About

Dr. Florence U Johnson is a dedicated nurse scientist and assistant professor at the University of Michigan School of Nursing, with a focus on caregiving, mental health, and health equity. Her research emphasizes dementia caregiving, particularly the challenges faced by Black caregivers, highlighting the mental health toll and systemic barriers they encounter. She investigates health disparities and social determinants affecting care access and outcomes, advocating for culturally responsive interventions and community-based support systems to enhance caregiver resilience and well-being. Dr. Johnson's policy-driven approach aims to influence healthcare reform to ensure equitable support and resources for marginalized and under-resourced communities. As an emerging nursing educator, Dr. Johnson draws on her extensive expertise to teach and mentor students, emphasizing culturally responsive care, critical inquiry, and integrating lived experiences into evidence-based practice. She has led seminars, public health workshops, and supported student research and community projects. Her work is characterized by a commitment to fostering inclusive, equity-driven learning environments that prepare students to become compassionate and socially conscious healthcare leaders. Her contributions extend to her active memberships in professional organizations and her recognition through awards such as the PhD Dissertation Award from the Midwest Nursing Research Society and the Excellence in Mentorship award from Sigma Theta Tau.

Research topics

• Medicine
• Psychology
• Gerontology
• Nursing
• Clinical psychology

Selected publications

• A cross-sectional study of caregiving tasks and mental health outcomes among diverse family dementia caregivers

  Geriatric Nursing · 2026-01-30

  article1st authorCorresponding
  PublisherDOI

• Capacity building in dementia research: insights from the World Young Leaders in Dementia

  Alzheimer s & Dementia · 2025-12-01

  articleOpen access

  Early-career researchers from low- and middle-income countries face systemic barriers to professional development and leadership growth. This article presents results from an initiative led by the World Young Leaders in Dementia (WYLD), including a leadership-focused session at the Alzheimer's Association International Conference 2024 and a global survey completed by 130 dementia researchers from 17 countries. The survey explored five capacity-building domains critical for leadership development. Over half of the survey respondents stated that scientific research in their country was not prioritized in public policy. Additionally, only 39% report holding full-time academic positions. The most cited challenges included lack of funding sources, training opportunities, and physical workspace. These findings highlight the urgent need to invest in research, training, and infrastructure to support future scientific leaders. As dementia incidence rises, prioritizing capacity building is essential to ensure global equity in research. HIGHLIGHTS: Early-career dementia researchers face major barriers, especially in LMICs. A networking session and a global survey explored capacity-building needs in dementia research. Key obstacles: lack of funding, training, workspace, and protected research time. Leadership development is a critical component of sustainable research capacity.

  PublisherOA PDFDOI

• Early-Life Experiences and Caregiver Status in Mid- and Later Adulthood

  Innovation in Aging · 2025-12-01

  articleOpen access1st authorCorresponding

  Abstract The selection of caregivers within families is a complex process influenced by various early-life factors, such as parental relationships, a history of physical abuse, and care provided by grandparents. Understanding how these contextual factors lead to the role of the adult family caregiver is crucial for developing effective support systems for caregivers. Using data from the 2019 Health and Retirement Study Life History survey, this study described early family life experiences below age 18 among caregivers and non-caregivers. Among the 2,849 respondents, we found 23% (n = 650) reported ever providing unpaid care to an adult family or friend for at least 6 months. Female respondents (29%) were more likely to be caregivers than male respondents (15%). We found respondents who lived with grandparents before 18 (27%) were more likely to be caregivers. Notably, about 32% of respondents who reported physical abuse before age 18 identified as caregivers, higher than the percentage of caregivers among those who did not report abuse (24%). Furthermore, we found those with good relationships with mothers were less likely to be caregivers (23% vs 27%). No difference in relationships with fathers was found (24%). Overall, these results highlight caregivers’ diverse backgrounds and experiences, underscoring the need for targeted support and resources to address the unique challenges different caregiving populations face. Further research is needed to understand the underlying factors driving these caregiving patterns and to develop interventions that can alleviate the burden on caregivers, particularly those with histories of trauma or living in multigenerational households.

  PublisherOA PDFDOI

• Race, Social Context, and Caregiving Intensity: Impact on Depressive Symptoms Among Spousal Caregivers

  International Journal of Environmental Research and Public Health · 2025-09-03 · 1 citations

  articleOpen access1st authorCorresponding

  Understanding the factors that influence the mental health of family caregivers is essential. This study examines the impact of caregiving intensity, operationalized as caregiving hours, on depressive symptoms, with a focus on racial differences and gender effects. We analyzed data from n = 2112 unique spousal caregivers across 6622 person-years of observations from the Health and Retirement Study (HRS) longitudinal data (2008–2014). We estimated the impact of caregiving hours on depressive symptoms, controlling for race, gender, and education. Random intercepts accounted for household-level variance. We assessed interaction terms to evaluate differential effects across racial groups. Depressive symptoms were positively associated with caregiving hours β = 1.74, SE = 0.24, suggesting that increasing caregiving hours is likely to lead to emotional distress. We observed a significant negative interaction effect among African American caregivers (β = −1.25, p = 0.013), indicating that increased caregiving hours led to a reduction in depressive symptoms. Gender was not significantly associated with caregiving hours (β = −0.36, p = 0.715). The random effects model demonstrated substantial household-level variation (var(_cons) = 266.07, p < 0.0001). Findings highlight racial differences in the effects of caregiving hours on depressive symptoms and point to the importance of culturally responsive interventions designed to mitigate depressive symptoms among caregivers. Future research should explore protective factors that mitigate psychological distress and promote resilience.

  PublisherOA PDFDOI

• Community support utilization by Black dementia caregivers: key factors

  Alzheimer s & Dementia · 2025-12-01

  articleOpen access1st authorCorresponding

  BACKGROUND: This qualitative study explores the factors influencing the utilization of community support services (CSS), such as respite care and support groups, by Black family caregivers of persons with dementia (PWD). Understanding these factors is crucial for enhancing the effectiveness of CSS and its impact on the community. METHOD: Focus group interviews with 17 current or former Black family caregivers of people living with dementia in the community, lasting approximately 1.5 hours each, were conducted to collect data on community support use, knowledge of dementia care, and self-care practices. The transcriptions were thematically analyzed using the Rigorous and Accelerated Data Reduction (RaDAR) method. RESULT: We identified three primary factors contributing to caregiver resilience: access to supportive environments, adaptability, and planning skills. The caregiver's reluctance to report depressive symptoms may be attributed to the strong Black woman schema. Additionally, four key themes emerged concerning barriers and facilitators of support use: (1) education on dementia stages, as understanding different stages of dementia helps caregivers manage challenging behaviors effectively; (2) empowerment through dementia subtypes, since knowledge of various dementia subtypes enables caregivers to seek appropriate support groups; (3) respite care access, as learning about and accessing respite care helps prevent caregiver burnout and promotes well-being; (4) emotional support, where addressing guilt is essential for the emotional well-being of caregivers. CONCLUSION: As the older adult population increases, dementia caregiving emerges as a critical public health concern. Our findings emphasize the necessity of comprehensive support service systems that can address both practical and emotional needs, thereby enhancing resilience among Black family dementia caregivers and improving their quality of life and the care they provide. IMPLICATIONS FOR POLICY: This study has significant policy implications, particularly in increasing funding for support programs. Black family caregivers of persons living with dementia (PLWD) could greatly benefit from enhanced federal and local initiatives. These programs should be specifically designed to address their unique needs and could include affordable, easily accessible, and culturally appropriate services such as respite care, counseling, and educational resources.

  PublisherOA PDFDOI

• Understanding the challenges faced by dementia researchers: Findings from a global survey on capacity building

  Alzheimer s & Dementia · 2025-12-01

  articleOpen access

  BACKGROUND: Different global initiatives aim to support researchers in their fields of study. World Young Leaders in Dementia (WYLD) is an international organization dedicated to connecting and supporting young professionals in the dementia field. One of its missions is to promote the development of leadership skills through capacity building. This concept encompasses five key areas: education and training, funding and investment, infrastructure development, collaborations and networking, and community engagement. Understanding researchers' working and academic conditions is the first step toward implementing targeted interventions to foster their growth. The aim of this work is to describe the main challenges faced by dementia researchers globally. METHOD: A comprehensive survey was designed to gather insights from dementia researchers, exploring demographic information and five key domains of capacity building. It was disseminated through WYLD's membership list and partnerships with dementia-focused organizations (e.g., ISTAART Professional Interest Areas, International Neuropsychological Society Special Interest Groups). A preliminary analysis was performed, focusing on education and training as well as funding and investment. RESULT: The participants (n = 125) were primarily women (69%) residing in low- and middle-income countries (75.2%). Among respondents, only 39% hold full-time academic positions, and just 20% dedicate 100% of their professional time to academia. A 65% report that the scientific system in their country is either underdeveloped or not prioritized as public policy. Furthermore, 93.7% state that funding sources-including salaries, grants, travel scholarships, and other forms of support-are scarce or nonexistent for early-career researchers. However, 62.4% reported receiving specialized training in dementia, and 65.6% stated their groups provide regular learning opportunities. Finally, the primary barriers to leadership development were: limited financial resources, limited infrastructure, and low visibility and recognition. Figure 1 summarizes the main results. CONCLUSION: The findings underscore significant challenges faced by dementia researchers. Limited financial resources, inadequate infrastructure, and low visibility and recognition remain critical barriers to leadership development and professional growth. Nevertheless, many researchers reported access to specialized training and regular learning opportunities within their groups, providing a foundation for strengthening capacity-building initiatives. Closing these gaps through targeted interventions is crucial to fostering the next generation of leaders in dementia research.

  PublisherOA PDFDOI

• Challenges and Policy Considerations of the Medicaid Unwinding for People with Disabilities

  Journal of General Internal Medicine · 2025-02-26 · 2 citations

  editorialOpen access
  PublisherOA PDFDOI

• Adaptive Coping and Caregiving Self-Efficacy Among Black Family Caregivers of Persons with Dementia

  Innovation in Aging · 2025-12-01

  articleOpen access

  Abstract Black family caregivers of persons with dementia have an increased risk of poor health, future cognitive impairment, and premature death related to stressors associated with caregiving. Understanding the relationships between adaptive coping, caregiving self-efficacy, and health can facilitate the development of resilience-focused interventions that may improve caregiver health. We surveyed 102 self-identified Black family caregivers of persons with dementia. Survey measures included the coping and adaptation processing scale (CAPS), the revised scale for caregiving self-efficacy, and the PROMIS global health scale. Analysis was completed using regression modeling. Adjusting for age, gender, marital status, employment status, income, education, and presence of chronic disease, we found that adaptive coping was positively associated with caregiver self-efficacy in managing disruptive behaviors (B = 1.57, 95% CI [.96, 2.173], p = 0.000) and controlling upsetting thoughts (B = 1.67, 95% CI [1.13, 2.22], p = 0.000). Adaptive coping was not significantly associated with mental health (i.e., emotional distress, social role satisfaction) (B=.07, 95% CI [-.28, 0.41], p = 0.707), or physical health (i.e., physical function, pain, fatigue) (B=-0.01, 95%CI [-.27, 0.24], p = 0.926). Adaptive coping strategies associated with caregiving self-efficacy and resilience theory included experience, use of planning skills, and humor. Designing caregiver support interventions that facilitate the development of effective planning skills may significantly improve caregiver mental health.

  PublisherOA PDFDOI

• Navigating the Challenges of Community Supports Services: A Focus Group for Black Family Caregivers

  Alzheimer s & Dementia · 2024-12-01

  articleOpen access1st authorCorresponding

  Abstract This qualitative study highlights the challenges faced by Black family caregivers who provide personal care to dementia patients without remuneration or training. Caring for a person with dementia can be stressful and negatively impact the caregiver’s health. Black family caregivers are particularly vulnerable to stress‐related mental health issues. Community support services (CSS) such as support groups, help‐seeking, respite, and dementia training can help address these issues. CSS can also help delay or avoid institutionalization and keep the person living with dementia and their community‐dwelling caregivers safe in their homes. The study used the RaDAR method to analyze and develop themes from the focus group interviews of six participants. The focus group participants validated the hypothesis that Black caregivers are less likely to use CSS, particularly respite and support groups. Financial constraints and lack of free time were reported as the main barriers to support groups and respite use. The study concludes that CSS can help address the mental health issues of Black family caregivers. However, financial constraints and lack of free time are significant barriers to CSS use. The study recommends that CSS providers consider offering flexible and affordable services that cater to the needs of Black family caregivers. The study also recommends that policymakers consider providing financial support to CSS providers to enable them to offer affordable services to Black family caregivers.

  PublisherOA PDFDOI

• “It Isn’t What I Had to Do, It’s What I Get to Do”: The Experiences of Black Family Caregivers Managing Dementia

  Journal of Family Nursing · 2024-10-20 · 6 citations

  articleOpen access

  Black family caregivers of persons with dementia experience high levels of stress that can negatively affect caregiver health outcomes and reduce caregiving capacity. However, Black caregivers tend to report low levels depressive symptoms or other negative health effects. This qualitative descriptive study aimed to identify factors that contribute to resilience among Black family caregivers. Using the rigorous and accelerated data reduction (RADaR) technique to complete thematic analysis, a team of five coders examined transcript data from three focus groups of Black current and former family caregivers ( n = 17) of persons with dementia. We identified three primary factors that contributed to caregiver resilience including access to supportive environments, adaptability, and planning skills. Caregiver resistance to reporting depressive symptoms may be attributed to the strong Black woman schema. Findings from this study may be used to develop future culturally responsive interventions that support caregivers and promote family health.

  PublisherOA PDFDOI

Frequent coauthors

• Sheria G. Robinson‐Lane

  University of Michigan–Ann Arbor

  22 shared

• Amanda Leggett

  Wayne State University

  9 shared

• Ann Spenard

  Qualidigm (United States)

  6 shared

• Alicia Carmichael

  University of Michigan–Ann Arbor

  5 shared

• Terry S. Field

  Reliant Medical Group

  5 shared

• Lianlian Lei

  Third People's Hospital of Huzhou

  5 shared

• Richard Gonzalez

  5 shared

• Natalie Leonard

  University of Michigan–Ann Arbor

  5 shared

Education

• Ph.D., Nursing

  University of Michigan

  2023

• MHA/MSN, Nursing

  University of Phoenix

  2010

• Bachelor of Science Nursing, Nursing

  University of Connecticut

  1990

Awards & honors

• PhD Dissertation Award, Gerontological Nursing Science Resea…
• Ambassador, International Society to Advance Alzheimer’s Res…
• Excellence in Mentorship, Sigma Theta Tau, Rho Chapter (2022…