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Center for Cardiovascular and Chronic Care

the Center

About the Center

"Cardiovascular health can be improved particularly in vulnerable populations through community engagement as well as future innovations in research."

The Center aims to provide state-of-the-art technology-assisted interventions, integrated training and career development activities, broad dissemination and implementation of research findings, and targeted health policy initiatives.

The Center works to significantly reduce cardiovascular health disparities through community engagement, scientific investigation, education, and policy initiatives. It supports the education, training, and mentoring of new investigators; provides administrative and mentoring services and support to Center investigators; and disseminates findings, data, and resources.


  • Provide an infrastructure dedicated to advancing nursing science to improve the cardiovascular health of vulnerable populations
  • Foster a new generation of nursing scholars engaged in interdisciplinary/transprofessional research in the area of cardiovascular health promotion for vulnerable populations
  • Enhance the translation and dissemination of research in the area of cardiovascular health among vulnerable populations


Center Associates

The Center Directors are advised on scientific and administrative decisions by the Executive Committee. The committee is composed of directors, core directors, and administrators at the School of Nursing. The committee meets monthly to ensure successful coordination of the center cores and functions.





Preventive Cardiovascular Nurses Association (PCNA) – The Premier Cardiovascular Nursing Conference

April 4-7, 2018
Marriot Baltimore Hotel
Baltimore, MD

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Sigma Theta Tau International 4th Biennial European Conference

June 4-8, 2018
Anglia Ruskin University
Cambridge, United Kingdom

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American Association of Heart Failure Nurses (AAHFN)- 14th AAHFN Annual Meeting

June 28-30, 2018
Sheraton Grand,
Chicago, IL

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Sigma Theta Tau 29th International Nursing Research Congress

July 19-23, 2018
Melbourne, Australia

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Heart Failure Society of America- 22nd Annual Scientific Meeting

September 15-18, 2018
Gaylord Opryland Hotel & Convention Center
Nashville Tennessee

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Pilot Projects

An Automated System for Prevention of CVD in HIV Care Settings (ASPIRE)

In a three-year study of 700 Baltimore patients with HIV/AIDS, Johns Hopkins University School of Nursing assistant professor Jason Farley will explore the effectiveness of healthcare clinicians in preventing cardiovascular disease (CVD) in HIV/AIDS patients.

Promoting Health Literacy of African Americans with HBP

Johns Hopkins University School of Nursing researcher Benita Walton-Moss�partnered with Baltimore's community leaders in reaching out to substance abusers with hypertension with the goal of improving cardiovascular health. The associate professor launched a two-and-a-half-year study in a Baltimore neighborhood with the aim of decreasing the high rate of hypertension among African Americans, particularly those who are substance abusers.

Other 2011-2012 Pilot Studies updates

Dr. Kathy Ruble, from the School of Medicine, is conducting a study to examine the development of preclinical cardiovascular disease amongst Acute Lymphoblastic Leukemia (ALL) Survivors. In this study, she has compared childhood cancer survivors to healthy controls to look for differences in early markers of cardiovascular disease, including endothelial dysfunction, arterial stiffness and metabolic syndrome. Dr. Ruble's research has focused on the long-term effects of cancer and therapy among survivors of childhood cancers and data from this study will expand her research into long-term cardiovascular health in this vulnerable population.

Dr. Linda Rose plans to begin a study of health literacy related to cardiovascular disease risk factors and cardiovascular disease in persons with mental illness. She hopes to identify strategies for addressing cardiovascular disease and risk reduction in this group of individuals who are at risk for cardiovascular disease and related complications.



Cardiovascular Disease
Commodore-Mensah, Y., Ukonu, N., Cooper, L. A., Agyemang, C., & Himmelfarb, C. D. (2017). The Association Between Acculturation and Cardiovascular Disease Risk in Ghanaian and Nigerian-born African Immigrants in the United States: The Afro-Cardiac Study. Journal of immigrant and minority health, 1-10.

Hayman LL, Berra K, Fletcher B, Miller NH, Himmelfarb CD. (2017) Promoting Cardiovascular Health Worldwide: The Global Cardiovascular Nursing Leadership Forum. Journal of cardiovascular nursing. 32(5):426-427. PMID: 28806307.

Gleason, K.T., Davidson, P.M., Tanner, E.K., Baptiste, D., Rushton, C., Day, J., Sawyer, M., Baker, D.,

Paine, L., Dennison-Himmelfarb, C.R. & David E. Newman-Toker. (2017) Defining the Critical Role of Nurses in Diagnostic Error Prevention: A Conceptual Framework and a Call to Action. Diagnosis. (Epub ahead of print) doi:

Dennison Himmelfarb, C.R., Hayman, L.L. (2016). Reducing Disparities in Heart Disease Treatment and Outcomes Among Women: A Call to Action. Journal of Cardiovascular Nursing, 31(5), 384-6. PubMed PMID: 27513676.

Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA, Williamson JD, Wright JT. 2017
ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. Journal of the American College of Cardiology Nov 2017, 24430; DOI:10.1016/j.jacc.2017.11.006.

Vargas-Meléndez GB, Cajita M, Whitehouse E, Han HR. (2017). Use of short text messages for hypertension management: A systematic review. Journal of Cardiovascular Nursing, 32(3), 260- 270. PMCID: PMC5085898

Agyemang C., Nyaaba G., Beune E,…Commodore-Mensah, Y., … Stronks, K, . Variations in hypertension awareness, treatment, and control among Ghanaian migrants living in Amsterdam, Berlin, London, and nonmigrant Ghanaians living in rural and urban Ghana - the RODAM study. J Hypertens. 2017. doi: 10.1097/HJH.0000000000001520 [doi], PMID 28858173

Coke LA, Dennison Himmelfarb CR. (2017). Type 2 Diabetes in the Older Adult: The Need for Assessment of Frailty. The Journal of cardiovascular nursing. 2017; 32(6):511-513. PMID: 28991868.

Renda, S. and Becker, K. (2017). The use of U-500 insulin for patients with severe insulin resistance: A case study.  The Nurse Practitioner Journal, 42(3), 12-16.
Renda, S., Baernholdt, M., and Becker, K. (2016). Evaluation of a Worksite Diabetes Education Program at a Large Urban Medical Center.  Workplace, Health and Safety, 64(1), 17-23.

Fitzpatrick, S. L., Golden, S. H., Stewart, K., Sutherland, J., DeGross, S., Brown, T., Wang, N. Y., Allen, J., Cooper, L. A., & Hill-Briggs, F. (2016). Effect of DECIDE (Decision-making Education for Choices In Diabetes Everyday) Program Delivery Modalities on Clinical and Behavioral Outcomes in Urban African Americans With Type 2 Diabetes: A Randomized Trial. Diabetes Care, 39(12), 2149-2157.


Petit Francis, L., Spaulding, E., Turkson-Ocran, R. A., & Allen, J. (2017). Randomized trials of nurse-delivered interventions in weight management research: A systematic review. Western journal of nursing research39(8), 1120-1150.

Park, H. K., Kwak, M. K., Kim, H. J., & Ahima, R. S. (2017). Linking resistin, inflammation, and cardiometabolic diseases. The Korean journal of internal medicine32(2), 239.

Stephens, J. D., Yager, A. M., & Allen, J. (2017). Smartphone technology and text messaging for weight loss in young adults: A randomized controlled trial. Journal of Cardiovascular Nursing, 32(1), 39-4.

Rankin, A. N. (2017). Childhood Obesity Prevention Partnerships: The Intersection of Clinics and Community to Create Sustainable Change. Journal of Pediatric Surgical Nursing6(2), 29-30.

Commodore-Mensah, Y. , Ukonu, N., Obisesan, O., Aboagye, J.K., Agyemang, C., Reilly, C.M., Dunbar, S.B., Okosun, I.S. (2016). Length of Residence in the United States is Associated with a Higher Prevalence of Cardiometabolic Risk Factors in Immigrants: A Contemporary Analysis of the National Health Interview Survey. Journal of the American Heart Association.

Thomason, D., Lukkahatai, N., Kawi, J. L., Connelly, K., & Inouye, J. (2016). A Systematic Review of Adolescent Self-management and Weight loss. Journal of Pediatric Health Care. [Epub ahead of print]. doi: 10.1016/j.pedhc.2015.11.016.

Commodore-Mensah, Y., Dennison Himmelfarb, C. R., & Agyemang, C. (2015). Cardiometabolic health in african immigrants to the United States: A call to re-examine research on African-descent populations. Ethnicity and Disease, 25(3), 373-379, PMID 26675140

Heart Failure

Xu J, Gallo JJ, Wenzel J, Nolan MT, Budhathoki C, Abshire M, Bower K, Arruda S, Flowers D, Szanton SL, Dennison-Himmelfarb C, Gonzalez K, Han HR. (2018). Heart failure rehospitalization and delayed decision making: The impact of self-care and depression. Journal of Cardiovascular Nursing, 33(1), 30-39. PMCID: PMC5711640

Casida, J. M., Abshire, M., Ghosh, B., & Yang, J. Y. (2017). The Relationship of Anxiety, Depression, and Quality of Life in Adults With Left Ventricular Assist Devices. ASAIO journal (American Society for Artificial Internal Organs: 1992).

Xu, J., Gallo, J.J., Wenzel, J., Nolan, M.T., Budhathoki, C., Abshire, M., Bower, K., Arruda, S., Flowers, D., Szanton, S.L., Dennison Himmelfarb, C., Gonzalez, K., Han, H. (2017). Heart Failure Rehospitalization and delayed decision making: The impact of self-care style and depression. Journal of Cardiovascular Nursing. PMID: 28574972.

Newhouse, R. P., Johantgen, M., Thomas, S. A., Trocky, N. M., Dennison-Himmelfarb, C., Cheon, J., ... & Pruitt, R. (2017). Engaging patients with heart failure into the design of health system interventions: Impact on research methods. Geriatric Nursing38(4), 342-346.

Deek, H., Chang, S., Newton, P. J., Noureddine, S., Inglis, S. C., Arab, G. A., Davidson, P.M. (2017). An evaluation of involving family caregivers in the self-care of heart failure patients on hospital readmission: Randomised controlled trial (the FAMILY study).International Journal of Nursing Studies, 75, 101-111. doi:10.1016/j.ijnurstu.2017.07.015

Abshire M, Prichard R, Cajita M, DiGiacomo M, Dennison Himmelfarb C. (2016). Adaptation and coping in patients living with an LVAD: A metasynthesis. Heart Lung, 45(5):397-405. PMID: 27342261.

Baptiste, D. Davidson, P. M., Groff Paris, L., Becker, K., Magloire, T., & Taylor, L. (2016). Feasibility study of a nurse-led heart failure education program. Contemporary Nurse. 20:1-12. [Epub ahead of print] doi:10.1080/10376178.2016.1229577

Xu J, Abshire M, Han HR. (2016). Decision making among persons living with heart failure. Journal of Cardiovascular Nursing, 31(5), E1-E9. PMCID: PMC4896844

Abshire, M., Xu, J., Baptiste, D., Almansa, J. R., Xu, J., Cummings, A., Andrews, M. J., & Dennison Himmelfarb, C. (2015). Nutritional interventions in heart failure: A systematic review of the literature. Journal of Cardiac Failure, 21(12), 989-999. doi:10.1016/j.cardfail.2015.10.004.

Heart Transplantation

Cajita, M. I., Denhaerynck, K., Dobbels, F., Berben, L., Russell, C. L., Davidson, P.M., & De Geest, S. (2016). Health literacy in heart transplantation: Prevalence, correlates and associations with health behaviors-Findings from the international BRIGHT study. Journal of Heart and Lung Transplantation. doi:10.1016/j.healun.2016.08.024

Cajita, M. I., Denhaerynck, K., Dobbels, F., Berben, L., Russell, C. L., Davidson, P.M., & De Geest, S. (2017). Health literacy in heart transplantation: Prevalence, correlates and associations with health behaviors—Findings from the international BRIGHT study. Journal of Heart and Lung Transplantation, 36(3), 272-279. doi:10.1016/j.healun.2016.08.024

Palliative Care/End-of-Life

Walczak, A., Butow, P. N., Tattersall, M. H. N., Davidson, P.M., Young, J., Epstein, R. M. Clayton, J. M. (2017). Encouraging early discussion of life expectancy and end-of-life care: A randomised controlled trial of a nurse-led communication support program for patients and caregivers. International Journal of Nursing Studies, 67, 31-40. doi:10.1016/j.ijnurstu.2016.10.008

Ho GW, Skaggs L, Yenokyan G, Kellogg A, Johnson JA, Lee MC, Heinze K, Hughes MT, Sulmasy DP, Kub J, Terry PB, Astrow AB, Zheng J, Lehmann LS, Nolan MT. (2017). Patient and caregiver characteristics related to completion of advance directives in terminally ill patients. Palliat Support Care. (1):12-19. PMID: 27237410

Virdun, C., Luckett, T., Lorenz, K., Davidson, P.M., & Phillips, J. (2017). Dying in the hospital setting: A meta-synthesis identifying the elements of end-of-life care that patients and their families describe as being important. Palliative Medicine, 31(7), 587-601.

Wright, R., Lowton, K., Robert, G., Grudzen, C., & Grocott, P. (2017). Emergency department staff priorities for improving palliative care provision for older people: A qualitative study. Palliative Medicine, doi:

Wright, R., Lowton, K., Robert, G., Grudzen, C., & Grocott, P. (2017). Using experiencebased Co-design with older patients, their families and staff to improve palliative care experiences in the Emergency Department: A reflective critique on the process and outcomes. International Journal of Nursing Studies, 68, 83-94. doi:


Han HR, Kim K, Murphy J, Cudjoe J, Wilson P, Sharps P, Farley J. Community health worker interventions to promote psychosocial outcomes among people living with HIV: A systematic review. PLoS One. (In press).

Tsui, S., Denison, J.A., Kennedy, C.E., Chang, L.W., Koole, O., Torpey, K., Praag, E.V., Farley, J.E., Ford, N., Stuart, L., Wabwire-Mangen, F. (2017). Identifying models of HIV care and treatment service delivery in Tanzania, Uganda, and Zambia using cluster analysis and Delphi survey. BMC Health Service
Stewart, J., Budhathoki, C., Thompson, K., & Hamilton, J. (2017). Associations of HIV testing with anxiety and stress within the African American church: implications for faith-based HIV testing and treatment. Mental Health, Religion & Culture20(5), 478-48

Farley, J.E, Stewart, J.M., Kub, J., Fowler, C., Lowensen, K., Becker, K. (2016). Development of the Johns Hopkins University School of Nursing adult/geriatric primary care nurse practitioner program in HIV prevention, treatment and care. Journal of the Association of Nurses in AIDS Care 27(3): 223-233.

Pain and Symptom Management

Allgood, S., Kozachik, S., Alexander, K., Thaxton, A., Vera, M., & Lechtzin, N. (in press). Descriptions of the pain experience in adults and adolescents with cystic fibrosis. Pain Management Nursing.

Burton, E. F., Suen, S. Y., Walker, J. L., Bruehl, S., Peterlin, B .L., Tompkins, A. …Campbell, C.M. (2017). Ethnic differences in the effects of naloxone on sustained evoked pain: A preliminary study. Diversity and Equality in Health and Care, 14(5), 236-242.

D’Amato, S. J., Mealy, M. A., Erdek, M. A., Kozachik, S. L., & Smith, T. J. (in press). Scrambler therapy for the treatment of chronic central pain: A case report. Anesthesia & Analgesia Case Reports.

Brant, J., Eaton, L., McLeod, K., & Yeh, C. H. (2017). A systematic review of the pharmacologic management for chronic and refractory cancer pain: Recommendations from the Oncology Nursing Society PEP Pain Team. Clinical Journal of Oncology Nursing, 21(S3), 31-53.

Eaton, L., Brant, J., McLeod, K., & Yeh, C. H. (2017). A systematic review of evidence-based nonpharmacologic interventions for chronic cancer pain. Clinical Journal of Oncology Nursing, 21(S3), 54-79

Walker, J. L., Thorpe, R. J., Harrison, T. C., Baker, T. A., Cary, M., Szanton, S. L., ... & Whitfield, K. E. (2016). The Relationship between Pain, Disability, and Sex in African Americans. Pain Management Nursing17(5), 294-301.




The Community-based Education and Cervical Cancer Prevention (CHECC-uP) Study (PI: Hae-Ra Han) is a randomized-controlled trial that aims to provide a health-literacy focused education to women living with HIV who have not received a Pap test in over 12 months. Women assigned to the intervention group receive a one-time education session, and monthly phone counseling sessions from a community health worker. A free phone app with information on HPV vaccines is also made available to women in the intervention group, and they are encouraged to share the information with their adolescent children. The delivery of the intervention is fully embedded within the community either at the participating community health clinics or a nurse-run wellness center. Women assigned to the control group receive a brochure with information on Pap testing, and places in the Baltimore area where they can receive a Pap smear.

The PLAN 4 Success-DM (PI: Hae-Ra Han) is a culturally tailored, nurse-led intervention program which involves diabetes related health literacy and disease education sessions, nurse home visits, and monthly phone counseling delivered by trained community health workers. The intervention is undergoing pilot testing in a sample of low-income African Americans residing in inner-city Baltimore. The PLAN 4 Success-DM program is fully integrated into the School of Nursing learning and service activities. The program utilizes Masters Entry nursing students as community health workers after training. Through the phone counseling, students are able to apply their health promotion knowledge and skills particularly in the area of cardiovascular health. Our program nurses are nurses who work with the JHU SON Center for Community Innovation and Scholarship (formerly Wald Clinic); a fully nurse-led clinic founded in 1994.

The PLAN-- Preparing successful aging through dementia Literacy education And Navigation—is a multi-faceted intervention to promote early detection of dementia (PI: Hae-Ra Han). It is currently being tested in Korean American caregivers. Korean Americans (KA), the 4th largest Asian minority groups in the U.S. with the rapid growth in population, have been specifically noted for poor access to dementia care. Even though their attachment to community is strong, dementia care is mostly done by family caretakers at home with isolation. Therefore, transition of families of individuals with probable dementia into healthcare access utilizing community resource can be one strategy to benefit patients and their families. The PLAN is delivered by trained community health worker housed in community based organization with the goal of promoting early detection of dementia and subsequent care transition.




The center is committed to providing an infrastructure dedicated to advancing the science of cardiovascular health in vulnerable populations. The following resources have been complied to help researchers in their endeavors.

Guidelines and Reports

Instruments and Tools

  • Self-Care Measurement Tools
  • Adherence
  • Health Literacy
  • Self-Efficacy
  • HTN Knowledge
  • Health Related Quality of Life

Related Literature


JNC-7ATP-III, JNC-7 Hypertension

Physical Activity


Cardiovascular Disease Risk Assessment

Cardiovascular Centers and Organizations at Hopkins

Below is a list of centers, institutions, and organizations that may have useful information pertinent to cardiovascular research in vulnerable populations.

Centers of Excellence (P30)

Other Relevant Organizations

Tips for Abstracts/Papers/Posters/Proposals