About

Barbara L. Brush, Ph.D., ANP-BC, FAAN, is a professor in the Department of Health Behavior and Clinical Sciences at the University of Michigan School of Nursing. Her research focuses on social determinants influencing health, with an emphasis on their role in fostering health disparities and inequalities within urban communities. Most studies are conducted collaboratively with partners in Detroit, utilizing a community-based participatory research approach. Over the past fifteen years, she has been actively engaged with Detroit partners to understand and address elements contributing to housing instability and homelessness among African American families. Her recent work includes efforts to enhance Black participation in cancer clinical trials to improve health outcomes. In addition to her community research, Dr. Brush explores nurse workforce development, capacity building, primary care practice, and international nurse migration. She has over 40 years of experience as a nurse practitioner and is dedicated to teaching, precepting, and supervising students across health disciplines, with a focus on community-based research activities. Dr. Brush has been recognized for her outstanding teaching contributions and is a fellow of the American Academy of Nursing.

Research topics

• Medicine
• Nursing
• Psychology
• Political science
• Sociology

Selected publications

• Abstract 626: Black/African American participation in cancer clinical trials: Healthcare professional perspectives

  Cancer Research · 2025-04-21

  article

  Abstract Purpose: The purpose of this community-based participatory research (CBPR) was to identify barriers and facilitators to Black/African American engagement and inclusion in cancer clinical trials in the Detroit Metropolitan Area. This presentation focuses on data from healthcare professionals at Henry Ford Cancer Institute. Design: The CBPR approach included the establishment of a Steering Committee composed of researchers, health professionals, and representatives of eight diverse organizations representing African American, African Caribbean, and Ghanaian communities. A qualitative methodology was employed to obtain contextual and experiential data. Fourteen healthcare professionals participated in individual interviews including physicians, surgeons, research nurses and navigators, clinical research coordinators, and cancer trial investigators. Interview guides were developed based on an extensive literature review. Interviews were audio recorded and transcribed. Data were coded and searches were conducted to identify themes within the coded data. Outcomes: Data were categorized into six constructs: 1. disparities; 2. trust; 3. advantages and disadvantages to trial participation; 4. clinical and system challenges for physicians’ trial engagement; 5. trial participant selection criteria; and 6. clinical trial recruitment protocols. Themes within disparities include inequitable access to healthcare and patient selection bias. Patient and community trust and distrust were discussed within historical and experiential abuses and neglect in Black/African American communities. Physicians perceived trial advantages to include access to new therapies and patient-internal rewards, e.g., contributing to wellbeing of future generations. Disadvantages included participants’ financial, social, and psychological costs. Physician challenges included awareness of trials, time allocation, and systemic expectations of output. Selection criteria themes were focused on the internal procedures required to identify eligible patients and the barriers associated with trial sponsor requirements. Recruitment barriers included complex consenting procedures and resources to support informed patient decision-making. Study respondents provided recommendations to address barriers for both patients and healthcare providers. Conclusions: Increasing diversity in clinical trials requires understanding barriers and facilitators at multiple levels including communities, patients and their families, healthcare professionals, health system leadership, and trial sponsors. Recognizing the experiences and perceptions of healthcare professionals is one step toward addressing the complex social environments in which cancer clinical trials reside. Recommendations from this study are being piloted. Citation Format: Linda Kaljee, Sylvester Antwi, Doreen Dankerlui, Donna Harris, Barbara Israel, Denise White-Perkins, Valerie Ofori Aboah, Livingstone Aduse-Poku, Harriet Larrious-Lartey, Barbara Brush, Chris Coombe, La'Toshia Patman, Nayomi Cawthorne, Sophia Chue, Zachary Rowe, Cassandra Mills, Kurt Fernando, Gwendolyn Daniels, Eleanor Walker, Evelyn M. Jiagge. Black/African American participation in cancer clinical trials: Healthcare professional perspectives [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 626.

  PublisherDOI

• Determinants of dementia diagnosis in U.S. primary care in the past decade: A scoping review

  The Journal of Prevention of Alzheimer s Disease · 2025-01-23 · 17 citations

  reviewOpen access

  BACKGROUND: Alzheimer's disease and related dementias (ADRD) are chronically underdiagnosed in the U.S., particularly among minoritized racial and ethnic groups. Primary care providers are at the forefront of diagnosis given the increasing prevalence of cases and shortage of dementia specialists. Advances in policy, detection, and treatment in the past decade necessitate an updated review of the current state of determinants of ADRD diagnosis in U.S. primary care settings. METHODS: Following Joanna Briggs Institute guidelines, we conducted a scoping literature review on ADRD diagnosis among older adults in U.S. primary care settings. Studies published in English from January 2010 to January 2024 were retrieved from PubMed, PsycINFO, and CINAHL. We extracted primary data on study characteristics and synthesized key findings according to facilitators, barriers, and rates of diagnosis in primary care. RESULTS: Of 563 articles retrieved, 12 met eligibility criteria. Three studies reported rates of diagnosis, and all but one reported facilitators and/or barriers to diagnosis. ADRD remains underdiagnosed in primary care settings, especially in the earliest symptomatic stage (i.e., mild cognitive impairment). Multi-level barriers and facilitators were identified including individual beliefs about ADRD (e.g., value of early diagnosis), interpersonal relationships between patients and their family members and providers (e.g., importance of an established clinical relationship), and healthcare system limitations (e.g., insufficient resources and training). CONCLUSION: Despite national policy efforts to improve timely diagnosis of ADRD, underdiagnosis remains a clinical and public health challenge. Increased attention to social and community contexts will be important for future research and intervention.

  PublisherDOI

• A Scoping Review of Approaches to Extragenital Chlamydia and Gonorrhea Screening for Adolescents and Young Adults in the United States

  Nursing for Women s Health · 2025-10-10

  reviewOpen access

  OBJECTIVE: To identify effective strategies for extragenital sexually transmitted infection screening among adolescents and young adults (AYAs). DATA SOURCES: Following the Joanna Briggs Institute method, searches were conducted in PubMed and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) for relevant, peer-reviewed articles published from January 2000 through December 2024. STUDY SELECTION: The search strategy identified studies pertaining to chlamydia, gonorrhea, extragenital sites, screening, and AYAs. Studies were included if most participants were 12 to 24 years old or if their outcomes were disaggregated. Selected studies described at least one approach to extragenital screening, reporting corresponding measures of uptake, preferability, or acceptability. Nine studies met the inclusion criteria. DATA EXTRACTION: Data on study characteristics, sampled populations, approaches, relative successes, infection prevalence, and correlates were extracted, critically appraised, and descriptively synthesized. DATA SYNTHESIS: Included studies demonstrated higher extragenital screening uptake in research studies (89%-100%) compared to routine care (0%-74%) and when standardized protocols and health care staff trainings were incorporated. Extragenital infections were prevalent among female AYAs with genital infection, as well as sexual and gender minority individuals assigned male at birth. CONCLUSION: Increasing clinical standardization as well as enhancing health care and nursing staff training may improve detection of common extragenital infections and help prevent associated sexual and reproductive health complications.

  PublisherDOI

• Black/African American participation in cancer clinical trials: A qualitative study of community members, patients with cancer, and survivors (Detroit, MI) using CBPR.

  Journal of Clinical Oncology · 2024-05-29

  article

  e13743 Background: Black/African Americans (B/AA) have a disproportionate cancer burden and the highest mortality rates of any racial/ethnic group for most cancers. Racial/ethnic variation in cancer burden reflects health inequities, differences in risk factors, heredity and genomic diversity, and lack of access to and participation in cancer prevention, screening, treatment, and clinical trials. Twelve percent of the United States population are B/AA; however, only about 5% B/AA participate in clinical trials. As a result, data regarding tumors from B/AA are not equally represented in new drug discovery efforts. Methods: Participatory Action for Access to Clinical Trials (PAACT) used a Community Based Participatory Research (CBPR) approach to support a partnership between Henry Ford Health (HFH) and eight African American, Caribbean, and continental African community-based organizations (CBOs). Focus group data were collected in-person and virtually with representatives from the CBOs and HFH cancer survivors. CBOs participated in Steering Committee meetings throughout the project and two community forums to obtain feedback on recommendations identified through the qualitative data. Results: Factors contributing to participation in cancer clinical trials included systemic issues related to racism, health disparities and trust in government, health systems, and clinical research. Other factors included personal experiences with healthcare systems, healthcare provider-patient communication, socio-economic barriers (e.g., time away from work, family), and perceptions of future benefits from trials for B/AA communities. Recommendations included: 1) on-going health system outreach to B/AA communities regarding cancer prevention and treatment, as well as clinical trials. 2) B/AA community liaisons and cancer survivors as providers of information related to clinical trials; 3) two-way provider-patient communication to address questions and concerns about treatment options and trial information; 4) monetary compensation for indirect trial costs; 5) information on the importance of diversity within trials; and 6) ensuring information is provided to patients’ support networks. Conclusions: CBPR is effective in the identification of factors that influence participation in clinical trials. Building trust between patients and the healthcare system begins before patients walk into a clinic and every interaction contributes to institutional worthiness of community and patient trust. It is possible and imperative for health systems to work with B/AA communities and jointly identify and implement recommendations to ensure informed decision-making regarding trial participation. We are currently designing intervention strategies based on the recommendations for implementation at HFH.

  PublisherDOI

• Cancer clinical trial participation: a qualitative study of Black/African American communities’ and patient/survivors’ recommendations

  JNCI Cancer Spectrum · 2024-11-25 · 2 citations

  articleOpen access

  BACKGROUND: Black/African Americans experience disproportionate cancer burden and mortality rates. Racial and ethnic variation in cancer burden reflects systemic and health-care inequities, cancer risk factors, and heredity and genomic diversity. Multiple systemic, sociocultural, economic, and individual factors also contribute to disproportionately low Black/African American participation in cancer clinical trials. METHODS: The Participatory Action for Access to Clinical Trials project used a community-based participatory research approach inclusive of Black/African American community-based organizations, Henry Ford Health, and the University of Michigan Urban Research Center. The project aims were to understand Black/African Americans' behavioral intentions to participate in cancer clinical trials and to obtain recommendations for improving participation. Audio-recorded focus group data were transcribed and coded, and searches were conducted to identify themes and subthemes. Representative text was extracted from the transcripts. RESULTS: Six community focus group discussions (70 participants) and 6 Henry Ford Health patient/survivor focus group discussions (29 participants) were completed. General themes related to trial participation were identified, including (1) systemic issues related to racism, health disparities, and trust in government, health systems, and clinical research; (2) firsthand experiences with health care and health systems; (3) perceived and experienced advantages and disadvantages of clinical trial participation; and (4) recruitment procedures and personal decision-making processes. Specific recommendations on how to address barriers were obtained. CONCLUSIONS: Community-based participatory research is effective in bringing communities equitably to the table. To build trust, health systems must provide opportunities for patients and communities to jointly identify factors affecting cancer clinical trial participation, implement recommendations, and address health disparities.

  PublisherOA PDFDOI

• Cultivating an ecosystem: A qualitative exploration of sustainability in long-standing community-based participatory research (CBPR) partnerships.

  PubMed · 2023-01-01

  article

  Background: While sustainability is crucial to the success of community-based participatory research (CBPR) partnerships, there is a lack of conceptual clarity on what defines sustainability and what characterizes sustainability-promoting practices in long-standing (in existence ≥ 6 years) CBPR partnerships. Objectives: The aim of this article is to explore the definition of sustainability, as well as practices that influence sustainability from the perspectives of academic and community experts in long-standing CBPR partnerships. Methods: This qualitative analysis is part of Measurement Approaches to Partnership Success (MAPS), a participatory mixed methods validity study that examined "success" and its contributing factors in long-standing CBPR partnerships. Thematic analysis of 21 semi-structured interviews was conducted, including 10 academic and 11 community experts of long-standing CBPR partnerships. Results: The key defining components of sustainability we identified include: distinguishing between sustaining the work of the partnership and ongoing relationships among partners; working towards a common goal over time; and enduring changes that impact the partnership. We further identified strengthening and capacity building practices at multiple levels of the partnership that served to promote the sustainability of the partnership's work and of ongoing relationships among partners. Conclusions: Sustainability can be understood as supporting an ecosystem that surrounds the beneficial relationships between academic and community partners. Ongoing evaluation and application of practices that promote the sustainability of partnership activities and relationships may strengthen the long-term effectiveness of CBPR partnerships in advancing health equity.

  Publisher

• Trauma-Disclosure, Meaning-Making, and Help-Seeking in Mothers Experiencing Homelessness: Results From a Trauma-Focused, Clinical Ethnographic Narrative Intervention

  Violence Against Women · 2023-04-26 · 4 citations

  articleSenior author

  Mothers experiencing homelessness are seldom asked about past trauma that may be causal to housing instability and poor health. There are also few validated trauma-focused interventions in family shelters. To address this gap, we tested the feasibility and acceptability of the trauma-focused clinical ethnographic narrative intervention (CENI-TF) in increasing mothers' trauma disclosure, appraisal of its meaning in their lives, and help-seeking behaviors. We also present the qualitative findings to contextualize the intervention. Findings are organized under three major domains and nine subthemes that capture participants' voices and experiences. The CENI-TF has the potential to promote help-seeking behaviors and interrupt recurring cycles of trauma and housing instability in this at-risk population.

  PublisherDOI

• 234 Understanding the utility of an evaluation instrument and a feedback mechanism in community-based participatory research (CBPR) partnerships

  Journal of Clinical and Translational Science · 2023-04-01 · 1 citations

  articleOpen access

  OBJECTIVES/GOALS: To examine i) how longstanding (≥6 years) community-based participatory research (CBPR) partnerships nationwide implemented a validated questionnaire to measure success and its contributing factors and ii) how the CBPR partnerships utilized and applied a feedback mechanism, or reports of findings from the questionnaire and a facilitation guide METHODS/STUDY POPULATION: This mixed methods study builds upon a larger NIH-funded project entitled ’Measurement Approaches to Partnership Success (MAPS). MAPS developed and validated the 109-item MAPS questionnaire to measure success in longstanding (≥6 years) CBPR partnerships. In 2020, 55 CBPR partnerships nationwide completed the MAPS Questionnaire and, a year later, received the MAPS Feedback Mechanism, consisting of questionnaire findings and a facilitation guide on how to present the findings. In this follow-up study, we administered multi-method surveys to each partnership contact person in 2022 to examine their experience with and utility of the MAPS Questionnaire and the MAPS Feedback mechanism. We performed descriptive analysis of quantitative responses using SAS and thematic analysis of qualitative responses. RESULTS/ANTICIPATED RESULTS: Survey responses have been presently collected from 14 partnerships. Preliminary findings suggest that the most frequently reported benefits of completing the MAPS Questionnaire included stimulating partnership reflections and ease of completion. Many partnerships shared results of the MAPS Questionnaire by e-mail or during partnership meetings. Nearly half of the partnerships rated components of the MAPS feedback mechanism as useful. Over one-third of the partnerships reported that the COVID pandemic limited their capacity to engage with the MAPS Feedback Mechanism. Key qualitative suggestions included making the MAPS Questionnaire shorter, providing it in a different format, and offering additional facilitation to support the implementation of the MAPS Feedback Mechanism. DISCUSSION/SIGNIFICANCE: This study examines how CBPR partnerships utilize an evaluation instrument and apply results on success. Current findings suggest potential utility of the MAPS Questionnaire and Feedback Mechanism for ongoing evaluation. Reducing the questionnaire length and providing facilitation resources may enhance implementation across diverse settings.

  PublisherOA PDFDOI

• Preparing nurse scientists for health services and policy research: Five-year outcomes of interprofessional postdoctoral training in the National Clinician Scholars Program

  Nursing Outlook · 2023-07-01 · 2 citations

  articleOpen access
  PublisherOA PDFDOI

• Using a CBPR Approach to Guide Successful Recruitment for an Online Questionnaire: The Measurement Approaches to Partnership Success (MAPS) Case Study

  Health Promotion Practice · 2023-11-19

  article

  The Measurement Approaches to Partnership Success (MAPS) study team effectively used a community-based participatory research (CBPR) approach to recruit 55 long-standing CBPR partnerships to participate in an online questionnaire to assess factors associated with partnership success. Our recruitment was guided by interconnected values of collaboration, transparency, and relationship-building to maintain fidelity to CBPR principles throughout the process. We operationalized these values into a series of strategies to recruit partnerships and sustain their involvement, including establishing primary points of contact, offering incentives for completion, personalizing recruitment materials, and practicing flexibility in our approach. We aim to inform public health researchers on the strategies that enabled our team to achieve 100% of our study recruitment goal, with the intent that our recommendations can be applied by others to enhance their recruitment efforts and reach their data collection goals for future public health research.

  PublisherDOI

Recent grants

• NIH Grant G13LM008512

  NIH · $151k · 2009

Frequent coauthors

• Elizabeth Capezuti

  City University of New York

  32 shared

• Barbara A. Israel

  University of Michigan–Ann Arbor

  16 shared

• Laurie Lachance

  12 shared

• Chris M. Coombe

  University of Michigan–Ann Arbor

  12 shared

• Megan Jensen

  University of Michigan–Ann Arbor

  11 shared

• Eliza Wilson‐Powers

  University of Michigan–Ann Arbor

  10 shared

• Laura M. Wagner

  University of California, San Francisco

  10 shared

• Laura Gültekin

  University of Michigan–Ann Arbor

  10 shared

Labs

• Barbara L. Brush LabPI

Education

• PhD, Nursing

  University of Pennsylvania

  1994

• MSN, Nursing

  University of Pennsylvania

  1982

• BSN, Nursing

  University of Massachusetts Dartmouth

  1979

Awards & honors

• Fellow, American Academy of Nursing (1999)
• Mae Edna Doyle Teacher of the Year, University of Michigan S…
• Excellence in Nursing Leadership Award, Sigma Theta Tau (200…