Back to Faculty Listings

Print the Profile

Diplomas / Degrees

Ph.D., University of Pittsburgh (1998)
M.S.W., University of Pittsburgh (1992)
M.S., Michigan State University (1987)

Recent Courses

Advanced Research Topics
Field Instruction I
Field Instruction I ( O Y R )
Field Instruction I Extended
Field Instruction I I
Field Instruction II
Field Instruction II ( O Y R )
Field Instruction II Extended
Field Instruction III
Field Instruction III Extended
Field Instruction IV
Field Instruction IV Extended
Foundations Of Social Work Practice I
Foundations Of Social Work Practice I
Human Behavior Theory For Social Work Practice I
Program Development And Evaluation

Personal Statement

My professional experiences in social work practice and evaluation enrich my teaching, advising, and scholarship. A medical social worker at the VA Pittsburgh Healthcare System for over seven years, I served a diverse group of veterans and families who were coping with various illnesses and caregiving demands, and I gained invaluable clinical experience across a wide range of health care settings (ambulatory, outpatient, inpatient, intensive care, physical rehabilitation, dementia care, and community nursing homes).

During this odyssey, I worked with older adults who were experiencing co-occurring medical conditions, multiple physical symptoms, and at times, depression. In some situations, the "masking" of sad or blue feelings undermined a patient's awareness of depression and the capacity of family and professionals to detect it, potentially threatening patient safety, care adherence, and discharge planning. I also became intrigued that in response to screening items, many older patients reported lower financial burden than younger patients despite experiencing similar economic circumstances. These limitations in detecting financial burden and depression in underserved elders sparked my interest in the more general phenomenon of biopsychosocial issues that remain hidden or masked, either fully or in part, despite assessment.

I draw upon my clinical skills, practice wisdom, and expertise in evaluation, research, and scholarship when I am in the classroom or advising students and their field instructors at community agencies. For instance, I may share novel ideas from my scholarship about program development or emerging social work roles. In turn, students and field instructors inform me about emerging needs in client populations and new developments in service delivery. I strive to foster this exchange and to integrate new perspectives from the field into teaching, and from teaching into field advising.

My innovative research and grantsmanship emphasize two areas within (and at the nexus of) health and aging:

- characteristics of individuals receiving palliative care who may be at risk of forgoing needed health care, based on interactions of socioeconomic and biopsychosocial factors; and

- clusters of physical symptoms or medical conditions that co-occur in the same individual and are accompanied by depression. (The depression may be hidden or masked, detected through screening, or characterized by distinct depressive symptoms).

I have published novel findings in these areas. I am excited to be pursuing research and scholarship that may foster improvements in social work practice and transprofessional collaboration within health care settings and public health programs.

In addition, I developed extensions to certain quantitative methodologies I frequently use, or discovered improvements in their application. I am seeking to publish these technical innovations in order to enhance, potentially, the utility of future work by other researchers, including doctoral students.

Teaching Specializations / Interests

Social work practice
Human behavior theory
Public health social work
Program development and evaluation
Advanced research topics

Research Interests

My background in clinical practice/programming, and ongoing experience in adapting and applying specific statistical methods and models, have led to important insights and directions in my work, including research on:

1. Hidden clinical issues in underserved patients.

I provided evidence for a coping process by chronically ill elders that may become maladaptive. Older outpatients initiating palliative radiation of cancer may cope with financial stress by accommodating more than younger outpatients to current financial demands (i.e., paying bills), and some may forego needed medical care to do so. Stronger accommodation by older outpatients to current financial circumstances may occur because they may be displacing perceptions of financial inadequacy onto plausible future situations of cancer progression that demand greater healthcare consumption. Older outpatients vulnerable to financial burden (including those foregoing needed healthcare) may be hidden from clinicians because common financial screening items focus solely on current circumstances.

In other research with inner-city African-Americans and Latinos receiving outpatient palliative care, under-insured participants (i.e., those who are uninsured or have limited coverage consisting only of Medicaid) expressed more hopeful pain and symptom attitudes when they disclosed a "religious affiliation." Although a religious affiliation may reflect a specific religious identity, it may also reflect a connection to a religious institution even when the participant does not identify with its religious beliefs or practices. (For instance, participants may attend a church-operated soup kitchen or be visited at home by church members who offer social and material support). The findings suggest that while more hopeful attitudes about pain and symptoms may foster coping in religious-affiliated outpatients, they may also conceal actual problems. Therefore, palliative care programs should proceed carefully in how they integrate religious support networks.

2. Depression presentation and phenomenology.

Other findings from the outpatient sample of African-Americans and Latinos receiving palliative care for diverse medical conditions suggested that a single item with forced-choice response options (either yes or no) to screen for depression in inner-city minorities may fail to detect older minority men at risk; however, the inclusion of a middle category for ambivalent or missing responses improves sensitivity of the item.

In other research with epidemiologic data, I am preparing manuscripts on distinct profiles of depressive symptoms that suggest differences in the overall experience, or phenomenology, of depression in community-residing older adults with progressive vascular conditions (see the next section, "Grants/Sponsored Research," for more details). These findings will also have implications for mental health assessment of older adults.

3. Co-occurring and interacting symptoms (symptom clusters).

This type of research could identify symptom-specific interventions that generate crossover impacts on co-occurring symptoms, resulting in better and more cost-effective strategies for symptom management than treating each symptom separately. Other symptom clusters could reveal when patients experience treatment toxicity or side effects. I am making empirical and methodological contributions to this multidisciplinary research arena:

In 2005, I published an article, cited more than twenty-five times by other scholars, that assessed how co-occurring physical symptoms moderate the relationship between a primary physical symptom and illness malaise. The study suggested that symptoms may participate in different clusters depending on severity and treatment. This oncology research was demanding, in part, because applying traditional methods to evaluate interactions among co-occurring physical symptoms(measured as ordinal variables) was taxing and time-consuming.

Recently, I developed a novel extension to a relatively unknown mathematical procedure that results in a simpler and quicker method for assessment. I am currently applying for funding to demonstrate this innovation using symptom data.

Grants / Sponsored Research

1. National Institute of Mental Health. Research Project Small Grant Award, R03 ($100,000).

This grant provided the funding for me to investigate the etiology and phenomenology of masked depression (with low endorsed dysphoric mood) in community-residing older adults with progressive vascular conditions (i.e., hypertension, atherosclerosis, vascular cognitive impairment, post-stroke cognitive impairment, low diastolic blood pressure) that manifest in specific sociodemographic and comorbidity contexts. This grant also supported an investigation that suggested older minority men (African-Americans and Latinos) from the inner city who were receiving palliative care may be at risk for hidden depression based on their overall attitude towards their physical symptoms.

2. John A. Hartford Foundation. Geriatric Social Work Faculty Scholar Award ($100,000).

Obesity and diabetes are known to accelerate atherosclerosis and vascular conditions. This grant provided the funding for me to investigate the etiology and phenomenology of depression in community-residing older adults when obesity or diabetes occurs in the context of a progressive vascular condition (i.e., hypertension, atherosclerosis, vascular cognitive impairment, stroke, post-stroke cognitive impairment). The identification of at-risk subgroups is important because earlier health and mental health interventions could prevent, identify, or reduce not only depression, but poor glycemic and symptom control, diabetic complications, strokes, and dementia.

3. Project on Death in America, Open Society Institute. Social Work Leadership Development Award ($65,000).

This grant provided the funding for me to investigate predictors and outcomes involving hidden depression, pain and symptom attitudes, religious affiliation, and underinsurance in inner-city African-Americans and Latinos receiving palliative care.

Book Chapters

Francoeur, R. B., & Elkins, J. (2006). Social work practice with older adults with diabetes and complications. In B. Berkman (Eds.). Handbook of Social Work in Health and Aging. (pp. 29-40). New York: Oxford University.

Christ, G., Sormanti, M., & Francoeur, R. (2001). Chronic physical illness and disability. In A. Gitterman (Eds.). Handbook of Social Work Practice with Vulnerable and Resilient Populations. (pp. 124-162). New York: Columbia University.

Recent Articles

Showing first 5 of 13. View All

Francoeur, R. B. (2009, 12). Agency social workers could monitor hypertension in the community. Social Work in Health Care, In Press

Francoeur, R. B. (2007, 12). The influence of age on perceptions of anticipated financial inadequacy by palliative radiation outpatients. Patient Education and Counseling, 69 (1-3), 84-92.

Francoeur, R. B., Payne, R., Raveis, V. H., & Shim, H. (2007, 1). Palliative care in the inner-city: Patient religious affiliation, underinsurance, and symptom attitude. Cancer, 109 (2 Suppl), 425-434.

Francoeur, R. B. (2006, 3). A flexible item to screen for depression in inner-city minorities during palliative care symptom assessment. American Journal of Geriatric Psychiatry, 14 (3), 227-235.

Francoeur, R. B. (2005, 6). Cumulative financial stress and strain in palliative radiation outpatients: The role of age and disability. Acta Oncologica, 44 (4), 369-381.

Invited Presentations and Lectures

Showing first 5 of 10. View All

Francoeur, R. B. (21 March 2008). Issues in palliative care, illness comorbidity, and depression [Adelphi Interdisciplinary Social & Behavioral Sciences Symposium (Part B); initially presented as a Brown Bag Lunch Seminar at the Adelphi University School of Social Work, March 2007]. Garden City, NY.

Francoeur, R. B. (15 May 2005). A flexible item to screen for depression in inner-city African-Americans and Latinos during comprehensive palliative care assessments [Columbia University-New York University Geriatric Education Center (Social Work Module)]. New York, NY.

Francoeur, R. B. (15 October 2003). Comorbid conditions in late-life depression: Diabetes, cerebrovascular disease, and chronic life stress [The October Institute of the Hartford Geriatric Social Work Faculty Scholars Program and the Gerontological Society of America]. Washington, DC.

Francoeur, R. B. (15 July 2003). Religious identity disclosed by underserved minorities in palliative care: A robust predictor of psychological well-being and physical symptom attitudes [Social Work Leaders Retreat, Project on Death in America, Open Society Institute]. Brewster, MA.

Francoeur, R. B. (15 May 2003). Sickness behavior: Depressed affect and comorbid physical symptoms during the initial phase of palliative radiation [Columbia University-New York University Geriatric Education Center (Social Work Module)]. New York, NY.

Conference Presentations and Papers

Showing first 5 of 9. View All

Francoeur, R. B. (15 February 2007). A flexible item to screen for depression in inner-city minorities during palliative care symptom assessment. Annual Assembly of the American Association of Hospice and Palliative Medicine, Salt Lake City, UT.

Francoeur, R. B. (15 February 2007). Palliative care in the inner city: Patient religious affiliation, underinsurance, and symptom attitude. Annual Assembly of the American Association of Hospice and Palliative Medicine, Salt Lake City, UT.

Francoeur, R. B. (15 January 2006). Palliative care for inner-city African Americans and Latinos: Patient religious affiliation, underinsurance, and pain and symptom attitude. Behavioral Research Center, American Cancer Society Conference (Exploring Models to Eliminate Cancer Disparities among African American and Latino Populations: Research and Community Solutions), Atlanta, GA.

Francoeur, R. B. (15 November 2005). A flexible item to screen for depression during comprehensive palliative care assessments of inner-city minorities. Gerontological Society of America, Clinical Medicine Section, Orlando, FL.

Francoeur, R. B. (15 November 2004). Cancer symptom clusters from middle through late adulthood: Pain, comorbid physical symptoms, and depressed affect. Gerontological Society of American, Clinical Medicine Section, Washington, DC.

Selected Dissertations Chaired

Kimiko Tanaka (2007). The Impact of Schizophrenia on Well Siblings: Are Their Narcissistic Needs Met?. Columbia University.

Honors and Accomplishments

Who's Who in America
Who's Who in Social Sciences Higher Education
One course load release for grant proposal development (2008)

Professional Activities

Adelphi University Authors and Artists Exhibition (Swirbul Library, September-October 2008, 2009). In 2008, I exhibited my two peer-reviewed articles published recently in Cancer and in the American Journal of Geriatric Psychiatry; in 2009, I exhibited my peer-review article published recently in Patient Education and Counseling.

Alumni and Friends Event 2008: Understanding and Implementing Evidence-Based Practice, with Ken Shriver, MPH, MD, Adelphi University, Garden City, NY (May 2008). Discussed applications of evidence-based practice to health and aging as part of a panel with two Adelphi social work colleagues (Professors Fenster and Joyce). Specifically, I spoke on "A vision of evidence based practice for health promotion with older adults: An expanded role for community social workers in hypertension screening and management."

Guest speaker for colloquium on: 1) "Social Work in Psychiatric Settings: Identifying Evidence-Based Information Using 'Google Scholar' and 'Google Books'" at Adelphi University School of Social Work, Garden City, NY (November 2009) and 2) "Using 'Google Scholar' to search for practice evidence" at Vassar Brothers Hospital, Poughkeepsie, NY (April 2008). Addressed social work students, alumni, community leaders, and faculty/administration from the Garden City or Hudson Valley campuses. (Sponsored by the New York State Office of Mental Health).

Translation and Diffusion of Geriatric Social Work Research Retreat for Hartford Scholars and Fellows, Chantilly, VA (April 2008). Participant in discussion sessions regarding application of the RE-AIM model for research translation and diffusion into current clinical practice for preventing, ameliorating, or enhancing coping with chronic health conditions.

Research Affiliate, Center for the Psychosocial Study of Health & Illness, Columbia University Mailman School of Public Health (New York, NY). Consultant to Victoria Raveis on her grant-supported intervention for facilitating older caregiver spouses' adjustment to widowhood (2006-2008). I advised on community outreach and linkages to aging programs and services, and I provided clinical feedback and consultation for the interventionists.

Reviewer, Journal of Pain and Symptom Management (2008).

Editorial board and reviewer, Journal of Social Work in End-of-Life & Palliative Care (since 2004).

Editorial board and reviewer, Journal of Psychosocial Oncology (since 1999).

Editorial advisory board and reviewer for the Social Work Series, Journal of Palliative Medicine (2004-2006).

Hartford Faculty Scholars & Doctoral Fellows Research Retreat, John A. Hartford Foundation, Rye, NY (2004).

Community and Corporate Leadership

Adelphi University Faculty Senate Committee on Academic Affairs (September 2008-June 2009)

Founding Member of the Social Work Hospice and Palliative Care Network (SWHPN, January 2008).

Community Advisory Committee to the Physical Health-Mental Health Integration Program, Flushing Hospital Medical Center (Queens borough, New York City, 2007-2008).

Social Work Practice Committee, Chair (Adelphi University School of Social Work, September 2007-June 2010).

Planned the 2004 and 2005 social work continuing education module "Culturally Appropriate Geriatric Care" of the Columbia-New York University Geriatric Education Center (2003-2006).

Hartford Geriatric Faculty Scholars Cohort IV Leadership (Washington, DC) and Teaching (Palo Alto, CA) Institutes, John A. Hartford Foundation (2004).

Assistant Professor, Columbia University School of Social Work (1998-2006).