Melissa S. Faulkner, Ph.D., R.N.

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SUMMARY

Melissa S. Faulkner, Ph.D., R.N., FAAN, focuses on identifying cardiovascular risks and developing personalized behavioral interventions for self-management in adolescents and young adults with type 1 or type 2 diabetes.

Dr. Faulkner's research includes noninvasive monitoring using heart rate variability. She explores changes in sympathetic and parasympathetic modulation of heart rate over 24 hours in connection with glycemic control and changes in sleep behavior in young people with diabetes. Dr. Faulkner also studies individual approaches that include family dynamics to promote optimal self-management interventions. Her research targets exercise as a key strategy for optimal diabetes management.

Focus areas

• Family influence on self-management of diabetes. Dr. Faulkner's research examines how families can influence the disease-management autonomy of adolescents and young adults. Dr. Faulkner has identified several key themes for optimal family influence on self-management:
  • Family stress that is not overwhelming but promotes better organization.
  • Family communication that exhibits warmth and caring.
  • Parental reminders of the daily medical regime.
  • Sibling watchfulness for younger teens.

• Cardiovascular changes and fitness in youth with diabetes. Dr. Faulkner has used 24-hour heart rate variability measures with power spectral analyses of R-R interval variation. These measures show the difference in time between heartbeats and detect early changes in heart rate response, which can be markers of future cardiovascular risk. Findings from this research revealed that lower heart rate variability is associated with poor glycemic control.

  Cardiovascular fitness is lower in people with type 2 diabetes than in people with type 1 diabetes. Also, higher levels of cardiovascular fitness are associated with better lipid profiles, glucose control, health perception and athletic competence in those with type 1 diabetes.

  Adolescents with type 2 diabetes have lower heart rate variability and higher triglycerides, as well as higher systolic and diastolic blood pressure, compared with those who have type 1 diabetes. Clinical case studies of adolescents with type 1 diabetes revealed that an elevated microalbumin-to-creatinine ratio is associated with lower heart rate variability. But regardless of the type of diabetes, female study participants and those who were less physically active and in poorer glycemic control exhibited lower cardiovascular fitness.

• Personalized exercise recommendations for adolescents with diabetes. Dr. Faulkner's group developed and tested a model for personalized exercise recommendations that were based on individual fitness levels and included family and community resources. Key findings of this research revealed that despite personalization of community-based exercise interventions for adolescents, the average duration of moderate-to-vigorous physical activity was 43 minutes a day, less than the recommended level of 60 minutes a day.

  Overall perceptions of health, a component of quality of life, improved for all participants. And adolescents with type 1 diabetes who had more moderate-to-vigorous physical activity each day also had improved glucose control.

Significance to patient care

Dr. Faulkner's research highlights how important it is to spot heart disease risk factors early in young people with diabetes. Creating unique plans that include family support can help young people better self-manage their health and improve their glycemic control. This may lead to better diabetes outcomes and lower cardiovascular risks in the future. Dr. Faulkner's research also shows that healthcare professionals should especially encourage women and girls and people with type 2 diabetes to exercise regularly as a key part of self-management.

Professional highlights

• Member, editorial board, Biological Research for Nursing, 2019-present.
• Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta:
  • Adjunct professor, 2016-present.
  • Lewis Distinguished Chair in Nursing, 2016-2018.
• Emory University:
  • Member, advisory board, Healthcare Ethics Consortium, 2015-present.
  • Associate dean, Nell Hodgson Woodruff School of Nursing, 2013-2014.
• Fellow, American Academy of Nursing, 2007-present.
• Study section participant, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 2004, 2005, 2008, 2018.
• Sorenson Endowed Chair, Diabetes Research, University of Arizona College of Nursing, 2007-2010.
• Associate Dean of Research, College of Nursing, Arizona State University, 2006-2007.
• Chief of Nursing, Boling Center for Developmental Disabilities, University of Tennessee Health Sciences Center, College of Medicine, 1995-2000.