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White, PhD, RN, Carole Leone

School of Nursing
Office of Faculty Affairs and Diversity
(210) 567-5831
whitec2@uthscsa.edu

My primary research goal is to optimize outcomes for stroke survivors and their family caregivers, utilizing health information technologies to enhance risk factor control and provide caregiver support. My primary teaching responsibilities are in the Doctor of Nursing Practice Program, focused on the promotion of evidence-based practice, including critical appraisal methodology and knowledge translation.

Appointments Education Expertise Teaching Publications Grants

9/2016 - Present

Professor

UT Health San Antonio, School of Nursing, San Antonio, TX

Clinical Trial Methodology

- My PhD training in epidemiology and biostatistics provided a strong foundation in research design methodology and quantitative statistics. I have managed an international NIH funded clinical trial for 7 years where I was able to apply what I had learned into the day-to-day execution of the trial. I was course faculty for 3 years in a course focused on clinical trial management given at the Society for Clinical Trials Annual Meeting.

Evidence-Based Practice

- I was fortunate to be work with David Sackett, the father of evidence-based medicine in the late 1980s. He and his group provided the methodological expertise to an international trial on stroke prevention that I was coordinating (the NASCET trial). This experience developed my interest in epidemiology and evidence-based practice (EBP). I have continued to gain expertise in this area as a co-investigator in a CIHR study examining how nurses use evidence in their practice. I was a nurse researcher in the clinical setting for many years, mentoring clinical nurse specialists to use evidence in their practice. I am currently teaching EBP in the Doctor of Nursing Practice program at the School of Nursing.

Family Caregiving

- My research is focused on measuring outcomes and designing and testing interventions for family caregivers of stroke survivors. This includes the development of a model of family caregiving, testing a measure of quality of life for family caregivers, examining the financial impact for family caregivers and making recommendations for interventions.

Neuroscience Nursing

- I have expertise in neuroscience nursing and have been involved in curriculum development for a clinical course in neuroscience nursing at the graduate level. As a research consultant in neuroscience nursing, I assisted neuroscience nurses in examining and developing evidence for their practice.

Optimizing Outcomes after Stroke

- My area of research involves outcomes for the stroke survivor and the family caregiver including depression, quality of life, and secondary stroke prevention and how health outcomes in one member of this dyad affect the other member.

Date	Description	Institution	# Students
5/2017 - 8/2017	Nursing: Quantitative Research Methods I	The University of Texas Health Science Center	5 students
This course is an introduction to research designs for causal inference. Experimental, quasi-experimental, and observational designs will be presented and evaluated for internal, external, construct, and statistical validity. Issues regarding sampling, measurement, randomization, treatment, and control will be addressed. The rationale for drawing causal inferences will be thoroughly explored. I have just taken over this course and have completely revised the curriculum to be consistent with the objectives.
9/2016 - 12/2017	Ph.D. Dissertations Directed	University of Texas Health Science Center at San Antonio

9/2012 - 12/2017	Membership on Supervising Committee	University of Texas Health Science Center at San Antonio, School of Nursing

5/2012 - 8/2017	Advanced Nursing: Clinical Application	The University of Texas Health Science Center	6 students
This is a new practicum in the new DNP program. I worked with another faculty to design this course and have been co-teacher for this clinical practicum since the fall of 2012. This practicum is offered once a year. This course provides the student with clinical specialty immersion experiences to facilitate integration and synthesis of the essential specialty competencies necessary to plan and design their DNP Practice Inquiry Project. Students will engage faculty and practice leaders in the plan and design of the project. The practice immersion experience may include a variety of activities related to the identification of the opportunity for improvement, analyzing the organizational context and strategies for design with appropriate clinicians in the clinical practice immersion. The setting and activities are specific to the student?s identified area of specialty. I have been working with students in this practicum since 2012. They are on average 6 students in the practicum.
5/2012 - 8/2017	Advanced Nursing? Seminar	The University of Texas Health Science Center	6 students
Course Director - I was one of the founding faculty members in this course and worked with another faculty member to develop the curriculum for this seminar in this new practice doctorate program. This is one of the two seminars that guides the Doctor of Nursing Practice in the design and implementation of the final project of their practice doctorate. I have been facilitating this seminar since August 2012. This seminar is a required course for all DNP students. The seminar has been rated very positively by the students who have completed it to date. This seminar course provides the student with knowledge to facilitate integration and synthesis of the essential specialty competencies necessary to plan and design their DNP Practice Project. This seminar includes a variety of activities related to the identification of the practice gap, refining their practice question, literature synthesis and evidence for their theory based organizational intervention at multiple system levels. The activities are specific to the student?s identified area of specialty. Faculty, practice leaders and experts assist with development of a plan that is relevant and feasible. The enrollment averages 6 students per course.

Abstract

Pickering CE, Overbaugh K, Piernik-Yoder B, Puga F, James DL, Patel D, Ford P, White C. Developing the Caring fro the Caregiver Program for the San Antonio Dementia Community; 2017 Jan. (Journal of the American Geriatrics Society).

Ku E, Scherzer R, Odden M, Shlipak M, White CL, Benavente OR, Pergola PE, Peralta CA. Patterns of Blood Pressure Change during Intensive Blood Pressure Lowerin in the Secondary Prevention of Small Subcortical Strokes (SPS3) Trial; 2016 Nov. (Abstract presented at American Society of Nephrology Kidney Week, Chicago, Ill).

Larrotta D, Garcia A, White CL. An Examination of Evidenced-Based Interventions for Family Caregivers of Persons with Alzheimer?s Disease and other Dementias; 2016 Sep. (Presented at Conference for Community Engagement and Healthcare Improvement, San Antonio, TX).

White CL, Finch L, Wood-Dauphinee S, Mayo N. A Mixed Methods Approach to Improve a Measure of Quality of Life for Family Caregivers of Stroke Survivors; 2016 Jan. (Quality of Life Research; vol. 25, no. 304.1).

Field TS, Pearce LA, Wardlaw JM, Doubal FN, Bazan C, Shoamanesh A, Ohba H, Catanese L, McClure LA, White CL, Hart RG, Benavente OR. Prediction of recurrent stroke in lacunar stroke patients: Performance of Small Vessel Disease (SVD) score in SPS3 Trial; 2016 Jan. (Stroke; vol. 47).

White CL, Ihegword B, Patterson M, Motz D, Williamson R, Caron J, Birnbaum LA. Feasibility Testing of mHealth for brainHealth: a Mobile Intervention to Support Secondary Stroke Prevention; 2016 Jan. (Stroke; vol. 47).

White CL, Patterson M, Motz D, Williamson R, Caron J, Birnbaum LA. Stroke Survivors? Perceptions about Risk Factor Management: Challenges and Opportunities; 2016 Jan. (Stroke; vol. 47).

Odden MC, Peralta CA, McClure LA, White CL, Wilkerson J, Pergola PE, Benavente OR, Sawaya P. Low Diastolic Blood Pressure and Risk of Stroke in the Setting of Intensive Systolic Blood Pressure Control: The SPS3 study; 2015 Mar. (Presented at Epi/Lifestyle Scientific Sessions, Baltimore, MD).

Wilson LK, Field TS, McClure LA, White CL, Benavente OR. Baseline disparities and Outcomes in Public vs Private US Health Care Institutions: The SPS3 Trial; 2015 Feb. (Presented at International Stroke Conference, Memphis, TN).

Field TS, McClure LA, White CL, Pergola PE, Hart RG, Benavente OR, Hill MD. Should Blood Pressure Targets After Lacunar Stroke Vary by Body Size? The SPS3 Trial; 2015 Feb. (Presented at International Stroke Conference, Memphis, TN).

Peralta CA, Odden MC, McClure LA, White CL, Shiplak M, Benavente OR, Pergola PE. Intensive Blood Pressure Lowering and Kidney Function Decline Among Persons with prior Lacunar Stroke: The SPS3 Randomized Trial; 2015 Jan. (J Am Soc Nephrol; vol. 26).

White CL, McClure LA, Lau H, Dhamoon MS, Lakshminarayan K, Brauer D, Benavente OR. Factors Associated with Self-Rated Health after Lacunar Stroke: Findings from the Secondary Prevention of Small Subcortical Strokes (SPS3) Trial; 2014 Oct. (Presented at the International Society for Quality of Life Research; Berlin, Germany).

Zhu S, McClure LA, Pikula A, Lau H, Kase C, White CL, Babikian V, Romero JR, Nguyen T, Benavente OR. Metabolic Syndrome in Patients with Lacunar Stroke: The SPS3 trial; 2014 May. (Presented at European Stroke Conference, Nice France).

White CL, Brady TL, Saucedo LL, Motz D, Sharpe J, Birnbaum LA. A Better Understanding of Readmission after Stroke by Including Stroke Survivor and Caregiver Perspectives; 2014 Feb. (Stroke; vol. 45).

Morris RM, White CL, Cantu AG, Trevino M. Interventions for Caregivers of Stroke Survivors: An Update of the Literature; 2014 Jan. (Stroke; vol. 45).

Elkind MSV, McClure MA, Zhang Y, Coffey C, White CL, Roldan A, Del Brutto OH, Pretell EJ, Pettigrew C, Tapia J, Matamala G, Hart RG, Luna J, Spitalnik SL, Wang H, Benavente OR. HsCRP predicts recurrent stroke and vascular events among patients with lacunar stroke: the Levels of Inflammatory Markers in Treatment of Ischemic Stroke (LIMITS) study; 2014 Jan. (Stroke; vol. 45).

Field TS, Patton K, McClure LA, Sussman C, White CL, Pergola PE, Hart RG, Benavente OR. The impact of Blood Pressure Variability on Stroke Recurrence: The SPS3 trial; 2014 Jan. (Stroke; vol. 45).

White CL, Szychowski JM, Pergola PE, Lau H, Benavente OR. Safety and Effectiveness of Intensive Blood Pressure Management in the Elderly: Findings from the Secondary Prevention of Small Subcortical Strokes Trial; 2014 Jan. (Stroke; vol. 45).

Pikula A, Coffey CS, Lau H, White CL, Kase CS, Benavente OR. Risk of Stroke and Vascular Events and Response to Antiplatelet Therapy in Young Adults with Recent Lacunar Strokes: The SPS3 Study; 2014 Jan. (Stroke; vol. 45).

Dhamoon MS, McClure LA, White CL, Benavente OR, Elkind MSV. Long-term disability after lacunar stroke: the Secondary Prevention of Small Subcortical Strokes Study (SPS3); 2014 Jan. (Stroke; vol. 45).

White CL, Barrientos R, Dunn K. Dimensions of Uncertainty after Stroke from the Perspectives of the Stroke Survivor and Family Caregiver; 2013 Jun. (Canadian Journal of Neuroscience Nursing; vol. 35, no. 1).

White CL, Szychowski JM, Benavente OR. Safety and Effectiveness of Intensive Risk Factor Management in the Elderly: Findings from the Secondary Prevention of Small Subcortical Stroke (SPS3) Trial; 2013 Jun. (Canadian Journal of Neuroscience Nursing; vol. 35, no. 1).

Field TS, Patton KL, McClure LA, Sussman CR, White CL, Pergola PE, Cervantes A, Conwit R, Hart RG, Benavente OR. The impact of Blood Pressure Variability on Stroke Recurrence: The SPS3 trial; 2013 May. (Abstract presented at the European Stroke Meeting).

Rochette A, Korner-Bitinsky N, White CL, Bravo G, Cote R, Greene T, Lanthier S, Wood-Dauphinee S. YOU CALL ? WE CALL Trial: Impact of a Multimodal Support Intervention After a ?Mild? Stroke; 2013 Feb. (International Stroke Conference - State-of-the-Science Stroke Nursing Symposium).

Szychowski JM, McClure LA, White CL, Pergola PE, Benavente OR, Coffey CS. Factors Affecting Time to Achieve Assigned Blood Pressure Targets in the Secondary Prevention of Small Subcortical Strokes (SPS3) Trial; 2013 Feb. (International Stroke Conference).

Dhamoon MS, McClure LA, White CL, Benavente OR, Elkind MSV. Quality of life after lacunar stroke: the Secondary Prevention of Small Subcortical Strokes (SPS3); 2012 Oct. (American Neurological Association Annual Meeting Abstracts).

Benavente OR, McClure LA, Pergola PE, White CL, Roldan AM, Benavente M-F, Hart RG. Feasibility of Blood Pressure Control in Lacunar Stroke Patients. The Secondary Prevention of Small Subcortical Strokes (SPS3) Trial; 2012 May. (Abstract presented at the European Stroke Meeting).

Lau H, White CL, Coffey CS, Romero J, Babikian V, Pikula A, Kase CS, Benavente OR. Benefits of Clinical Trial Participation for Risk Factor Control: Experience from the SPS3 Study; 2012 Feb. (Stroke).

Electronic/Web Publication

White CL. Strategies to Support Engagement are Key to Managing Risk and Preventing Stroke 2014 Oct. Available from: http://my.americanheart.org/professional/ScienceNews/Strategies-to-Support-Engagement-are-Key-to-Managing-Risk-and-Preventing-Stroke_UCM_469081_Article.jsp .

Journal Article

Odden MC, McClure LA, Sawaya BP, White CL, Peralta CA, Field TS, Hart RG, Benavente OR, Pergola PE. Achieved Blood Pressure and Outcomes in the Secondary Prevention of Small Subcortical Strokes Trial Hypertension 2016 Jan;67:63-69.

Peralta CA, McClure LA, Scherzer R, Odden MC, White CL, Shlipak M, Benavente OR, Pergola PE. The effect of intensive vs. usual blood pressure control on kidney function among persons with prior lacunar stroke: a post-hoc analysis of the SPS3 randomized trial Circulation 2016 Jan;133:584-591.

White CL, Cantu AG, Trevino MM. Interventions for Caregivers of Stroke Survivors: An Update of the Evidence Clinical Nursing Studies 2015 Jan;03(03):87-95.

Field TS, McClure LA, White CL, Pergola PE, Hart RG, Benavente OR, Hill MD. Should blood pressure targets after lacunar stroke vary by body size? The SPS3 Trial American Journal of Hypertension 2015 Jan;28(6):756-764.

Zhu S, McClure LA, Lau H, Romero JR, White CL, Babikian V, Nguyen T, Benavente OR, Kase CS, Pikula A. Recurrent Vascular Events in Patients with Lacunar Stroke, Metabolic Syndrome and/or Diabetes Neurology 2015 Jan;85:935-941.

White CL, Szychowski JM, Pergola PE, Field TS, Talbert RL, Lau H, Peri K, Benavente OR. Can Blood Pressure be Lowered Safely in Older Adults with Lacunar Stroke? The SPS3 Experience Journal of the American Geriatrics Society 2015 Jan;63:722-729.

Lau H, White CL, Coffey C, Kase C, Babikian V, Pikula A, Romero JR, Nguyen T, Benavente OR. Benefits of Clinical Trial Participation for Health Behavior Modification: Experience from the Secondary Prevention of Small Subcortical Strokes (SPS3) Trial Journal of Neurological Disorders and Stroke 2015 Jan;3(1):1-6.

White CL. An Update on Secondary Prevention of Stroke American Nurse Today 2015 Jan;10(12):1-7.

Dhamoon MS, McClure LA, White CL, Lakchminarayan K, Benavente OR, Elkind MSV. Long-term disability after lacunar stroke: Secondary Prevention of Small Subcortical Strokes Study Neurology 2015 Jan;84(10):1002-1008.

White CL, Brady TL, Saucedo LL, Motz D, Sharp J, Birnbaum LA . Toward a Better Understanding of Readmissions after Stroke: Partnering with Stroke Survivors and Caregivers Journal of Clinical Nursing 2015 Jan;24:1091-1100.

Adams AE, White CL, Kennedy GT. Implementing an Evidence-Based Intervention to Improve Care for Ventilator-Dependent Residents in a Nursing Home Facility Clinical Nursing Studies 2015 Jan;3(2):109-114.

Pergola PE, White CL, Szychowski JM, Talbert RL, del Brutto O, Castellanos M, Graves JW, Matamala M, Pretell EJ, Yee J, Rebello R, Zhang Y, Benavente OR. Achieved Blood Pressures in the Secondary Prevention of Small Subcortical Strokes (SPS3) Study: Challenges and Lessons Learned American Journal of Hypertension 2014 Jan;27(8):1052-1060.

White CL, Barrientos R, Dunn K . Dimensions of Uncertainty after Stroke: Perspectives of the Stroke Survivor and Family Caregiver Journal of Neuroscience Nursing 2014 Jan;46(4):233-240.

Dhamoon MS, McClure LA, White CL, Lau H, Benavente OR, Elkind MSV. Quality of life after lacunar stroke: the Secondary Prevention of Small Subcortical Strokes Study (SPS3) Journal of Stroke and Cerebrovascular Diseases 2014 Jan;23:1131-1137.

Barbic SP, Mayo NE, White CL, Bartlett SJ. A model of caregiver Emotional Vitality to support the ?invisible backbone? of our healthcare system Quality of Life Research 2014 Jan;23:2865-2872.

Elkind MSV, Luna JM, McClure LA, Zhang Y, Coffey CS, Spitalnik S, Roldan A, Del Brutto O, Pretell EJ, Pettigrew LC, Meyer B, Tapia J, White CL, Benavente OR. High-sensitivity C-reactive Protein as a Prognostic Marker after Lacunar Stroke: The Levels of Inflammatory Markers in the Treatment of Stroke (LIMITS) Study Stroke 2014 Jan;45:707-716.

Lewis BL, Pearce LA, Field TS, White CL, Benavente OR. Living Supports, Antiplatelet Adherence and Trial Participation: The SPS3 Trial International Journal of Stroke 2014 Jan;9:443-448.

White CL, Szychowski JM, Roldan AM, Benavente MF, Pretell EJ, Del Brutto OH, Kase CS, Arauz A, Meyer BC, Meissner I, Demaerschalk BM, McClure LA, Coffey CS, Pearce LA, Conwit R, Irby LH, Peri K, Pergola PE, Hart RG, Benavente OR for the SPS3 Investigators. Clinical Features and Racial/Ethnic Differences among the 3020 Participants in the Secondary Prevention of Small Subcortical Strokes (SPS3) Trial Journal of Stroke and Cerebrovascular Diseases 2013 Jan;22(6):764-774.

Rochette A, Korner-Bitensky N, Bishop D, Teasell R, White CL, Bravo G, Cote R, Green T, LeBrun LH, Lanthier S, Kapral M, Bayley M. The YOU CALL - WE CALL Randomised Clinical Trial: Impact of a Multimodal Support Intervention after a "Mild" Stroke Circulation: Cardiovascular Quality and Outcomes 2013 Jan;6:674-679.

White CL, Pergola PE, Szychowski JM, Talbert R, Cervantes-Arriaga A, Clark HD, Del Brutto OH, Godoy IE, Hill MD, Pelegri A, Sussman CR, Taylor AA, Valdivia J, Anderson DC, Conwit R, Benavente OR. Blood Pressure after Recent Stroke: Baseline Findings from the Secondary Prevention of Small Subcortical Strokes Trial American Journal of Hypertension 2013 Jan;26(9):1114-1122.

Graves JW, White CL, Szychowski JM, Pergola PE, Benavente OR, Coffey CS, Hornung LM, Hart RG. Predictors of Lowering Systolic Blood Pressure to Assigned Targets at Twelve Months in the Secondary Prevention of Small Subcortical Strokes (SPS3) Study Journal of Hypertension 2012 Jan;30:1233-1240.

Turan TN, Lynn MJ, Nizam A, Lane B, Egan BM, Le NA, Lopes-Virella MF, Hermayer KL, Benavente OR, White CL, Brown WV, Caskey MF, Steiner MR, Vilardo N, Stufflebean A, Derdeyn CP, Fiorella D, Janis S, Chimowitz MI. Rationale, Design, and Implementation of Aggressive Risk Factor Management in the Stenting and Aggressive Medical Management for Prevention of Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) Trial Circulation: Cardiovascular Quality and Outcomes 2012 Jan;5:e51-e60.

Benavente OR, White CL, Pearce L, Pergola PE, Roldan AM, Benavente M.F., Coffey C, McClure L.A., Szychowski J.M., Conwit R., Heberling P.A., Howard G., Bazan C, Vidal-Pergola G., Talbert RL, Hart RG. The Secondary Prevention of Small Subcortical Strokes (SPS3) Study International Journal of Stroke 2011 Jan;6(2):164-175.

Federal
Funding Agency	NIH/NINDS
Title	Secondary Prevention of Small Subcortical Strokes (SPS3) Phase III
Status	Complete
Period	2/2003 - 3/2016
Role	Contributor
Grant Detail	Two randomized, multicenter clinical trials that follow a 3 year NINDS-sponsored pilot study and will enroll 2500 participants (20% of whom will be Hispanic Americans) with symptomatic, MRI-defined S3 without carotid stenosis or major cardiac sources of embolism. Patients are assigned, in a factorial design, to two interventions: 1. Antiplatelet Intervention: 325 mg/d vs aspirin 325 mg/d plus clopidogrel 75 mg/d. 2. Blood Pressure Intervention: systolic blood pressure targets of 130 to 149 mmHg vs <130 mmHg. Mean follow up period of 3.5 years. The NINDS special panel reviewed the grant for renewal on June 2007 (score 1.1). The project was approved by NIH Council for continuation on September 2007 from 2008 to 2011. Resubmission and approved with budget to 2013 with a no-cost extension to March 2014. I had 100% contribtion to the grant from 05/2003 until 01/2010 and 20% contribution from 09/2010 to 03/2014.
Funding Agency	NINDS
Title	A New Paradigm for Hypertension in the Elderly- Beyond Age
Status	Active
Period	3/2013 - 3/2016
Role	Consultant
Grant Detail	Dr. Carole White, PhD is coordinator for the SPS3 study and she is the chair of the publications committee. She is trained in epidemiology and has extensive expertise in examining quality of life, depression, and secondary prevention activities among stroke survivors. As such, Dr. White will be providing guidance on methodology and study design pertaining to SPS3, particularly as it relates to measures of self rated health, cognition and quality of life.
Funding Agency	NINDS
Title	Stenting and Aggressive Medical Management for Prevention of Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) Trial
Status	Complete
Period	10/2008 - 10/2014
Role	Consultant
Grant Detail
Private
Funding Agency	The Nancy Smith Hurd Foundation
Title	Caring for the Caregiver Center Grant
Status	Active
Period	9/2015 - 9/2017
Role	Principal Investigator
Grant Detail	The Caring for the Caregiver Center will provide care, support, and education for caregivers throughout the caregiving trajectory. The aims in developing the Center are to: 1) identify resources/services and build university and community education, service, and research collaboration; 2) evaluate current state of evidence-based care programs that would be appropriate for our San Antonio community; 3) develop and present a plan of action for implementation of the Center.
Funding Agency	San Antonio Area Foundation Grant
Title	Caring for the Caregiver Center: Community Engagement
Status	Active
Period	1/2016 - 12/2016
Role	Principal Investigator
Grant Detail	To better serve family caregivers of those with Alzheimer?s disease in San Antonio, the School of Nursing is developing the Caring for the Caregiver Center, housed within the region?s first comprehensive Institute for Alzheimer and Neurodegenerative Disease. The purpose of this specific project and request is to convene community partners, including family caregivers, to identify strengths and gaps within our current system of care and opportunities for collaborative, comprehensive care.
State
Funding Agency	IIMS Community Engagement Small Project Grants
Title	CARE: A Rural Community Partnership to Address the Health of Family Caregivers
Status	Active
Period	11/2016 - 10/2017
Role	Co-Investigator
Grant Detail
Funding Agency	School of Nursing - Dean`s Catalyst Award
Title	A User-Centered Design Approach to the Development and Feasibility Testing of a Multimodal Mobile Intervention for Stroke Survivors and their Family Caregivers
Status	Complete
Period	6/2013 - 12/2015
Role	Principal Investigator
Grant Detail	Purpose/Objectives: The purpose of this pilot study was to develop and test the feasibility of a multimodal mobile intervention for blood pressure control, targeting underserved stroke survivors and their caregivers. Our long-term goal is to improve blood pressure control in persons at risk for recurrent stroke.

Year	Degree	Discipline	Institution
2003	PhD	Epidemiology & Biostatistics	McGill University Montreal , Canada
1993	MSN	Nursing (Dean's Honor Roll)	McGill University Montreal , Canada
1985	BSN	Nursing (Graduated with Distinction)	University of Saskatchewan Saskatoon , Canada
1980	Certificate	Neuroscience Nursing	Foothills Hospital Calgary , Canada

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