David Abramson
David Abramson
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Clinical Associate Professor of Social and Behavioral Sciences
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Professional overview
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Dr. David Abramson is a Clinical Associate Professor at NYU’s School of Global Public Health and the director of the research program on Population Impact, Recovery and Resilience (PiR2). His research employs a social ecological framework to examine the health consequences of disasters, individual and community resilience, and long-term recovery from acute collective stressors. His work has focused on population health consequences, interactions of complex systems, and risk communication strategies associated with hurricanes Katrina and Sandy, the Joplin tornado, the Deepwater Horizon oil spill, H1N1, and Zika, among other natural, technological, and man-made disasters. Before joining NYU’s faculty, Dr. Abramson was the Deputy Director at Columbia University’s National Center for Disaster Preparedness at the Earth Institute.
In 2005 Dr. Abramson launched the Gulf Coast Child and Family Health study, an ongoing longitudinal cohort study of over 1,000 randomly sampled Katrina survivors in Louisiana and Mississippi, which is presently a core research project in the NIH-funded Katrina@10 Program (P01HD082032, NICHD). After Superstorm Sandy he partnered with colleagues at Rutgers University, Columbia University, and the University of Colorado to conduct the Sandy Child and Family Health study, an observational cohort study modeled on the Katrina study. More recently, he was funded by the National Science Foundation and the Robert Wood Johnson Foundation to study the risk salience of an evolving threat, the Zika virus, among the US population in general and among women of child-bearing age. In addition, Dr. Abramson serves on two National Academies of Medicine panels, the Standing Committee on Medical and Public Health Research During Large-Scale Emergency Events, and the Committee on Evidence-Based Practices for Public Health Emergency Preparedness and Response.
Prior to entering the field of public health, Dr. Abramson spent a decade as a national magazine journalist, having worked at or written for such publications as Rolling Stone, Esquire, and Outside magazines, and was a nationally-certified paramedic. He has a PhD in sociomedical sciences, with a sub-specialization in political science, and an MPH, both from Columbia University.
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Education
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BA, English (High Honors), Queens College, New York, NYMPH, Sociomedical Sciences, Columbia University, New York, NYPhD, Sociomedical Sciences/Political Science, Columbia University, New York, NY
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Honors and awards
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Columbia University Alumni Association Scholarship (2003)Eugene Litwak Prize for best doctoral dissertation proposal, Mailman School of Public Health (2002)Columbia University School of Public Health Alumni Association Scholarship Award (1982)Nyack Hospital Paramedic Program Valedictorian (1989)
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Areas of research and study
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Community HealthDisaster HealthDisaster Impact and RecoveryEnvironmental ImpactPopulation HealthPublic Health SystemsSocial BehaviorsSocial Determinants of Health
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Publications
Publications
Children as bellwethers of recovery: Dysfunctional systems and the effects of parents, households, and neighborhoods on serious emotional disturbance in children after Hurricane Katrina
AbstractAbramson, D. M., Park, Y. S., Stehling-Ariza, T., & Redlener, I. (n.d.).Publication year
2010Journal title
Disaster medicine and public health preparednessVolume
4Page(s)
S17-S27AbstractBackground: Over 160 000 children were displaced from their homes after Hurricane Katrina. Tens of thousands of these children experienced the ongoing chaos and uncertainty of displacement and transiency, as well as significant social disruptions in their lives. The objectives of this study were to estimate the long-term mental health effects of such exposure among children, and to elucidate the systemic pathways through which the disaster effect operates. Methods: The prevalence of serious emotional disturbance was assessed among 283 school-aged children in Louisiana and Mississippi. These children are part of the Gulf Coast Child & Family Health Study, involving a longitudinal cohort of 1079 randomly sampled households in the two states, encompassing a total of 427 children, who have been interviewed in 4 annual waves of data collection since January 2006. The majority of data for this analysis was drawn from the fourth round of data. Results: Although access to medical care for children has expanded considerably since 2005 in the region affected by Hurricane Katrina, more than 37% of children have received a clinical mental health diagnosis of depression, anxiety, or behavior disorder, according to parent reports. Children exposed to Hurricane Katrina were nearly 5 times as likely as a pre-Katrina cohort to exhibit serious emotional disturbance. Path analyses confirm the roles played by neighborhood social disorder, household stressors, and parental limitations on children's emotional and behavioral functioning. Conclusions: Children and youth are particularly vulnerable to the effects of disasters. They have limited capacity to independently mobilize resources to help them adapt to stressful postdisaster circumstances, and are instead dependent upon others to make choices that will influence their household, neighborhood, school, and larger social environment. Children's mental health recovery in a postdisaster setting can serve as a bellwether indicator of successful recovery or as a lagging indicator of system dysfunction and failed recovery.Emergency response and public health in Hurricane Katrina: What does it mean to be a public health emergency responder?
AbstractVan Devanter, N., Leviss, P., Abramson, D., Howard, J. M., & Honoré, P. A. (n.d.).Publication year
2010Journal title
Journal of Public Health Management and PracticeVolume
16Issue
6Page(s)
E16-E25AbstractSince 9/11, federal funds directed toward public health departments for training in disaster preparedness have dramatically increased, resulting in changing expectations of public health workers' roles in emergency response. This article explores the public health emergency responder role through data collected as part of an oral history conducted with the 3 health departments that responded to Hurricane Katrina in Mississippi and Louisiana. The data reveals a significant change in public health emergency response capacity as a result of federal funding. The role is still evolving, and many challenges remain, in particular, a clear articulation of the public health role in emergency response, the integration of the public health and emergency responder cultures, identification of the scope of training needs and strategies to maintain new public health emergency response skills, and closer collaboration with emergency response agencies.Experiences of Public health workers in responding to Hurricane Katrina: Voices from the storm
Moon-Howard, J., VanDevanter, N., Abramson, D., Leviss, P., & Honoré, P. A. (n.d.).Publication year
2010Journal title
Journal of Public Health Management and PracticeMeasuring individual disaster recovery: A socioecological framework
AbstractAbramson, D. M., Stehling-Ariza, T., Park, Y. S., Walsh, L., & Culp, D. (n.d.).Publication year
2010Journal title
Disaster medicine and public health preparednessVolume
4Page(s)
S46-S54AbstractBackground: Disaster recovery is a complex phenomenon. Too often, recovery is measured in singular fashion, such as quantifying rebuilt infrastructure or lifelines, without taking in to account the affected population's individual and community recovery. A comprehensive framework is needed that encompasses a much broader and far-reaching construct with multiple underlying dimensions and numerous causal pathways; without the consideration of a comprehensive framework that investigates relationships between these factors, an accurate measurement of recovery may not be valid. This study proposes a model that encapsulates these ideas into a single framework, the Socio-Ecological Model of Recovery. Methods: Using confirmatory factor analysis, an operational measure of recovery was developed and validated using the five measures of housing stability, economic stability, physical health, mental health, and social role adaptation. The data were drawn from a sample of displaced households following Hurricane Katrina. Measures of psychological strength, risk, disaster exposure, neighborhood contextual effects, and formal and informal help were modeled to examine their direct and indirect effects on recovery using a structural equation model. Findings: All five elements of the recovery measure were positively correlated with a latent measure of recovery, although mental health and social role adaptation displayed the strongest associations. An individual's psychological strength had the greatest association with positive recovery, followed by having a household income greater than $20 000 and having informal social support. Those factors most strongly associated with an absence of recovery included the time displaced since the hurricane, being disabled, and living in a community with substantial social disorder. Discussion: The socio-ecological framework provides a robust means for measuring recovery, and for testing those factors associated with the presence or absence of recovery.Recovery research, Katrina's fifth anniversary, and lessons relearned
Redlener, I., & Abramson, D. M. (n.d.).Publication year
2010Journal title
Disaster medicine and public health preparednessVolume
4Page(s)
S8-S9Lessons from Katrina – What Went Wrong, What Was Learned, Who’s Most Vulnerable
Abramson, D., Redlener, I., & Garfield, R. (n.d.).Publication year
2009Journal title
Cardozo Journal of Law and GenderVolume
14Issue
2Page(s)
783 - 790Analyzing postdisaster surveillance data: The effect of the statistical method
AbstractDi Maggio, C., Abramson, D., & Galea, S. (n.d.).Publication year
2008Journal title
Disaster medicine and public health preparednessVolume
2Issue
2Page(s)
119-126AbstractData from existing administrative databases and ongoing surveys or surveillance methods may prove indispensable after mass traumas as a way of providing information that may be useful to emergency planners and practitioners. The analytic approach, however, may affect exposure prevalence estimates and measures of association. We compare Bayesian hierarchical modeling methods to standard survey analytic techniques for survey data collected in the aftermath of a terrorist attack. Estimates for the prevalence of exposure to the terrorist attacks of September 11, 2001, varied by the method chosen. Bayesian hierarchical modeling returned the lowest estimate for exposure prevalence with a credible interval spanning nearly 3 times the range of the confidence intervals (Cls) associated with both unadjusted and survey procedures. Bayesian hierarchical modeling also returned a smaller point estimate for measures of association, although in this instance the credible interval was tighter than that obtained through survey procedures. Bayesian approaches allow a consideration of preexisting assumptions about survey data, and may offer potential advantages, particularly in the uncertain environment of postterrorism and disaster settings. Additional comparative analyses of existing data are necessary to guide our ability to use these techniques in future incidents. (Disaster Med Public Health Preparedness. 2008;2:119-126).Prevalence and predictors of mental health distress post-katrina: Findings from the gulf coast child and family health study
AbstractAbramson, D., Stehling-Ariza, T., Garfield, R., & Redlener, I. (n.d.).Publication year
2008Journal title
Disaster medicine and public health preparednessVolume
2Issue
2Page(s)
77-86AbstractBackground: Catastrophic disasters often are associated with massive structural, economic, and population devastation; less understood are the long-term mental health consequences. This study measures the prevalence and predictors of mental health distress and disability of hurricane survivors over an extended period of recovery in a postdisaster setting. Methods: A representative sample of 1077 displaced or greatly affected households was drawn in 2006 using a stratified cluster sampling of federally subsidized emergency housing settings in Louisiana and Mississippi, and of Mississippi census tracts designated as having experienced major damage from Hurricane Katrina in 2005. Two rounds of data collection were conducted: a baseline face-to-face interview at 6 to 12 months post-Katrina, and a telephone follow-up at 20 to 23 months after the disaster. Mental health disability was measured using the Medical Outcome Study Short Form 12, version 2 mental component summary score. Bivariate and multivariate analyses were conducted examining socioeconomic, demographic, situational, and attitudinal factors associated with mental health distress and disability. Results: More than half of the cohort at both baseline and follow-up reported significant mental health distress. Self-reported poor health and safety concerns were persistently associated with poorer mental health. Nearly 2 years after the disaster, the greatest predictors of poor mental health included situational characteristics such as greater numbers of children in a household and attitudinal characteristics such as fatalistic sentiments and poor self-efficacy. Informal social support networks were associated significantly with better mental health status. Housing and economic circumstances were not independently associated with poorer mental health. Conclusions: Mental health distress and disability are pervasive issues among the US Gulf Coast adults and children who experienced long-term displacement or other serious effects as a result of Hurricanes Katrina and Rita. As time progresses postdisaster, social and psychological factors may play greater roles in accelerating or impeding recovery among affected populations. Efforts to expand disaster recovery and preparedness policies to include long-term social re-engagement efforts postdisaster should be considered as a means of reducing mental health sequelae. (Disaster Med Public Health Preparedness. 2008;2:77-86).Children and Megadisasters: Lessons Learned in the New Millennium
AbstractGarrett, A. L., Grant, R., Madrid, P., Brito, A., Abramson, D., & Redlener, I. (n.d.).Publication year
2007Journal title
Advances in PediatricsVolume
54Issue
1Page(s)
189-214AbstractMany specific lessons were learned from recent megadisasters in the United States at the expense of children who suffered from a government and a citizenry that was desperately unprepared to respond to and recover from the disaster's short- and long-term effects. During the 9/11 attacks, the nation learned a new sense of vulnerability as the specter of terrorism was delivered repeatedly to our collective consciousness. As this article has emphasized, children experienced significant and widespread psychological effects from this event, and many did not receive adequate treatment. Hurricane Katrina exploited the weaknesses of an already strained child mental health system and vividly demonstrated the liability of poor preparedness and inadequate communication by both families and governments. The impact of Katrina continues to affect many thousands of children over a year later, as the systems that were intended to care for them have largely moved on. Indeed, there was no mention of Hurricane Katrina, the Gulf Coast, or the storm's survivors in the 2007 State of the Union address by the President. After 9/11 and the unprecedented federal spending that occurred to increase our nation's readiness, it is discouraging that the response to Hurricane Katrina fell so short of what had the potential to be the greatest disaster response and recovery story in the history of our nation. It is unlikely that further uncontained expenditures will solve the problems that were exposed in the Gulf Coast. There is not a solution that money can buy. One need only look a few hundred miles south to the Cuban disaster response system to appreciate where some of our shortfalls lie. Cuba has succeeded where the United States has not in part because its citizens are participants in their own preparedness. They engage their children and their families in preparedness planning and they rely upon other members of their community to strengthen their ability to survive as individuals. The American mentality of "dial 911 in an emergency and wait for help" works only as long as there are enough resources to match the need. In a disaster, this approach has proven to be inadequate over and over again. In America, we are well positioned to be leaders in responding to the needs of children affected by disaster. The resources of our government and the resourcefulness of our people should offer much promise for the future. By analyzing our past shortfalls and taking practical steps to mitigate the existing barriers to preparedness, our children, we hope, will fare much better the next time a megadisaster strikes. Box 7 includes suggestions for national priorities for child disaster care.Housing need, housing assistance, and connection to HIV medical care
AbstractAidala, A. A., Lee, G., Abramson, D. M., Messeri, P., & Siegler, A. (n.d.).Publication year
2007Journal title
AIDS and BehaviorVolume
11Page(s)
S101-S115AbstractHIV infection has become a chronic condition that for most persons can be effectively managed with regular monitoring and appropriate medical care. However, many HIV positive persons remain unconnected to medical care or have less optimal patterns of health care utilization than recommended by good clinical practice standards. This paper investigates housing status as a contextual factor affecting access and maintenance in appropriate HIV medical care. Data provided from 5,881 interviews conducted from 1994 to 2006 with a representative sample of 1,661 persons living with HIV/AIDS in New York City demonstrated a strong and consistent relationship between housing need and remaining outside of or marginal to HIV medical care. In contrast, housing assistance increased access and retention in medical care and appropriate treatment. The relationship between housing and medical care outcomes remain controlling for client demographics, health status, insurance coverage, co-occurring mental illness, and problem drug use and the receipt of supportive services to address co-occurring conditions. Findings provide strong evidence that housing needs are a significant barrier to consistent, appropriate HIV medical care, and that receipt of housing assistance has an independent, direct impact on improved medical care outcomes.Patient satisfaction with different interpreting methods: A randomized controlled trial
AbstractGany, F., Leng, J., Shapiro, E., Abramson, D., Motola, I., Shield, D. C., & Changrani, J. (n.d.).Publication year
2007Journal title
Journal of general internal medicineVolume
22Page(s)
312-318AbstractBACKGROUND: Growth of the foreign-born population in the U.S. has led to increasing numbers of limited-English-proficient (LEP) patients. Innovative medical interpreting strategies, including remote simultaneous medical interpreting (RSMI), have arisen to address the language barrier. This study evaluates the impact of interpreting method on patient satisfaction. METHODS: 1,276 English-, Spanish-, Mandarin-, and Cantonese-speaking patients attending the primary care clinic and emergency department of a large New York City municipal hospital were screened for enrollment in a randomized controlled trial. Language-discordant patients were randomized to RSMI or usual and customary (U&C) interpreting. Patients with language-concordant providers received usual care. Demographic and patient satisfaction questionnaires were administered to all participants. RESULTS: 541 patients were language-concordant with their providers and not randomized; 371 were randomized to RSMI, 167 of whom were exposed to RSMI; and 364 were randomized to U&C, 198 of whom were exposed to U&C. Patients randomized to RSMI were more likely than those with U&C to think doctors treated them with respect (RSMI 71%, U&C 64%, p < 0.05), but they did not differ in other measures of physician communication/care. In a linear regression analysis, exposure to RSMI was significantly associated with an increase in overall satisfaction with physician communication/care (β 0.10, 95% CI 0.02-0.18, scale 0-1.0). Patients randomized to RSMI were more likely to think the interpreting method protected their privacy (RSMI 51%, U&C 38%, p < 0.05). Patients randomized to either arm of interpretation reported less comprehension and satisfaction than patients in language-concordant encounters. CONCLUSIONS: While not a substitute for language-concordant providers, RSMI can improve patient satisfaction and privacy among LEP patients. Implementing RSMI should be considered an important component of a multipronged approach to addressing language barriers in health care.Public health disaster research: surveying the field, defining its future.
Abramson, D. M., Morse, S. S., Garrett, A. L., & Redlener, I. (n.d.).Publication year
2007Journal title
Disaster medicine and public health preparednessVolume
1Issue
1Page(s)
57-62HIV-positive men sexually active with women: Sexual behaviors and sexual risks
AbstractAidala, A. A., Lee, G., Howard, J. M., Caban, M., Abramson, D., & Messeri, P. (n.d.).Publication year
2006Journal title
Journal of Urban HealthVolume
83Issue
4Page(s)
637-655AbstractThis study examines patterns of sexual behavior, sexual relating, and sexual risk among HIV-positive men sexually active with women. A total of 278 HIV-positive men were interviewed every 6-12 months between 1994 and 2002 and reported considerable variability in sexual behaviors over time. Many were not sexually active at all for months at a time; many continued to have multiple female and at times male partners. Over one-third of the cohort had one or more periods when they had engaged in unprotected sex with a female partner who was HIV-negative or status unknown (unsafe sex). Periods of unsafe sex alternated with periods of safer sex. Contextual factors such as partner relations, housing status, active drug use, and recently exchanging sex showed the strongest association with increased odds of unsafe sex. A number of predictors of unsafe sex among African American men were not significant among the Latino sub-population, suggesting race/ethnic differences in factors contributing to heterosexual transmission. Implications for prevention interventions are discussed.Antiretroviral therapy and declining AIDS mortality in New York City
AbstractMesseri, P., Gunjeong, L., Abramson, D., Aidala, A., Chiasson, M. A., & Jessop, D. J. (n.d.).Publication year
2003Journal title
Medical CareVolume
41Issue
4Page(s)
512-521AbstractOBJECTIVE. This study estimates the impact of Highly Active Antiretroviral Therapy (HAART) and other antiretroviral therapy combinations on reducing mortality risk for a cohort of HIV-infected persons living in New York City. MATERIALS AND METHODS. Data for this study come from the CHAIN project, an ongoing multiwave longitudinal study of HIV-infected persons is living in New York City (n = 700) initiated in 1994. The study sample is drawn from the clients of 43 medical and social service agencies and is broadly representative of New York City residents, who were aware of their positive serostatus at time of enrollment. Occurrences of deaths were obtained through routine field tracking and searches of death certificates and an online death registry. Information on other study variables was obtained through in-person interviews. A Cox proportional hazard model was applied to estimate the effects of medication on mortality risk. RESULTS. Mortality rates for the CHAIN cohort dropped steadily from a high of 131 deaths per 1000 persons/year in 1995 to 31 deaths per 1000 persons/year in 1999, with the historically low mortality rates continuing through 2000. Current use of HAART was associated with a 50% reduction in mortality risk (hazard ratio = 0.51, PAntiretroviral therapy and declining AIDS mortality in New York City
AbstractMesseri, P., Gunjeong, L., Abramson, D. M., Aidala, A., Chiasson, M. A., & Jessop, D. J. (n.d.).Publication year
2003Journal title
Medical careVolume
41Issue
4Page(s)
512-521AbstractOBJECTIVE. This study estimates the impact of Highly Active Antiretroviral Therapy (HAART) and other antiretroviral therapy combinations on reducing mortality risk for a cohort of HIV-infected persons living in New York City. MATERIALS AND METHODS. Data for this study come from the CHAIN project, an ongoing multiwave longitudinal study of HIV-infected persons is living in New York City (n = 700) initiated in 1994. The study sample is drawn from the clients of 43 medical and social service agencies and is broadly representative of New York City residents, who were aware of their positive serostatus at time of enrollment. Occurrences of deaths were obtained through routine field tracking and searches of death certificates and an online death registry. Information on other study variables was obtained through in-person interviews. A Cox proportional hazard model was applied to estimate the effects of medication on mortality risk. RESULTS. Mortality rates for the CHAIN cohort dropped steadily from a high of 131 deaths per 1000 persons/year in 1995 to 31 deaths per 1000 persons/year in 1999, with the historically low mortality rates continuing through 2000. Current use of HAART was associated with a 50% reduction in mortality risk (hazard ratio = 0.51, P <0.01). CONCLUSIONS. These results demonstrate that in the case of HAART, the therapeutic benefits of an innovative but costly medical treatment are reaching populations that traditionally have poor access to quality health care.The impact of ancillary HIV services on engagement in medical care in New York City
AbstractMesseri, P. A., Abramson, D. M., Aidala, A. A., Lee, F., & Lee, G. (n.d.).Publication year
2002Journal title
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIVVolume
14Page(s)
S15-S29AbstractThe advent of antiretroviral therapies in 1996 prompted an interest in the role played by ancillary services in improving access to and retention in medical care, particularly since the success of the new therapies is often contingent upon ongoing and appropriate primary medical care. Using self-reported survey data from a longitudinal representative sample of 577 HIV-positive adults in New York City, this paper explores the impact of such supportive services as drug treatment, case management, housing assistance, mental health treatment and transportation on engagement with medical care. The study's principal finding was that specific ancillary services were significantly associated with an increase in an individual's likelihood of entering medical care and maintaining appropriate medical care services for HIV, particularly when the services addressed a corresponding need.Passing the Test: New York’s Newborn HIV Testing Policy, 1987-1997
Failed generating bibliography.Publication year
1999The Pocket Guide to Cases of Medicine & Public Health Collaboration
Lasker, R. D., Freedman, (Grace R., & Abramson, D. (n.d.). (1–).Publication year
1998Medicine & Public Health: the Power of Collaboration
Failed generating bibliography.Publication year
1997A balancing act: The tension between case-finding and primary prevention strategies in New York State's voluntary HIV counseling and testing program in women's health care settings
AbstractHealton, C., Howard, J., Messeri, P., Sorin, M. D., Abramson, D., & Bayer, R. (n.d.).Publication year
1996Journal title
American journal of preventive medicineVolume
12Issue
4Page(s)
53-60AbstractThis study sought (1) to identify factors that influence women's willingness to accept voluntary HIV counseling and testing at New York State Family Planning Programs (FPPs) and Prenatal Care Assistance Programs (PCAPs) and (2) to evaluate the effectiveness of such a voluntary counseling and testing program. Telephone interviews elicited organizational-level data from 136 agencies; a combination of telephone and face-to-face interviews was used to gather provider data from 98 HIV counselors; and client data were gathered from 354 women in face-to-face interviews at counseling sites. Slightly fewer than 60% of women agreed to be counseled, and, of those, under half consented to an HIV test at the counseling site. Approximately two thirds of the women who were tested returned for their results and posttest counseling. Clients' recall of pretest counseling content was relatively poor. Bivariate and regression analyses suggest that client, provider, and organizational factors are all associated with rates of pretest counseling and testing. The current voluntary counseling and testing program is achieving only moderate success. Although a substantial number of clients accept HIV counseling, many women remain reluctant to consent to HIV testing, and many who accept testing do not return for their results. Moreover, among those who receive pretest counseling, many do not recall important informational content, which suggests variation may exist in the quality of counseling or that one-time HIV counseling interventions are insufficient to communicate complex information. Medical Subject Headings (MeH): AIDS, HIV serodiagnosis, women's health, patient education.Recruiting Rare and Hard-to- reach Populations: A Sampling Strategy for Surveying NYC Residents Living with HIV/AIDS doi
Abramson, D., Messeri, P., Aidala, A. A., Healton, C., Jessop, D., & Jetter, D. (n.d.).Publication year
1995Journal title
Journal of the American Statistical Association