Collaborative Alliance for Nursing Outcomes (CALNOC) Research Fund
The American Nurses Foundation (ANF) and the Collaborative Alliance for Nursing Outcomes (CALNOC), the nation’s first database of nurse sensitive measures and a pioneer in health services research, established the CALNOC Research Fund in March 2021. The $2.5 million gift from CALNOC supports and fosters health services research in the ambulatory setting with a focus on the nursing profession’s contribution to improving health care delivery. This gift is the largest endowment for ANF.
The substantial endowment to establish this CALNOC Research Fund is a testament to and a celebration of the past efforts of CALNOC researchers and nurse scientists, as well as the contributions of nurses, nursing leaders, and executives who have championed quality and safety measurement to improve patient care.
“This Endowment ensures the legacy of CALNOC will continue and flourish through the American Nurses Foundation. We are grateful for the Foundation and American Nurses Credentialing Center for their support and stewardship of this endeavor.” – Mary Foley, RN, PhD, FAAN, Chairperson of CALNOC
ANF drives philanthropy and partnerships to advancement in nursing to turn toward the future. Our foundation’s Reimagining Nursing Initiative includes three focus areas: 1. nurse-led research and innovation, 2. new approaches to nurse well-being, and 3. scholars and fellows who represent communities that they serve. As the philanthropic arm of the enterprise, ANF advances the nursing profession by serving as a thought leader, catalyst for action, convener, and funding conduit.
Research Areas of Interest
ANF uses the CALNOC Research Fund as a vehicle for innovative research and scientific inquiry on the contributions of nursing practice in ambulatory care to patient care, safety, and quality. ANF, with counsel from the American Nurses Credentialing Center (ANCC), provides grants from the Fund.
“We are committed to advancing the quality of nursing and patient care. This Fund will enable nurses to continue their integral role of improving the quality and safety of patient care through research and innovation.” – Rebecca Graystone, MS, MBA, RN, NE-BC, Senior Vice President, ANCC
Studies funded should provide new evidence and/or support the existing evidence base on ambulatory nursing by focusing on the unique contribution of ambulatory nursing structures and processes to patient, family, and/or population outcomes. The current and subsequent funding cycles will encourage the growth of a cohesive body of research, each study extending knowledge gained across the trajectory of studies.
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2026 Award: "VOICE (Virtual Outreach and Individualized Coaching Extension): A Nurse-Led Hybrid Care Program Using Personalized Voice Technology for Older Adults with Chronic Conditions and Mild Cognitive Impairment," Principal Investigator Jane Chung, PhD, RN, FGSA
Community-dwelling older adults with multiple chronic conditions and mild cognitive impairment (MCI) face substantial barriers to self-management and often fall through gaps in ambulatory care between scheduled visits, leading to poor quality of life, increased emergency department (ED) utilization, and mortality risk. MCI compromises the ability to follow treatment regimens, manage symptoms, and maintain healthier habits. In-home voice-activated smart speakers offer unique potential for this vulnerable population by reducing traditional technology barriers. However, successful adoption requires individualized nurse coaching to bridge digital literacy gaps and ensure appropriate task selection based on treatment plans and cognitive abilities.
The VOICE (Virtual Outreach and Individualized Coaching Extension) program is a nurse-led hybrid care program that combines in-home visits and telehealth coaching with personalized smart speakers and smartwatches, both integrated with a voice-based agent, to support chronic disease self-management among community-dwelling older adults with MCI. Ambulatory care nurses are in primary positions to utilize this program to improve older adults’ self-management of their chronic conditions. The proposed study aims to examine the feasibility, acceptability, and preliminary efficacy of the VOICE program and identify ambulatory nursing structures and process factors affecting the program implementation.
We will enroll 50 individuals (65+, with 2 or more chronic conditions and MCI) for 3 months. Recruitment will be based on referrals by geriatricians at Emory Health Ambulatory Clinics and outreach efforts building on the team’s ongoing partnerships with community entities (e.g., Atlanta Housing, Meals on Wheels). Registered nurses, paired with nursing students, will conduct an initial home visit to assess patient’s treatment plans, cognitive abilities, living situation, and motivation. Then nurses will apply clinical judgment to match smart speaker tasks (selected from 25 evidence-based options) to patient needs (e.g., medication reminders, daily check-ins, health tracking) and provide individualized smart speaker task training. For the remaining period, supervised nursing students will perform virtual coaching sessions every other week to assess clinical status and additional digital skill training needs. If necessary, we will make home visits to provide necessary clinical, emotional, or technical support. Registered nurses will supervise nursing students in delivering hybrid care through regular check-ins and coordinate with primary care when issues arise.
Based on the Individual and Family Self-Management Theory, we will measure preliminary efficacy in terms of intervention mechanism (self-efficacy in managing chronic conditions and confidence in using digital technology), main health outcomes (engagement in self-management behaviors and health-related quality of life), and distal outcomes (ED utilization and hospitalization). These individual-level measures will be assessed at baseline, at the end of the program, and 2 months after. To identify potential factors to ensure sustainability and scalability, we will examine ambulatory nursing structures (e.g., RN and nursing student FTE per patient, technology support infrastructure, and organizational policies enabling this care model) and processes (e.g., # of contacts with patients, time spent on coaching calls, smart speaker task selection protocols, RN’s communication patterns and frequencies with nursing students and primary care).
The VOICE program addresses a critical gap in ambulatory care by demonstrating how nurses can leverage digital health tools to support chronic disease self-management between outpatient visits, particularly for high-risk older adults with cognitive impairment. By examining outcomes and care processes, this study will provide evidence for scalable technology-enhanced ambulatory nursing interventions to improve disease management, reduce avoidable healthcare utilization, and strengthen nursing capacity in digital health.
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2022 Award: “Nurses Address Perinatal Mental Health Inequities among Black Women: A Feasibility Study,” Co-Principal Investigators: Kortney Floyd James, PhD, RN & Kristen Choi, PhD, PMHNP-BC, FAAN
Outcomes Summary
Perinatal mood and anxiety disorders (PMADs), including depression and anxiety, are the most common complications of pregnancy and childbirth. Left untreated, they contribute to poor outcomes for mothers and infants, including preterm birth, impaired bonding, and maternal suicide. Black women are disproportionately affected, facing both higher rates of PMADs and greater barriers to screening and treatment. This project addressed these gaps through two approaches: testing the feasibility of a provider training program called Black Maternal Mental Health 360 (BMMH 360) and evaluating perinatal mental health screening using electronic health record (EHR) data within the same health system.
The BMMH 360 training aimed to prepare perinatal nurses and frontline staff to screen for PMADs with both clinical accuracy and cultural sensitivity. The curriculum included education on PMADs alongside modules on empathy, implicit bias, and the specific barriers faced by Black women and birthing people. Twenty-two providers, including registered nurses, medical assistants, and mental health specialists, completed the program in either in-person or virtual formats. Surveys before and after training showed significant gains in beliefs about the effectiveness of PMAD treatment, along with near-significant increases in readiness to screen. Participants described the training as practical and valuable for their daily work, confirming its feasibility and acceptability.
Alongside the training, EHR data was analyzed from nearly 12,000 deliveries in one California health system between 2019 and 2023. Screening increased dramatically during this period, from just 3% of pregnant patients screened in 2019 to nearly 80% in 2023. Postpartum screening also improved, rising from 14% to almost 69%. The increases in screening can largely be attributed to the passage of California Assembly Bill (AB) 2193, which mandated maternal mental health screening beginning in 2019. Still, by 2023, one in five pregnant patients and nearly one in three postpartum patients were not screened, showing that universal screening remains an unmet goal.
Together, these findings demonstrate that combining screening with provider training is essential to advancing equitable maternal mental health care. The BMMH 360 program improved provider readiness to screen, while screening expanded system-wide in the same time period due to a policy change in 2019 mandating screening. However, ongoing gaps in treatment access point to the need for investment in the mental health workforce, as well as nurse-led PMAD screening and support groups, alongside stronger referral networks. By linking education, policy, and practice, this project provides a model for ensuring that all women and birthing people are screened and supported during the perinatal period.
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American Nurses Foundation: Interest Form
As additional research grant opportunities open, notice will be posted to this webpage.
If you would like to receive updates, including notice of new grant opportunities, please complete this American Nurses Foundation interest form. You will be added to the ANF email distribution list to receive updates when new open grant opportunities are posted.
