health disparities - The University of Tulsa

health disparities

Doctor of Nursing Practice student aims to help Hispanic women combat heart disease

The Centers for Disease Control and Prevention report that cardiovascular disease is the leading cause of death in the United States. While rates vary according to age, ethnicity and gender, one of the populations most affected by heart disease is Hispanic women. According to Erica Dees, a student in The University of Tulsa’s doctor of nursing practice (DNP) program and a critical care cardiology nurse at Saint Francis Hospital, “Hispanic women tend to develop heart disease 10 years earlier than Caucasian women. They also experience the lowest rates of health literacy for heart disease risk factors.”

As a Hispanic woman herself, Dees notes that she, too, possesses a number of those potentially threatening risk factors. More generally, studies on racial and ethnic disparities in health care access and utilization regularly identify Hispanics as one of the most disadvantaged ethnic groups in the country. “It is essential,” Dees said, “for communities to provide educational heart health promotion interventions that target this underserved population and, in particular, Spanish-speaking immigrant Latinas.”

Disease prevention through community-based education

As part of the DNP program’s requirements, each student must carry out an extensive research project focused on addressing a specific health issue. For her investigation, Dees will implement a pilot program involving a bilingual community-based disease prevention strategy. Dees’ program has three main objectives:

  • To increase participants’ knowledge of heart disease risk factors
  • To bolster their recognition of the importance of early treatment after the onset of heart attack or stroke symptoms
  • To discuss with the participants and help them identify the symptoms of a heart attack and how they present in women.

At the center of Dees’ program is The Heart Truth®, a toolkit developed by the National Heart, Lung, and Blood Institute. In this resource are a PowerPoint presentation and fact sheets detailing heart-disease risk factors and stroke symptoms, as well as how to recognize heart attack symptoms.

“My plan is to deploy this toolkit in a six-week program comprising once-a-week sessions lasting 60 minutes each,” Dees said. “The sessions will comprise an interactive health lecture by me, followed by small-group discussions among the participants. My inclusion criteria are women who identify as Hispanic and are between the ages of 35 and 60, which is the age range when women are at most risk for heart disease. They must also be able to read, write and speak Spanish or English at a basic level.” Dees plans to measure the effectiveness of the training using the 25-item Heart Disease Fact Questionnaire (HDFQ), which she will administer before and after the intervention.

Commenting on Dees’ project, Director of the School of Nursing Sheryl Stansifer remarked, “Nurse practitioners are advocates for improving patient outcomes. Erica identified a need to improve cardiovascular health in migrant Hispanic women, and her project will empower this population to make informed decisions about their well-being.”

Community partnership

A core element of Dees’ research is the partnership she struck with YWCA Tulsa. Participants in her pilot program will be members, clients and guests from the organization’s health and wellness department as well as immigrant and refugee services department.

“We are proud to partner with Erica in her research,” said Lacey Thompson Caywood, the director of health and wellness at YWCA Tulsa. “We understand the value of the work she is doing and the impacts it can have on families and the Tulsa community at large.

“The need for this type of research is especially important for Oklahoma considering we have one of the highest rates of heart disease mortality in the country and many times signs and symptoms of heart attacks can look very different in women. Additionally, white adults in Tulsa are almost twice as likely to be insured as Hispanic/Latinx adults. Between these and other compounding factors, Erica’s work will benefit many Hispanic/Latina women and their families in Tulsa, and we are more than happy to assist in that mission any way we can.”

Next steps

“This is a disadvantaged but growing population, and I believe we have to do something to improve their health,” Dees observed. “I’ve had a lot of positive feedback on my project from Hispanic women in the community, the YWCA and faculty here at Oxley College. The DNP program has helped me to feel I can do something truly impactful.”

Now that her general plan and a project partner are in place, it’s down to the specifics. Dees expects to initiate her project during the fall of 2019. “I intend to begin implementing the interventions in March and then spend April analyzing and interpreting my data,” Dees said. She anticipates devoting May to final evaluation and documentation.


Becoming a nurse practitioner through TU’s doctor of nursing practice program is a three-year journey toward health care excellence. If you hold a BSN and would like to advance your knowledge and career as a nurse practitioner, TU offers two pathways that might interest you: family nurse practitioner and adult-gerontology acute care nurse practitioner. There is also a post-master’s pathway for advanced practice nurses.

Schweitzer Leadership Summit addresses Tulsa health disparities

The first-ever Schweitzer Leadership Summit welcomed more than 60 graduate students and professionals from across the country to Tulsa earlier this month to learn how local leaders are improving health disparities and strengthening the Schweitzer Fellowship U.S. network.

The event was hosted November 2-4 by current and past Albert Schweitzer Fellows who saw an opportunity to bring their counterparts to Tulsa and expand the organization’s network of alumni through meaningful engagement.

The role of a Schweitzer Fellow

schweitzer leadership summit“Schweitzer Fellows and alumni are talented, passionate individuals who do ground-breaking work to address health disparities,” said Rachel Gold, director of the Albert Schweitzer Fellowship Tulsa chapter. “The goal of this leadership summit was to reinforce the energy, passion and spark that drove Fellows and alumni to the Schweitzer Fellowship in the first place, and that will continue to inspire them towards reaching their leadership goals.”

Schweitzer Fellows are competitively selected from graduate and professional degree programs statewide in traditional health-focused fields such as medicine, nursing, dentistry and public health as well as related fields including education, social work, law and the arts. Schweitzer Fellows gain knowledge and experience in innovative project design, leadership and community health by designing and implementing yearlong initiatives that address health disparities and social determinants of health such as poverty, the environment and education.

schweitzer leadership summitPast projects include a concept developed by University of Tulsa clinical psychology doctoral student Danielle Zanotti, a member of the inaugural class of Tulsa Schweitzer Fellows in 2016. Zanotti implemented a program to help veterans strengthen parenting skills and gain developmentally appropriate knowledge about what to expect from their children. The community site was The Coffee Bunker — a place in Tulsa where veterans can connect. After her year of Schweitzer service, Zanotti was selected for an internship at a VA hospital in Houston and plans to return to Oklahoma to pursue her career in mental health and community leadership.

A deep dive into Tulsa, growing as a leader

Other fellows such as Ekene Ezenwa, a third-year student in the University of Oklahoma School of Community Medicine, focused their projects directly on health education. Ezenwa and her Schweitzer Fellow partner established a health leadership program called HEAL at Union Middle and High Schools, where they connected participants to health professions and supported them in designing health workshops for younger students.

“This fellowship is good for anyone who wants to do a deep dive into Tulsa and be able to not only help the community grow but also grow as a leader,” Ezenwa said. “The Schweitzer Fellowship provides participants with so many resources and so much guidance to do the things they want to do – design projects that the community really wants and needs, learn how to successfully write grant proposals and advocate in the community.”

Through careful planning, including a series of virtual meetings with counterparts around the country, the Schweitzer Fellowship Leadership Summit planning team, including seven Tulsa Schweitzer alumni and Gold, created an agenda that shone a spotlight on the status of health and social issues in Tulsa, the second-largest city in a state that ranks 48th, 49th or 50th in many national health measures. Gold says Tulsa was the perfect backdrop for Schweitzer Fellows and alumni to reunite and take a closer look at Tulsa efforts to reduce community health gaps while brainstorming new strategies for improving health outcomes.

“This conference reinforced the leadership skills of our planning team, refined their own career goals related to improving health and promoted self-awareness of their capabilities and visions for the local and national Schweitzer Fellowship communities,” Gold said.

Renewed inspiration from a Schweitzer alumna

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Leslie Hsu Oh

Award-winning writer, skilled photographer and honored public health leader Leslie Hsu Oh served as keynote speaker for the event. As a 1997-98 alumna of the Schweitzer Fellowship at Harvard University School of Public Health, she founded the Hepatitis B Initiative to tackle the prevalence of hepatitis B in Boston’s Asian communities by offering free screenings and vaccinations. Her Schweitzer project is still in operation.

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The Gathering Place

A special session led by Tulsa Mayor G.T. Bynum and University of Tulsa President Gerard Clancy discussed health disparities in the city. Participant-led workshops at Tulsa’s 36 Degrees North entrepreneurial hub focused on approaching mental health through a social justice lens, gratitude as an act of leadership and transforming health care organizations through immigrant-friendly policy. Conference attendees visited facilities for Women in Recovery, the Take Control Initiative, the John Hope Franklin Center for Reconciliation, the Center for Individuals with Physical Challenges and Community Health Connection. The weekend concluded with a tour of The Gathering Place.

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Tulsa Mayor G.T. Bynum (left) and TU President Gerard Clancy

Sponsors included the TU Oxley College of Health Sciences, Morningcrest Foundation, George Kaiser Family Foundation, TYPROs, the Community Food Bank of Eastern Oklahoma and Trust Co. of Oklahoma.