Alexis Gallardo Foreman, DNP, MSN, FNP-BC
Assistant Professor
Boston University Chobanian & Avedisian School of Medicine
Medicine

MSN, Regis College
MA, Lesley University
BS, Regis College
BA, Bethany College

Pronouns: she/her/hers



My career has consistently focused on promoting diversity and equity within marginalized communities. Prior to my career in medicine, holding a Master's in Intercultural Relations with a background in cultural competemility training, I collaborated with Dr. Alex Green and Dr. Joseph Betancourt at Massachusetts General Hospital to develop online cultural training programs for healthcare providers, focusing on understanding and demystifying cultural beliefs and norms. This work highlighted the underrepresentation of Latine professionals in healthcare and inspired my NP career.

As a doctorally prepared Nurse Practitioner (NP), I have dedicated the past 13 years to serving marginalized patients facing barriers such as food and housing insecurity, inadequate transportation, lack of dependent care, and low health literacy. I have witnessed firsthand the devastating impact of these barriers on health disparities. Early in my NP career at the East Boston Neighborhood Health Center, I leveraged my shared cultural background to create a patient-informed, multilingual (English, Spanish, Portuguese, and Arabic) exercise and dietary wellness program providing hands-on diabetes self-management education. The program was well-received, and patients reported increased confidence in managing their diabetes through diet and exercise efforts.

At Boston University/Boston Medical Center (BMC), in the Pulmonary Department, I've witnessed how these disparities manifest as advanced lung disease, including COPD and poorly controlled asthma, often stemming from limited access to preventive care, social determinants of health, low health literacy, and challenges navigating the healthcare system. With mentorship from Dr. Hasmeena Kathuria and Dr. Fred Little, and in collaboration with community health worker (CHW) Jinesa Howard, MPH, I developed a COPD readmission reduction program that successfully decreased hospital-wide COPD readmissions to 17.9% by addressing patients' social determinants of health. Dr. Kathuria's subsequent study validated this innovative NP/CHW model, which included increased patient touchpoints and resources to reduce barriers to care. This led to mentorship requests from other hospitals, educational presentations on addressing COPD patient needs (including nicotine dependence), and secured funding for educational resources. With this funding, we created accessible (English and Spanish) educational videos and handouts on inhaler techniques and nicotine replacement therapy, which are now used to educate patients, providers, and staff.

As a member of the Pulmonary Sleep team, I expanded my work beyond COPD to treat patients with Chronic Respiratory Failure across various etiologies, including restrictive lung diseases, neuromuscular conditions, and sleep-disordered breathing. With the mentorship of Dr. Eric Heckman, together we Co-Direct the Chronic Respiratory Failure clinic and provide inpatient consultations to optimize patient care and ensure smooth transitions to post-discharge follow-up.

As a Trained Tobacco Cessation Specialist, recently appointed Co-Director of BMC's Tobacco Dependence Treatment program, I work alongside fellow NP Cornelia Wakeman, Dr. Lauren Kearney, Dr. Zack Rich, Parixit Kathwadia, MPH, and Jennifer Margolis, MPH to provide smoking cessation education and therapy to the more than 400 patients admitted monthly with a history of tobacco use and those needing follow-up care. We provide counseling via telehealth and in-person visits, with referrals from within BMC and community health centers. Recognizing that our BMC patient population is disproportionately screened for lung cancer due to inaccurate data on tobacco use and screening criteria, we have teamed up with Dr. Katrina Steiling’s Lung Cancer Screening team to address gaps in knowledge through various community events where we engage with patients and answer questions using our “piggy lungs” to promote education and vape and smoking cessation. Our goal for the new year is to offer nicotine replacement therapy (NRT) training to colleagues across the health system to increase provider comfort with prescribing NRT.

In 2023, I obtained my Doctorate in Nursing with my scholarly practice project focused on creating a culturally sensitive survey to assess a patient with long COVID and their interest in participating in an in-person or online Pulmonary Rehabilitation program. I received my Bachelor's, Master's, and Doctorate Nursing degrees from Regis College and hold a Master's in Intercultural Relations from Lesley University. I have a background in writing training programs to promote cultural awareness among healthcare providers. I'm a member of the Boston University Medical Group and Pulmonary Department’s Equity, Vitality, and Inclusion committees and an active member of the Advanced Practice Providers (APPs) Department of Medicine workgroup and a member of the APP Council. Lastly, I'm a member of the American Academy of Nurse Practitioners and a member of the Massachusetts Coalition of Nurse Practitioners.

Diversity, Equity, Inclusion and Accessibility

My nursing career started later in life as I became a Nurse, then a Nurse Practitioner in my early 30s. I have always worked in the realm of diversity and equity among marginalized communities, but it wasn’t until I worked alongside physicians who were writing cultural training programs for providers that I understood the dire need for providers from underrepresented groups. I have found my nursing career to be one of great reward and fulfillment but also a great responsibility. For the past 10 years of practice, I have devoted my training to caring for patients from marginalized communities with little access to resources like food, housing, transportation, dependent care, and education. I have used my shared culture to encourage upward mobility among patients who look like me. I’ve sought resources to push patient care forward by creating programs to help patients improve their diabetes through exercise and dietary wellness programs that are designed and influenced by patient culture. I’ve created teach-back programs to help patients better understand their disease process and how to effectively use inhalers and medications in multiple languages and various media offerings. Since COVID, the stakes for patient care have escalated and the providers in the field have burnt out or left the field. The need to teach up the next wave of providers is paramount. I recently obtained my Doctor of Nursing degree and have made it my mission to share my knowledge and experience with the next generation of Nurses and Nurse Practitioners. My research entitled, A Pilot Study To Assess Association Of Social Determinants Of Health (SDOH) On Choice Of Participation In An Online Or In-person COVID Pulmonary Rehabilitation Program At A Large Safety Net Hospital In New England, highlights the need to address barriers of access to "long COVID" therapy.

Member
Boston University
Pulmonary Center


Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Faculty can login to make corrections and additions.

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  1. Flores A, Wiener RS, Hon S, Wakeman C, Howard J, Virani N, Mattus B, Foreman AG, Singh J, Rosen L, Bulekova K, Kathuria H. Sustainability of an Opt-Out Electronic-Health Record-Based Tobacco Treatment Consult Service at a Large Safety-Net Hospital: A 6-Year Analysis. Nicotine Tob Res. 2024 Jul 22; 26(8):1081-1088.View Related Profiles. PMID: 38320328
     
  2. Shusterman S, Villarreal-Calderon R, Gunawan A, Gallardo Foreman A, O'Donnell C, Wakeman C, Javeed H, Keteyian J, Howard J, Bulekova K, de Silva S, Campbell T, Lasser K, Kathuria H. A Financial Incentives Program to Promote Smoking Cessation Among Recently Hospitalized Individuals: Feasibility and Acceptability Study. JMIR Form Res. 2023 May 29; 7:e44979.View Related Profiles. PMID: 37247216; PMCID: PMC10262029; DOI: 10.2196/44979;
     
  3. Kathuria H, Gunawan A, Spring M, Aijaz S, Cobb V, Fitzgerald C, Wakeman C, Howard J, Clancy M, Foreman AG, Truong V, Wong C, Steiling K, Lasser KE, Bulekova K, Wiener RS. Hospitalization as an opportunity to engage underserved individuals in shared decision-making for lung cancer screening: results from two randomized pilot trials. Cancer Causes Control. 2022 Nov; 33(11):1373-1380.View Related Profiles. PMID: 35997854; DOI: 10.1007/s10552-022-01620-8;
     
  4. Kearney L, Wiener RS, Dahodwala M, Fix GM, Hicks J, Little F, Howard J, Foreman AG, Wakeman C, O'Donnell C, Bulekova K, Drainoni ML, Kathuria H. A mixed methods study to inform and evaluate a longitudinal nurse practitioner/community health worker intervention to address social determinants of health and chronic obstructive pulmonary disease self-management. BMC Pulm Med. 2022 Mar 01; 22(1):74.View Related Profiles. PMID: 35232414; PMCID: PMC8889692; DOI: 10.1186/s12890-022-01863-w;
     

This graph shows the total number of publications by year, by first, middle/unknown, or last author.

Bar chart showing 4 publications over 3 distinct years, with a maximum of 2 publications in 2022

YearPublications
20222
20231
20241

Contact for Mentoring:

72 East Concord Street
Boston MA 02118
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