Lucero, Robert J. PhD, MPH, RN, FAAN
Associate Dean for Diversity, Equity, and Inclusion
Professor of Nursing, and Audrienne H. Moseley Endowed Chair in Diversity, Equity and Inclusion
University of California, Los Angeles, School of Nursing
My research program focuses on improving health outcomes of vulnerable populations using innovative health systems and informatics approaches. Two prominent themes of my work are: enhancing the quality of care for hospitalized older adults and improving self-management of chronic health conditions among Hispanic, African-American, and LGBTQ+ populations. My research is distinguished by interdisciplinary team science, which bridges nursing, medicine, psychology, computer science, and engineering, health systems, communities, and other academic institutions.
My research is leading the way to inform infrastructure development for data-driven knowledge generation that serves as a model for organizations across the United States (US) to improve the quality of care for hospitalized older adults. I am leveraging electronic patient, clinical, and administrative data and data science methods to identify valid, modifiable factors that predict hospital-acquired falls (HAF), which affect annually approximately one million US hospitalized patients. Studies I have published show that, in 168 US hospitals, poor nursing care quality was associated with more adverse patient events, including HAF. Using artificial intelligence approaches with electronic health record (EHR) data, I have discovered a set of six new clinical and organizational factors that can predict HAF. These findings were among the most downloaded in 2019, and have widespread implications since hospital patient falls continue to be a significant clinical concern internationally in healthcare systems. My lab also explores the use of registered nurses’ (RNs’) progress notes, or text data on patient observations, to predict HAF. We were the first to publish that RNs’ notes contain information about clinical, environmental, and organizational factors that can predict fall risk. I am Principal Investigator (PI) of a 5-year $2.57 million award from the National Institute on Aging. This cutting-edge health systems project is exploiting the use of text and structured EHR data to validate predictors of HAF and hospital-induced delirium. This study will expand the University of Florida Health EHR research infrastructure for data-driven knowledge generation.
The other cornerstone of my research program is developing health information technology (HIT) to promote chronic disease self-management. I pioneered and published a HIT design approach, known as Consumer-centered Participatory Design (C2 PD). Unlike other design approaches, C2 PD provides public health and community-based organizations, academic researchers, and commercial designers with a theoretically informed approach that engages consumers throughout the development and evaluation of HIT. C2 PD builds on the strengths and resources within a community, promotes a collaborative learning and empowering process, facilitates collaborative partnerships, and incorporates four components of HIT design, namely; user preferences, functions, tasks, and representational requirements, to develop highly usable systems. We introduced this innovative approach and presented our findings to informaticians at the International Medical Informatics Association Nursing Informatics Congress in 2012. We demonstrated that using the C2 PD approach resulted in a highly useful and usable fall prevention self-management system for English- and Spanish-speaking older adults. Since then, multiple investigators of HIT development and systematic review articles have referenced the use of the C2 PD approach. The C2 PD approach has been the basis of my other funded studies, including a $2.8 million National Institute of Nursing Research and $1.0 million Agency for Healthcare Research and Quality award. I have disseminated further wide-ranging use of the C2 PD method, including creating a mobile Health (mHealth) application (app) interface for Hispanic caregivers of persons with dementia to self-manage chronic stress and burden and an mHealth app to support African American caregivers of children with chronic asthma and obesity. The lessons I learned developing the C2 PD approach are represented in a paper I co-authored that focuses on using HIT to engage communities to improve health and reduce health disparities in populations. This is significant to the work I am conducting among people living with HIV. A study I published showed that a large proportion (85.5%) of people living with HIV are interested in using a mHealth app that supports HIV self-management, including functions to identify health services, provide health tips and medication reminders, communicate with healthcare providers, track their mood and emotions, and engage in social networking. My lab is expanding this research with funding from the Health Services and Resources Administration (HRSA) and the Florida Department of Public Health to inform creating and testing a technology-enabled self-management intervention.
I have developed an independent and externally funded health services and informatics research program of over $8.85 million as PI. I publish in high impact journals and researchers and scholars in nursing, health services, and informatics cite my research regularly according to citation analytics (>1024, h-index:14, i10-index:18). Additionally, federal government agencies have recognized my research. I was a standing member of the Agency for Healthcare Research and Quality HIT Research review panel from 2016-2020, and served on multiple NIH Special Emphasis Review Panels. My peers have recognized the impact of my research nationally, and I am disseminating my research program internationally. I am a Fellow of the American Academy of Nursing and the New York Academy of Medicine. In 2019, I received a 3-year UF Term Professorship that acknowledged my academic accomplishments in shaping the UF College of Nursing and the nursing discipline. I am currently the Associate Dean for Diversity, Equity, and Inclusion; Professor of Nursing (with tenure); and, the Adrienne H. Mosely Endowed Chair in Diversity, Equity and Inclusion at the University of California, Los Angeles, School of Nursing.
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