 So it's my pleasure to introduce a new director, Collie, relatively new director, Collie, but one that we wanted to introduce to our council. And I know she's happy to learn more about thoughts from our council members. This is Dr. Shannon Zink, who is the director of the National Institute of Nursing Research, or NINR. And as NINR director, Shannon Overseas Institute with an annual budget nearly $170 million and a scientific mission to improve the lives of individuals and families living with illness and to develop personalized strategies to maximize health and wellbeing at all stages of life and across diverse populations and settings. NINR it devotes significant resources to training and career development to foster the next generation of nurse scientists. Now, prior to coming to NIH in 2020, Shannon was the nursing collegiate professor in the Department of Population Health Nursing Science at the University of Illinois Chicago College of Nursing and a fellow at the university's Institute for Health Research and Policy. She was elected as a fellow of the American Academy of Nursing in 2013 and was inducted in the International Nurse Researchers Hall of Fame in 2019. And Shannon has spent time as a visiting scholar in Lumanda and Australia. In terms of education and training, she earned her bachelor's in nursing from the Illinois Wesleyan University, her master's degree in public health nursing and community health sciences from the University of Illinois Chicago and her doctorate in health behavior and health education from the University of Michigan. She's a registered nurse and leading nurse researcher. Her own research focuses on social inequities and health and the goal of identifying effective multi-level approaches to improve health and eliminate racial and ethnic and socioeconomic health disparities. And I'm pleased to have Shannon here today to update our council on NINR activities. And it really is a particularly timely thing to have happen. And it just worked out that NINR just released their 2022 to 2026 strategic plan earlier this month. And I suspect Shannon will be talking about this new plan in her talk. And welcome Shannon and you are one of these directors that I've spoken about to my council before who was recruited in the midst of the pandemic and which I think is truly admirable and we're delighted to have you here and increasingly I'm seeing you more and more and more in person, but today we see you virtually. So I take it away. Thank you so much. Thank you, Dr. Green for that very nice introduction and for inviting me to speak with your council today. And indeed I am excited to tell you about NINR's new strategic plan and to start a conversation about how our institutes might collaborate to achieve our mutual goals. So next slide please. So today I'll share with you how I got started in research, some background on NINR and our new strategic plan. And then some of the ways NINR is collaborating with partners at NIH including NHGRI and beyond. And I'm really looking forward to a conversation at the end to talk more about how our ICs can work together. So before I begin, let me tell you a little bit about NINR and the importance of nursing science to help and well-being. NINR was founded as an NIH center in 1985 and was elevated to institute status in 1993. Since its founding, NINR science has supported research that develops the scientific basis for clinical practice as well as policy. And what sets NINR apart from other NIH institutes is that our research with nursing's perspective at its core is focused on health solutions for people in the context of their lives and living conditions. Next slide. It's this unique perspective that makes nursing science so well positioned to lead research focused on the whole picture of health from the biology of a person's cells and genes to their whole self, their family and resources and the community and society in which they live. Nurses, as you might know, are everywhere in our hospitals and clinics, in our schools and workplaces, in homes and justice settings and throughout our communities. We approach prevention, treatment, and care holistically and in context. And the scope of our practice and discipline and the breadth of our knowledge extends from improving the health of individuals to that of entire populations. Next slide, please. My own program of research grew out of this holistic context. I became interested in how resources and risks were distributed across communities and the resulting implications for people's health while practicing as a home healthcare nurse. Spending time in people's homes and in different communities, I was really struck by the tremendous differences in the environments of patients in my caseload, both in terms of privilege as well as poverty. And I found it difficult to talk to some patients about healthy eating, for example, when what they really needed to restore their health was far more fundamental. Decent and stable housing, a safe environment, access to affordable healthy foods nearby. So in response to these clinical observations, I decided to learn more about what I could do to address these issues. Next slide, please. Throughout my graduate education, I was exposed to troubling research showing large inequities in health based on where people lived, as well as Dr. David Williams' hypothesis that racial residential segregation was a fundamental cause of racial disparities in health. Now, one of the pressing questions at that time was what were the mechanisms by which segregation and community economic conditions, for example, affected health. My own research on what would become known as food deserts showed that low income and black communities have less access to healthy foods. Further research documents that it's not only healthy foods that are unequally distributed across communities, but so are a wide variety of other resources, such as jobs that pay a living wage, good schools, municipal services such as public transit, pharmacies, attractive parks and green spaces, destinations and infrastructure for walking and biking, and clean air and water. Likewise, low income communities of color are often subjected to more hazards, such as excessive monitoring by police and immigration officials, greater availability and marketing of tobacco, alcohol and junk food, pollution and toxic substances. Given their implications for people's health and health disparities, an important question then is, how can we right the historic and contemporary wrongs of racism and race-based residential segregation that have produced and perpetuated racial inequities and access to health-relevant resources? We critically need scientific evidence on what policies and interventions are effective in increasing resources and removing risks in communities of color and ultimately improving health behaviors and health outcomes. Next slide, please. The task of eliminating inequities is nothing new to nurses. Nursing's earliest pioneers recognize that health must be considered within the context of people's lives and living conditions. In other words, they were among the earliest to incorporate social determinants into their solutions to help problems. At NINR, we continue to build on this rich history through nurse-led efforts to address intensifying inequities and social determinants of health. And a recent Future of Nursing report makes a compelling case for new nurse-led models to address social determinants of health and social needs, all with the goal of achieving health equity. Next slide, please. So with that nursing and nursing context in mind, let me turn to NINR's latest strategic plan. We launched our 2022-2026 strategic plan just 10 days ago on Friday, May 6, which was the first day of National Nurses Week. Next slide. At NINR, we're committed to leading nursing science to solve pressing health challenges and inform practice and policy, optimizing health and advancing health equity into the future. Our mission statement reflects our belief that nursing research is the key to unlocking the power and potential of nursing. And our strategic plan describes how we want to leverage the strengths and unique knowledge and perspectives inherent to the discipline, to the benefit of all people. Next slide, please. The strategic plan includes guiding principles that is important qualities that all NINR supported research should have going forward. In considering applications for funding, the extent to which studies reflect these principles will be a factor in our decision. We need to support research that addresses today's challenges and helps us be better prepared for the future, discover solutions to optimize health across clinical, community, and policy settings, advances equity, diversity, inclusion, and accessibility, and is innovative, applies rigorous research methods and has the potential for significant impact on health and well-being. Next slide, please. The plan also includes five research lenses. So let me explain what we mean by that term. Simply put, when we say a lens, we're describing a perspective through which we examine a health challenge. In developing our scientific strategy, NINR identified five lenses that we think best leverage the strengths of nursing science to innovate, think bigger, and greatly increase our impact. The lenses in the strategic plan are health equity, social determinants of health, population and community health, prevention and health promotion, and systems and models of care. So I'll give you a closer look of each of those lenses. Next slide, please. Our health equity lens aims to reduce and ultimately eliminate the systemic and structural inequities that place some population groups at an unfair, unjust, and avoidable disadvantage in attaining their full health potential. From NINR's perspective, health inequities are rooted in systemic and structural factors, including historical and contemporary laws, systems, values, and institutions that limit access to power, opportunities, and resources. These factors include structural racism and create barriers to health and can lead to persistent health inequities. We are interested in supporting nursing research that improves health and well-being for all through structural interventions that remove obstacles to health, increase availability and accessibility of resources, and alter social and institutional norms. We urgently need nursing research that recognizes that as a nation, we must work collectively to address inequities that prevent people from attaining their full health potential. Next slide, please. Our social determinants of health lens aims to identify effective approaches to improve health and quality of life by addressing the conditions in which people are born, live, learn, work, play, and age. From NINR's perspective, the social determinants of health and community conditions, such as job opportunities, school quality, transportation systems, social cohesion, and green space, and individual and family social and economic circumstances, such as income, educational attainment, social isolation, traumatic experiences, nutrition security, and housing. We are interested in supporting nursing research that identifies and develops interventions delivered at the right place and the right time to target social determinants of health. We want our investigators to discover creative solutions powerful enough to address upstream and midstream causes of positive and negative health outcomes, identify how to limit exposure, to adverse social and economic conditions and circumstances, and consider how to limit susceptibility to biological embedding of social determinants over the life course and across generations. Next slide, please. Our population and community health lens aims to address critical health challenges at a macro level that persistently affect groups of people with shared characteristics. From NINR's perspective, population health refers to health and well-being of groups of individuals with one or more shared characteristics, such as demographics, cultures, health conditions, life stages, social affiliations, and places. And as a subset of population health, community health refers to health and well-being among those connected by place, such as neighborhoods, towns, cities, counties, or tribal jurisdictions. We're interested in supporting nursing research that uses ideologic, applied, and translational approaches to identify risk and risk factors. We're also interested in developing effective factors, investigates variations in population and community health, tests and evaluates planned and natural experiments of macro level interventions, and utilizes community action and partnerships in the many settings in which nurses work. Next slide, please. The next lens aims to prevent disease and promote health. From NINR's perspective, prevention refers to actions taken to reduce the risk of disease, disability, and injury, along a continuum that begins with primordial prevention, which targets underlying risks, and continues to tertiary prevention, which aims to reduce symptoms, severity, and progression. Health promotion includes efforts to facilitate prevention of disease and enhance well-being. We're interested in supporting research that identifies the mechanisms through which interventions work to prevent disease and promote health, and we recognize that effective prevention and health promotion efforts must aim to eliminate health inequities by accounting for social, environmental, behavioral, psychosocial, and biological factors that affect risk. Next slide, please. The next lens aims to address clinical organizational and policy challenges through new systems and models of care. From NINR's perspective, we need innovative systems and models of care that are comprised of coalitions and partnerships that span clinical and community settings and address social factors and needs for populations and individuals. We also need to focus on the models of care that consider how to leverage the public's trust in and the expertise of the nursing workforce, employee policy, and organizational solutions informed by the on-the-ground experiences of nurses, and focus on help promoting care that encompasses the whole person in the context of their lives and living conditions before, during, and after points of care. We're interested in supporting nursing research that informs the development, dissemination, and implementation of new organized systems and models of care, and grapples with systems-level challenges, such as coordinating care and integrating data across clinical and community settings, testing models of contextualized care, and understanding the impacts of organizational practices and policy and quality of care and its outcomes. Next slide, please. These research lenses are complementary and synergistic. In addition to leveraging the strengths of nursing research, the lenses promote multilevel approaches, cross-disciplinary and cross-sectoral collaboration, and community engagement in research. As shown in our research framework graphic, NINR-supported investigators have the flexibility to apply a single lens or a combination of lenses in their study designs and training programs. We encourage researchers to view the health equity and social determinants of health lenses as primary foci through which to consider the population and community health, prevention and health promotion, and systems and models of care lenses. Next slide. NINR's research lenses will allow our investigators to consider a full spectrum of nursing topics that encompass health and illness within the context of people's lived experiences. Thus, these lenses will allow nurse scientists to examine new topics while also allowing those with long-standing research programs to take a different look at their areas of interest. Many of our lenses build on NINR's investment in long-standing areas of interest. For example, 43% of NINR's budget already supports prevention research. A third of our budget focuses on research to eliminate health disparities, and already 26% of our budget focuses on social determinants of health. Next slide, please. The stewardship section of the strategic plan describes our approach to developing and managing our research and training programs and creating new initiatives that are focused on achieving our mission. As stewards of the public trust, like all NIH institutes, centers and offices, we want to establish and follow best practices in setting research priorities, managing science, and assessing progress, all with the goal of funding the best science with the strategic plan. Next slide, please. You can find the full strategic plan on our website. We do consider this a living document which will respond quickly and nimbly to emerging issues or crises so that we believe that the strategic plan is best housed on our website. You can always find it here. Next slide, please. Collaboration is vital to furthering research. In support of our guiding principles for research, we're making sure that NINR is at the table and leading efforts to collaborate with partners both within NIH and across the federal government. Next slide, please. For example, we are excited to be collaborating on the NIH-wide climate change and health initiative which supports research to understand the potential health and health of NINR. We are also very pleased to be co-chairing with NIMHD, a new NIH-wide social determinants of health research coordinating committee. We are glad to have NHGRI with us today. We are also very pleased to be co-chairing with NIMHD, a new NIH-wide social determinants of health research coordinating committee. We are glad to have NHGRI as part of the executive committee represented by Dr. Vence Bonham. The goal of the social determinants of health research coordinating committee is to accelerate social determinants of health research across NIH, across diseases and conditions, populations, stages of the life course, and social determinants of health domains. Next slide, please. And NINR, along with our colleagues from several NIH institutes and offices is co-chairing a new 10-year $397 million NIH Common Fund program called Compass. Compass will be transformative and help us make real progress in eliminating health inequities by looking upstream at the systems and structures that are causing socially and economically disadvantaged populations in the first place. The program has two overarching goals. It will facilitate and implement a cross-IC framework for health equity intervention research. And it will deploy and evaluate community-driven structural health equity interventions that leverage intersectoral partnerships. More on this program will be available in the coming weeks. Next slide, please. Additionally, NINR is helping to lead the transformative research to address health disparities and advance health equity Common Fund program, which is supporting innovative translational research projects to prevent, reduce, or eliminate health disparities and advance health equity. So we are proud to be part of this program, and I want to thank NHGRI's Dr. Ebony Madden for serving on this program as well as Compass. Next slide, please. So in addition to these NIH initiatives and committees, the examples I just gave, we're also contributing to several HHS and government-wide initiatives. These include the HHS Social Determinants of Health Work Group, the HHS Initiative to Strengthen Primary Healthcare, the Interdepartmental Health Equity Collaborative, the Social Policy Committee, and the Interagency Working Group for the National Healthcare Quality and Disparities Report. And we're represented on the Climate Change Food Systems and Nutrition Security Work Group of the U.S. Global Change Research Program. Next slide, please. So our institutes, though they may seem different on the surface, share a number of values on which I believe we will be able to work together. So we're also contributing to our partnerships towards our common goals. Like NINR, NHGRI includes a commitment to diversity and inclusion in its guiding principles. In fact, NINR's Advisory Council recently impaneled two working groups that are addressing diversity and inclusion in our research workforce and in the science we support. So we're looking forward to working with NINR as well. We're also looking forward to working with NINR as well, like NHGRI, to share best practices and lessons learned on these issues. In addition, like NINR, NHGRI is committed to embracing interdisciplinary and team science, exploring social determinants of health in our science, and training the next generation of scientists in the field. So I'm very happy to be able to share my thoughts and ideas that I see between the institutes. And I'd like for today's presentation to be just the beginning of a dialogue between us. I'd like to know, for example, how do you see genomics research applying the unique perspective of nursing and nursing science? What are the opportunities for nurse and nurse research? And what are the initiatives that NINR and NHGRI can partner on to improve health and well-being, especially for populations that experience health disparities? Next slide, please. So before I wrap up, I'd like to encourage you to attend the next meeting of NINR's advisory council to learn more about our current initiatives. The meeting will be virtual, and many of you will be able to log in and learn about our strategic priorities. The meeting is May 24th at 11 o'clock a.m. Next slide, please. So again, thank you so much for inviting me to talk with you today. I certainly look forward to a robust discussion with our remaining time. And if you have any questions, anything we're not able to cover today, anything you'd like to follow up on, please go ahead. Thank you. Thank you. Thank you for the email address shown here. So thank you so much. Renee, could you take down the slides, please? We've got a panel here. Thank you. Thank you, Shannon. I'm sure council members are going to have questions. I'm just, I don't want to jump ahead of the line because I certainly have some if the car. And maybe you could introduce yourself. I'm a cardiologist and a genetic epidemiologist at Mayo Clinic and deal a lot with heritable cardiac disorders. I think there are two aspects that struck me while you were speaking. One is that since nurses and nurse researchers are active at the community and family level, and that's the unit where we're interested in terms of heritable disorders, there may be some opportunities for collaboration there. I think one of the unfortunate aspects of heritable diseases is that the uptake of cascade testing in family members is very low in the United States. And there may be some opportunities that manager and NINR can address some of those aspects of the low uptake. The other aspect worth considering is I know there are several specialty tracks in nursing and whether, you know, what your thoughts are on the track that is geared towards genetic counseling or at least supporting counseling. We have a very acute shortage of genetic counselors and I know many nursing colleagues are interested in that particular pathway. So there may be some opportunities there for collaboration. So I just thought I would bring up those two points of collaboration between the two institutes. Yeah, I appreciate that. Yeah, certainly I think genetic counseling, you know, if looked at through one of our lenses is certainly an area we would consider. So thank you for sharing those ideas. Laura. Hi, thank you for the wonderful talk today. And I actually see kind of another parallel with NHGRI because as I think about genetics, I actually think genetics covers all the institutes, you know, whether it's heart, lung, mental health, you know, there's really a genetic underpinning to all those illnesses. And I was kind of listening to your different lenses of social determinants of health and disparities. I also think that that's an important component of the work in all of the institutes. So what I'm just trying to kind of understand more is what is unique about what you're doing versus what should be based in the other institutes. Yeah, I think a lot of the institutes are focused on a certain life stage or certain disease or condition as you mentioned. I think we're one of the few institutes that really spans or disease agnostic, for example, we don't focus on a particular life stage. And I think for us how what we see as our contribution is really this holistic perspective on people's health or what people need to be healthy, really a multi-level perspective on intervention targets drawing on the strengths of nursing. So that's what we think we offer to NIH in general. And I think there are ways to collaborate with NHGRI that really brings that perspective with your focus as well. Thank you. It's extending what Shannon said and very much alive with Laura's question. I mean, we spent a lot of time at these council meetings talking about the both the challenges and the opportunities of being as you called it a disease agnostic institutes. We're one as well. And obviously very different in some of the aspects, but once you're not disease specific, both sort of you have to constantly be positioned to justify why you're doing what you're doing as opposed to being an institute, but at the same time, it gives you incredible nimbleness to move around. So I think these are the things we frequently do talk about. And it really, I'm sure internally at NINR, similar conversations are happening and prioritizing. It also means that your priorities could shift because as you see uptake of things in other institutes, you could say you could back off and deal with the next set of challenges that could be beneficial or you raise everybody's vote. So I can identify with that. Olga. And again, maybe say a sentence to who you are just so that Shannon knows. Hi, Shannon. Thank you for a great presentation Olga Transk, I'm a professor of computer science and genomics at Princeton University. I'm also at the Flatiron Institute for the Simons Foundation. And I work in computational biology broadly, but with strong interest in precision medicine type of questions. So I was wondering sort of echoing several comments recently, I think that there is actually a lot of similarities in how NIGRI is also in a way holistic, right? I mean, we're holistic as in we're not disease specific and we're basing everything in the genetics and the genome. And there seems to be some really interesting possibilities for collaborations in terms of the social determinants of health and, you know, specific subgroups, right? For example, the African ancestry populations that have an incredible genetic diversity and that's so linked to outcomes and, you know, as well as environment and genetics interactions that are really causing some major major health disparities that we're I think just starting to really dig into. So are you at all thinking about potentially maybe, you know, having genetics, you know, sort of genetics be part of some of the holistic efforts that you guys are thinking about? Yeah, thank you. Certainly, you know, we do take a really holistic perspective on health, you know, and that includes genetics. I think you identified some really exciting opportunities. I agree. Gene by environment interactions and really understanding, I think we can get a better understanding of environmental influences on health and social determinants. If we do look at subgroups as you pointed out. So I think there's tremendous opportunities and that would love to continue conversations about how we can collaborate in these areas. Eric, we have a question from the chat. Can I read it? Yeah, go ahead and read it from one of our extramural program director. Correct. How does NINR think about the development of training opportunities for the research and clinical practice workforce? Are these separate domains or is there integration between the two? Yeah, good question. I mean, NINR does focus on training future researchers. So we invest along all stages of career development. So I think that's a really good question. A lot of nurse scientists get their research questions from practice as I highlighted in my talk in the community that really led to the research questions I asked. So there's a connection there. But we don't focus as much on clinical training. It really is focused on the research training. There's a tremendous need for scientific training for nurses. The workforce, there's far too few nurse scientists. And so we really feel we fill a very important need in the field by focusing on the research training. Let me jump in and ask a question I was thinking about. I could imagine some of the medical geneticists at my council like Gal Jarvik, Hal Dietz, but others I'm sure are thinking about this. And Iftacar sort of touched on it through a genetic counseling question. But our institute's interacted with the nursing institute for a number of years around just educational training of nurses in the basics of genetics and genomics. And I think about our institute spends a lot of time thinking about genomic literacy and especially genomic literacy of patients. I mean, who's going to be on the front line of explaining as more and more genetics and genomics gets mainstreamed into medicine. Yes, there'll be some done by genetic counselors, but there are not enough genetic counselors in the world to explain all of it. And as busy physicians oftentimes don't have the time to explain some fundamental, that's often a role for nurses and could be a valued and valuable role for nurses. And I guess, has there been any thought, Shannon, about other ways that we could be working with you as we're thinking more broadly about genomic literacy of the public, of health professionals, et cetera, et cetera. I mean, among those would certainly be nurses. And I think that's something that's going to be a challenge for all of us as more and more genomic medicine gets implemented. Certainly, yeah, as we think about systems and models of care, I think that can address a wide variety of issues. And so if there's scientific questions around, you know, what you just brought up, then certainly, you know, I think that's an area that we could talk more about. Okay. Any last questions or comments from any members of council? Well, Shannon, thank you for coming and visiting. It's terrific that members of council were able to hear your vision, especially with your recent release of your latest strategic plan. And so, and then to be continued is probably the best phrase I should leave it at. And we look forward to working with you and we're excited to get to know some of the elements of your implementation of your strategic plan, how they can align with some of any of your eyes goals. Thanks so much, Eric. Okay. Thanks, Shannon. So Rudy, I turn it back to you. Thank you very much, Dr. Sanks. Next up is Marie Bernard.