford to hire a project manager to work 15-20 hours/week. But having someone whose primary responsibility was to keep the project moving and on track was indispensable. Since 2003, I have been blessed to have the most amazing project manager working with me on several studies. Connie has been the glue that holds every project together and I would never have accomplished all I have without her.
Over the past 24 years, I have been blessed to have so many amazing mentors, students, trainees and colleagues who shared my passion for research that improves patient outcomes. All of these have collaborated with me, critiqued my work, celebrated successes, supported me through failures (which are inevitable and numerous) and taught me so much. The key to a successful research career is persistence and finding the right environment and colleagues. I was fortunate to come to IU in search of a postdoc where, because of the incredibly supportive and strong research environment, I stayed to pursue a successful academic career. I am indebted to my colleagues in the Schools of Nursing, Medicine, Public Health and the IU Simon Comprehensive Cancer Center who have been generous collaborators and always challenged me to think and, as a result, grow as a scientist. My hope is that each young nurse scientist reading this is as fortunate.