PhD Nurse Profiles

These PhD-prepared nurses are contributing to RWJF’s goal of building a Culture of Health.

Jason Farley, PhD, MPH, CRNP, FAAN

When he was a child, Jason Farley, PhD, MPH, CRNP, FAAN, was taught that HIV was a punishment from God toward gay people, and secretly believed that he himself would one day be punished for being gay with the virus that causes AIDS. But he learned the true etiology of HIV early on as a nursing student—a revelation that fueled his desire to study and care for people with the disease.

He credits a progressive course at the University of Alabama for the epiphany. “It opened my eyes to the biases I had been exposed to growing up and set me on a path that gave me a passion for working with people living with the disease,” he says.

After earning separate master’s degrees in public health and nursing, Farley enrolled in a doctoral program at Johns Hopkins University and, at the same time, worked as an infection control epidemiologist at Johns Hopkins Hospital, where there was an emphasis on reducing the spread of Methicillin-Resistant Staphylococcus aureus (MRSA) and other antibiotic resistant organisms within the hospital.

The experience led Farley to study antibiotic resistant organisms—a major threat to people with HIV infections. For his doctoral dissertation, Farley found that 16 percent of newly arrested men within the Maryland Department of Corrections were colonized by MRSA—far higher than the 1 percent rate in the general U.S. population. The findings countered the conventional wisdom at the time, which held that MRSA colonization and infections were acquired in hospitals but were less likely in community settings.

Farley conducted a subsequent study that found similar rates of carriers of drug-resistant bacteria in newly admitted psychiatric patients at Johns Hopkins Hospital. And he will soon publish a study showing that routine testing procedures for drug-resistant bacteria are inadequate. He says that is further evidence that MRSA is deeply misunderstood in the health care system. “It is essential that we determine ways of preventing antibiotic-resistant organisms,” Farley says.

As a Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar (2012-2014), Farley is evaluating the spread of MRSA in individuals with HIV and their household members. And as an adjunct associate professor at the University of Kwa-Zulu, Natal, in South Africa, he is studying HIV patients with strains of tuberculosis that are resistant to multiple drugs (MDR-TB). Although rare in the United States, tuberculosis is the leading cause of death globally among patients with HIV.

Over the past few decades, Farley has traveled far on the path he set out on as a young university student, and the world is taking notice of his groundbreaking work. One recent example: Last year, he was inducted as a fellow into the American Academy of Nursing, one of the profession’s most prestigious honors. “Becoming a member of this distinguished group of nurses demonstrates wonderful recognition of my research, clinical practice, and education in HIV and associated co-infections,” Farley says.

It also sends a very different message than the one he got as a child, a message that is grounded in acceptance and hope, rather than fear and ignorance.

Ann Cashion, PhD, RN, FAAN

In 2000, world leaders and preeminent scientists gathered at the White House to celebrate the completion of the first survey of the entire human genome—an accomplishment that President Clinton hailed at the time as the “most important, most wondrous map ever produced by human kind.”

From that year on, Ann Cashion, PhD, RN, FAAN, an alumna of the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program (2005-2008), was hooked on the promise and potential of genetics and genomics in nursing.

Then as a faculty member in the College of Nursing at the University of Tennessee Health Science Center, she applied for a summer research training program in genetics and genomics at the National Institute of Nursing Research (NINR), a division of the National Institutes of Health in Bethesda, Md., and was selected to participate in the program’s inaugural cohort.

The experience introduced her to the field and changed the trajectory of her entire career; after a dozen years of her own research into genetics and genomics, she is now scientific director of the division of intramural research at NINR. “I came here in 2000 and I was just in awe,” she says. “Now, 14 years later, it’s where I work. I wouldn’t be here now if I had not had that positive experience all those years ago.”

After her summer experience in 2000, Cashion returned home and began researching the link between genetics, genomics, and the environment among organ transplant recipients. In a recent study, she combined emerging technologies and behavioral questionnaires to investigate the role of genes and environmental factors in patients who gained unhealthy weights after kidney transplants. Last year, she published the findings of her research, which showed that six genes, as well as certain environmental factors, increased the risk that kidney transplant recipients would become obese in the first year after transplantation. The results have the potential to improve health for post-transplant patients.

In her new role at NINR, Cashion oversees research that is conducted by nurse scientists at its Bethesda campus. This kind of “intramural research” comprises about 5 percent of NINR’s appropriated funding and usually involves the study of biological and behavioral data, such as measures of genomics, depression, past traumatic events, physical activity, and diet. “Because we’re nurses, we’re very aware of the environmental and clinical factors that affect our patients,” she says.

During her tenure, Cashion aims to mentor and support nurse scientists and encourage research using emerging methodologies such as epigenetics, which explores the influence of factors like food and stress on gene activity. “It’s fun. It’s all a puzzle. The more you learn, the more you realize you don’t know. And that curiosity is what drives all scientists.”

Rahshida Atkins, PhD, APNc

Raised in a low-income household headed by a single mother in inner-city New Jersey, Rahshida Atkins triumphed over the challenging circumstances of her childhood, and now she’s helping other women and children do the same.

Atkins attended some of the lowest-achieving public schools in New Jersey, but she nevertheless saw education as a path out of poverty. She studied hard, became her high school’s valedictorian, earned a scholarship to Rutgers, the State University of New Jersey, and graduated with a bachelor’s degree in nursing with highest honors and a near-perfect grade-point-average. She went on to earn her master’s degree in nursing, followed by a doctorate, supported by the Robert Wood Johnson Foundation (NJNI) New Jersey Nursing Initiative.

Now at the end of her long and successful educational journey, Atkins, PhD, APNc, is looking back to her childhood, but this time through the lens of science. Atkins recently received a post-doctoral fellowship at the University of Pennsylvania School of Nursing, where she will continue to study depression among Black single mothers—a population at high risk for the condition. “My mom was a single Black mother, and many female relatives and friends are as well,” she says. “I saw them struggle with psychosocial and mental challenges.”

Even when women had outside supports, such as government-provided health insurance coverage or access to free transportation, depression and other mental health challenges had the power to rob them of the motivation to care for themselves and their children, Atkins says.

Identifying and effectively treating depression, however, isn’t easy. The causes can be many, ranging from poor and unstable living conditions, intermittent employment, short-term relationships, poverty, racism, and other psychosocial challenges. And some women are reluctant to seek treatment or are unaware that they are suffering from mental illness. Even so, there aren’t clear, evidence-based interventions to treat and prevent the problem in this particular population.

Atkins is working to change that. As a New Jersey Nursing Scholar, she studied a group of more than 200 single Black mothers in Camden and Trenton, N.J., to develop a theory about the cultural and psychosocial factors that contribute to depression in the population. She found that anger, stress, perceived racism, and low self-esteem were linked in different ways to the development of depressive symptoms among study participants, and she used the findings to develop a theory to guide nursing research and practice in the area.

More recently, she completed a study to examine predictors and outcomes of depression in more than 160 Black single mothers. She found that negative thinking contributes to depression in these mothers, which subsequently diminishes their participation in positive health practices and their perception of social support.

She hopes her work will enable health care providers to better understand the causes of depression in the population and make more informed recommendations for treatment and prevention. “I want to prevent depressive symptoms, or diminish them, and improve quality-of-life so these women can maintain employment, enjoy stable relationships, and become productive members of society,” she says. That, she adds, will be good for women, their children, and for society too.