About

Alexandra A. García, PhD, RN, APHN-BC, FAAN, is a Professor in the School of Nursing and the Interim Director of the St. David's Foundation Center for Health Promotion and Disease Prevention Research in Underserved Populations (CHPR). She also serves as a courtesy professor of Population Health at the Dell Medical School, where she was the inaugural director from 2016 to 2020. Dr. García teaches undergraduate and graduate students in research, public health, health policy, and global health. Her research focuses on the social, cultural, and economic influences on health, self-management of chronic diseases, and symptom experiences, particularly among Latinx adults with type 2 diabetes and other co-occurring chronic illnesses. She has directed faculty-led study abroad programs to Guadalajara, Mexico, and Heredia, Costa Rica, and collaborates with clinicians and nurses in Eldoret, Kenya on education and research projects. Dr. García is a Fellow of the American Academy of Nursing and the Texas Public Health Association, and has served as past President of the Texas Public Health Association and past Chair of the Public Health Nursing Section of the American Public Health Association.

Research topics

• Nursing
• Medicine
• Sociology
• Psychology
• Political Science
• Gerontology
• Environmental health
• Physical therapy
• Family medicine
• Psychotherapist
• Psychiatry
• Internal medicine
• Clinical psychology

Selected publications

• Interventions to Prevent Diabetes in Latin America: A Systematic Review of the Literature

  Diabetes Obesity and Cardiometabolic CARE · 2026-03-01

  article

  BACKGROUND More than 40 million people living in Latin America have been diagnosed with diabetes, and this number is expected to increase. As the risk of diabetes and diabetes mortality increases, diabetes interventions tailored specifically for individuals in Latin America are essential. PURPOSE To identify components of diabetes interventions that effectively reduce diabetes risk to inform interventions for Latin American populations. DATA SOURCES Systematic review of PubMed, CINAHL, LILACS, and Web of Science was performed from 2013 to 2025. STUDY SELECTION Studies testing interventions to prevent diabetes in Latin America were included. Studies were assessed for bias using the Critical Appraisal Skills Programme. DATA EXTRACTION Intervention elements and outcomes, including HbA1c and other obesity markers, were collected. No pooling of findings was possible. DATA SYNTHESIS The analysis included 11 articles. The majority significantly reduced the risk of diabetes, as assessed by markers including HbA1c, glucose, weight, and BMI. Studies that included multiple aspects, including diet, exercise, and lifestyle education, were more likely to report significant changes. LIMITATIONS Studies that did not contain the keywords used for the search or were indexed only in other databases may have been missed. Heterogeneity of study interventions and outcomes prevented a quantitative synthesis of effect sizes. Half of the included studies did not test interventions against a control or comparison group, limiting conclusions about their effectiveness. CONCLUSIONS Although more rigorous studies are needed, interventions with interdisciplinary teams and multiple phases can potentially reduce diabetes risk. Interventions that follow participants for an extended period may be more successful over the long term.

  PublisherDOI

• Burmese Refugees’ Beliefs and Experiences of Diabetes Self-management in Texas

  Advances in Nursing Science · 2025-02-27

  articleSenior author
  PublisherDOI

• Information avant la prescription d'une sérologie VIH, des principes à la réalité ? 

  Médecine et Maladies Infectieuses Formation · 2025-05-28

  article
  PublisherDOI

• A Community-Engaged Ethnographic Investigation into Public Transit Among Older Adults Experiencing Homelessness

  International Journal of Environmental Research and Public Health · 2025-04-21

  articleOpen accessSenior author

  Nearly 50% of single homeless adults are over the age of 50, and adults aged 50 years and older are the fastest growing subpopulation of the homeless in the U.S. This subpopulation has unique mobility needs and barriers to transportation. We used rapid ethnographic assessments to explore the practices, needs, perceptions, and values of unhoused older adults in relation to their efforts to access and navigate health and social services via public transit. We conducted 23 observations of 12 participants as they navigated public transit to meet their travel needs. Our data consist of 65 h of observations with field notes, walking interviews, and travel diaries. Two themes-waiting and friction-encompassed participants' experiences of mobility and their ongoing negotiations that involved time, space, individual ability, and interpersonal interactions within their environmental context. For this population, attainment of housing and improved health and well-being is contingent on access to reliable transportation-a condition that is not met in many communities. For the participants in our study, the physical demands of accessing public transit combined with the cognitive load of interpreting multi-step directions in specific time schedules were often insurmountable. The public transit system was often hostile, such that participants were stigmatized and segregated. Professionals who work with older homeless individuals must consider the capacity of their clients to successfully navigate public transit, and policymakers should consider the transit needs of their entire population when designing transit systems.

  PublisherOA PDFDOI

• Entre efemérides e (re)existências: festas escolares, currículos e decolonialidade nos cotidianos

  Curriculo sem Fronteiras · 2025-12-01

  articleOpen access

  busca discutir vivncias populares e os 'saberesfazeres'

  PublisherDOI

• The Effect of Acculturation on Diabetes Knowledge Among Chinese Americans With Type 2 Diabetes

  The Science of Diabetes Self-Management and Care · 2025-03-31 · 1 citations

  articleSenior author

  PurposeThe purpose of the study was to examine the level of diabetes knowledge among Chinese Americans with type 2 diabetes (T2DM) and the influence of acculturation levels on diabetes knowledge. T2DM is a significant health issue for Chinese Americans because of the unique challenges they face that reflect a complex interplay of culture, language, insufficient numbers of culturally congruent health care providers, and socioeconomic factors. Diabetes knowledge is an essential foundation for effective diabetes self-management behaviors. However, few studies have assessed Chinese Americans' level of diabetes knowledge and its relationship to acculturation.MethodsA secondary analysis of cross-sectional survey data from 110 Chinese Americans with T2DM was conducted. Descriptive analyses summarized specific knowledge deficits, and a hierarchical regression model was used to test the contribution of acculturation to the level of knowledge after controlling for demographics, diabetes duration, treatment, number of comorbidities, and diabetes numeracy.ResultThe average percentage of correct responses on the Diabetes Knowledge Questionnaire-Revised was approximately 77%. Items that were answered incorrectly the most frequently pertained to low or high blood glucose symptoms, desired A1C level, and glucose levels' relation to emotions. Diabetes numeracy and acculturation significantly predicted diabetes knowledge after controlling for demographic and health indicators.ConclusionChinese American patients may have significant gaps in knowledge regarding diabetes and its management that correspond to lower numeracy and acculturation levels. Health care providers should reinforce diabetes education for Chinese American patients who have lower acculturation levels.

  PublisherDOI

• Impacts of North Korean Defectors’ Cultural Orientation, PTSD, and Resilience on Their Social Adaptation in South Korea

  Journal of Transcultural Nursing · 2025-09-28

  article

  Introduction: Over 30,000 North Koreans have fled to South Korea, facing challenges in adapting to a new society. This study aimed to examine how cultural orientation, PTSD, and resilience influence their social adaptation. Methods: A cross-sectional survey was conducted with 171 North Korean defectors using validated tools to assess cultural orientation, PTSD symptoms, resilience, and social adaptation. Results: PTSD was prevalent in 24% of participants and strongly negatively correlated with social adaptation ( r = −.61, p < .001). Resilience showed a positive association with adaptation ( r = .46, p < .001) and served as a protective factor against PTSD. Horizontal cultural orientation correlated with adaptation but was not a significant predictor. PTSD severity was the strongest predictor of poor adaptation. Discussion: These findings underscore the need for long-term, culturally appropriate mental health interventions and resilience-building programs to enhance the social integration of North Korean defectors and inform refugee support policy.

  PublisherDOI

• Latent Profile Analysis of Fatigue Subtypes in Adults With Type 2 Diabetes

  Nursing Research · 2025-01-29 · 2 citations

  articleSenior author

  BACKGROUND: People with type 2 diabetes mellitus (T2DM) commonly report a higher fatigue intensity than the general population. However, effective fatigue management is lacking because little is known about other fatigue characteristics, including timing, distress, and quality, as well as the potential fatigue subtypes experienced in people with T2DM. OBJECTIVE: This study aims to describe fatigue intensity, timing, distress, and quality and to identify fatigue subtypes in people with T2DM. METHODS: This cross-sectional, descriptive study included a sample of 150 participants with T2DM recruited from two diabetes outpatient clinics in Taiwan. Fatigue intensity, timing, and distress were measured using the Fatigue Symptom Inventory. Fatigue quality was measured using the Multidimensional Fatigue Inventory. Fatigue subtypes were identified using a latent profile analysis. RESULTS: Participants reported a mild fatigue intensity, experiencing fatigue for about 22% of the day with worse fatigue in the afternoon and evening and having mild disturbances. Three fatigue subtypes were identified. The "high/persistent fatigue with mild distress" subtype was characterized by high fatigue intensity and duration with severe general, physical, and mental fatigue that mildly interfered with functioning. The "moderate/frequent fatigue with minimal distress" group showed moderate levels of fatigue intensity and duration levels with intermediate of general, physical, and mental fatigue and minimal fatigue disturbances. The "no fatigue and distress" subtype was characterized by overall low fatigue scores. DISCUSSION: We identified fatigue characteristics and subtypes in people with T2DM, providing insights into better fatigue management. People with T2DM reported having mild but persistent fatigue. The latent profile analysis revealed that fatigue is likely composed of a mixture of physical and mental components. Nurses should assess both the physical and the mental aspects of fatigue while addressing features of the fatigue characteristics in tailored management strategies to alleviate all aspects of fatigue in people with T2DM.

  PublisherDOI

• Adaptation of the Florida Cognitive Activities Scale for Latinx adults with chronic diseases

  Ethnicity and Health · 2025-01-29

  articleSenior author

  BACKGROUND: Latinx adults experience disparately high rates of chronic diseases and cognitive dysfunction. Participating in cognitive-stimulating activities, such as reading, is thought to improve and preserve cognitive function. However, little is known about cognitively stimulating activities preferred by Latinx adults. In addition, surveys to measure participation in cognitively stimulating activities are not culturally sensitive to Latinx preferences and tend to feature activities that require financial resources and leisure time and may not include cognitively stimulating activities that are more accessible or preferable. METHODS: We conducted an instrumentation study in three phases to adapt the Florida Cognitive Activities Scale (FCAS): Phase (1) revision and translation of the FCAS for Latinx adults with chronic diseases; Phase (2) feasibility testing; and Phase (3) reliability and validity testing. RESULTS: < .01), and temporal reliability (the interclass correlation coefficient between test and retest times was 0.81). CONCLUSION: The FCAS-L is a valid and reliable updated measure of cognitively stimulating activities for Spanish- and English-speaking Latinx adults with chronic conditions.

  PublisherDOI

• Oral Health Knowledge, Risk of Periodontitis, and Diabetes Management Self-Efficacy Among People With Type 2 Diabetes

  The Science of Diabetes Self-Management and Care · 2025-12-18

  articleSenior author

  PurposeThe purpose of the study was to examine the association between the level of oral health knowledge (OHK), the risk of periodontitis, and diabetes management self-efficacy (DMSE) among individuals with type 2 diabetes (T2DM).MethodsA cross-sectional survey of 93 adults with T2DM in central Texas was used to examine OHK levels with descriptive analyses; 5 hierarchical regression analyses were conducted to explore the impact of OHK and periodontitis risk on DMSE.ResultsParticipants' mean age was 59.60 ± 12.76 years, 54.8% were female, and 54.8% were White. Their average duration of having diabetes was 12.17 ± 11.27 years, and 77.4% took oral medications. Their average A1C was 6.75 ± 1.56; nearly half (47.3%) had more than 1 comorbidity. The risk of periodontitis was high, and the level of OHK was low. On average, 65% of the OHK questions were answered correctly; the 2 questions with the lowest rates of being answered correctly were related to dry mouth risks. Forty-two percent of participants were at risk of periodontitis. Hierarchical regression analyses showed that only the risk of periodontitis significantly predicted DMSE in managing diet, DMSE in managing exercise and weight, and overall DMSE after controlling for age, gender, number of comorbidities, duration of diabetes, and treatment types.ConclusionsHealth care providers should proactively assess OHK and periodontitis risk, especially when patients indicate low efficacy concerning diet and body weight management.

  PublisherDOI

Recent grants

• NIH Grant F31NR007407

  NIH · $32k

• NIH Grant R21DK076705

  NIH · $408k · 2012

Frequent coauthors

• Julie A. Zuñiga

  The University of Texas at Austin

  49 shared

• Sharon A. Brown

  47 shared

• Craig L. Hanis

  The University of Texas Health Science Center at Houston

  33 shared

• Kenneth J. Gruber

  25 shared

• Hong Zhao

  Peking Union Medical College Hospital

  25 shared

• Jie Hu

  Nanjing University of Chinese Medicine

  25 shared

• Huaping Liu

  Central South University

  25 shared

• Kamiar Kouzekanani

  Minnesota Department of Education

  22 shared

Education

• PhD, School of Nursing

  The University of Texas at Austin

Awards & honors

• Fellow of the American Academy of Nursing
• Fellow of the Texas Public Health Association