Cheryl Merzel
Cheryl Merzel
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Clinical Associate Professor of Social and Behavioral Sciences, Community Health Science and Practice
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Professional overview
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Cheryl Merzel has over 30 years’ experience in public health research, evaluation, program development, advocacy, and education. She is Director of the GPH Doctor of Public Health program. Previously, she served as the School’s MPH Program Director and as Director of Educational Advancement and Assessment. In addition to NYU, she has served on the public health faculty at a number of institutions including Columbia University Mailman School of Public Health, the City University of New York, and Albert Einstein College of Medicine. Dr. Merzel is currently Editor-in-Chief of the journal Pedagogy in Health Promotion: The Scholarship of Teaching and Learning. Dr. Merzel’s work focuses on the design and evaluation of community-based health promotion interventions and development of community capacity to engage in efforts to improve population health. Past areas of research include adolescent health, maternal and child health, and tobacco control. Her recent work involves developing approaches to support public health practitioners and communities in translating research to relevant, evidence-based practice. Dr. Merzel is committed to improving public health pedagogy through scholarship and innovative teaching practice.
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Education
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BA, Biology, Yeshiva University, New York, NYMS, Jewish Education, Yeshiva University, New York, NYMPH, Sociomedical Sciences, Columbia University, New York, NYDrPH, Sociomedical Sciences/Political Science, Columbia University, New York, NY
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Honors and awards
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Delta Omega Honorary Society in Public Health, Delta Beta Chapter (2016)Calderone Award for Junior Faculty Development, Columbia University (2000)Marissa de Castro Benton Dissertation Prize, Columbia University (1988)Alumni Scholarship, Columbia University (1987)
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Areas of research and study
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Community-based health promotionCommunity-based intervention design and evaluationCommunity-based participatory researchDissemination and Implementation of Evidence-based ProgramsPublic Health Pedagogy
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Publications
Publications
A cost-effectiveness analysis of interventions to increase repeat testing in patients treated for gonorrhea or chlamydia at public sexually transmitted disease clinics
AbstractGift, T. L., Malotte, C. K., Ledsky, R., Hogben, M., Middlestadt, S., Vandevanter, N. L., St. Lawrence, J. S., Laro, M., Paxton, K., Smith, L. V., Settlage, R. H., Davis, R., Richwald, G. A., Penniman, T., Gaines, J., Olthoff, G., Zenilman, J., Vanblerk, G., Ukairo, C., … Pequegnat, W. (n.d.).Publication year
2005Journal title
Sexually Transmitted DiseasesVolume
32Issue
9Page(s)
542-549AbstractBackground: Persons who have been infected with chlamydia or gonorrhea (CT/GC) are at elevated risk for reinfection. The cost-effectiveness of interventions designed to encourage public sexually transmitted disease (STD) clinic patients to return for rescreening has not been well-evaluated. Goal: The goal of this study was to conduct a program- and societal-perspective cost-effectiveness analysis of five interventions designed to encourage public STD clinic patients infected with CT/GC to return for rescreening 3 months after initial treatment. Study: Researchers at two STD clinics collected cost data for the five interventions. These were combined with study data on return rates and CT/GC positivity rates among returning patients to compare the cost-effectiveness of the interventions. Results: The cost per patient counseled with a brief recommendation to return, followed by a telephone reminder after 3 months, was higher than two interventions: a brief recommendation to return with no reminder and a $20 incentive, received on return. However, the brief recommendation with a telephone reminder yielded the highest return rate (33%) and was the least costly in terms of cost per infection treated ($622 program, $813 societal). In-depth motivational counseling that helped clients identify risk factors and provided reasons for returning was more costly than a phone reminder alone and was not more effective. Conclusions: Phone reminders are more cost-effective than motivational counseling and improve return rates over a brief recommendation given at the time of initial treatment.Psychological mediating factors in an intervention to promote adolescent health care-seeking
AbstractHogben, M., Ledsky, R., Middlestadt, S., Vandevanter, N., Messeri, P., Merzel, C., Bleakley, A., Malotte, C. K., Sionean, C. K., & St. Lawrence, J. S. (n.d.).Publication year
2005Journal title
Psychology, Health and MedicineVolume
10Issue
1Page(s)
64-78AbstractSome of the highest rates of curable sexually transmitted diseases in the USA are found among adolescents. Routine, comprehensive health care that includes a sexual history may contribute to alleviating this problem. We designed and ran a three-session small-group workshop for adolescents, using local community organizations as intervention sites, with peers (typically 2-3 years older) helping facilitate the interactive sessions. Outcomes are summarized elsewhere: in this paper, we present an examination of theoretically based psychological mediating factors that we sought to influence during the intervention, Adolescents' health care-seeking beliefs, general attitudes to seeking care, and intentions to do so all changed such that they held more positive beliefs, evaluated health care more favorably, and developed stronger intentions to seek care. Furthermore, relationships among these constructs were strengthened according to theoretical precepts. Adolescents' self-efficacy and their perceptions of social norms pertaining to health care-seeking, however, were unaffected by the intervention. We explored gender differences in mediating factors, finding no interaction, although females did score higher on post-intervention attitude and intention measures.Attitudinal and contextual factors associated with discussion of sexual issues during adolescent health visits
AbstractMerzel, C. R., Vandevanter, N. L., Middlestadt, S., Bleakley, A., Ledsky, R., & Messeri, P. A. (n.d.).Publication year
2004Journal title
Journal of Adolescent HealthVolume
35Issue
2Page(s)
108-115AbstractPurpose To examine attitudinal and contextual factors associated with the occurrence of sexual health assessments during adolescent primary care visits. Methods A total of 313 primarily African-American youth aged 11-21 years from 16 community-based organizations in suburban Maryland and in New York City completed questionnaires focusing on sexually transmitted diseases (STD) and health care. The analysis examined the relationship of sexual activity, attitudes, and presence of the parent at the health care visit with discussion of three sexual health topics and testing for STD at the most recent health care visit. Data were analyzed using Chi-square tests and logistic regression. Results Overall, 74% of respondents reported that they had talked about at least one sexual health topic at their last health care visit but only 32% had discussed all three topics of sexual behavior, birth control, and STD. Females were more likely than males to discuss birth control although there were no gender differences in the overall likelihood of talking about a sexual health topic. Few adolescents initiated discussion of sexual issues. Positive attitudes toward discussing sexual issues with a provider and absence of a parent at the visit were independently associated with higher odds of discussing at least one sexuality topic and STD testing. Conclusions Although relatively large numbers of adolescents in the sample received sexual health assessments, the proportion was below recommended guidelines. The opportunity to speak privately with a clinician and having positive attitudes about discussing sex with a doctor appear to be important influences on the receipt of sexual health assessments. Improving the quality of adolescent preventive care will require creating a health care environment that facilitates discussion of sexual health issues.Comparison of methods to increase repeat testing in persons treated for gonorrhea and/or chlamydia at public sexually transmitted disease clinics
AbstractMalotte, C. K., Ledsky, R., Hogben, M., Larro, M., Middlestadt, S., St. Lawrence, J. S., Olthoff, G., Settlage, R. H., Van Devanter, N. L., Paxton, K., Smith, L. V., Davis, R., Richwald, G. A., Penniman, T. V., Gaines, J., Merzel, C., Messeri, P., Bleakley, A., Weifuse, I., … Pequegnat, W. (n.d.).Publication year
2004Journal title
Sexually Transmitted DiseasesVolume
31Issue
11Page(s)
637-642AbstractBackground: Retesting 3 to 4 months after treatment for those infected with chlamydia and/or gonorrhea has been recommended. Goal: We compared various methods of encouraging return for retesting 3 months after treatment for chlamydia or gonorrhea. Study: In study 1, participants were randomly assigned to: 1) brief recommendation to return, 2) intervention 1 plus $20 incentive paid at return visit, or 3) intervention 1 plus motivational counseling at the first visit and a phone reminder at 3 months. In study 2, participants at 1 clinic were randomly assigned to 4) intervention 1,5) intervention 1 plus phone reminder, or 6) intervention 1 plus motivational counseling but no telephone reminder. Results: Using multiple logistic regression, the odds ratios for interventions 2 and 3, respectively, compared with intervention 1 were 1.2 (95% confidence interval [CI], 0.6-2.5) and 2.6 (95% CI, 1.3-5.0). The odds ratios for interventions 5 and 6 compared with intervention 4 were 18.1 (95% CI, 1.7-193.5) and 4.6 (95% CI, 0.4-58.0). Conclusions: A monetary incentive did not increase return rates compared with a brief recommendation. A reminder phone call seemed to be the most effective method to increase return.Computer Access and Internet Use among Urban Youths
AbstractBleakley, A., Merzel, C. R., VanDevanter, N. L., & Messeri, P. (n.d.).Publication year
2004Journal title
American journal of public healthVolume
94Issue
5Page(s)
744-746AbstractThis report presents data on computer access, Internet use, and factors associated with health information seeking on the Internet among a sample of youths aged 15 to 30 years in New York City. Findings from street intercept surveys indicate substantial computer access at home (62%) and frequent (everyday or a few times a week) Internet use (66%). Fifty-five percent of the sample reported seeking health information on the Internet, which was associated with positive beliefs about getting a health checkup and frequent Internet use.On reconsidering community-based health promotion [3] (multiple letters)
Kuller, L. H., & Merzel, C. R. (n.d.). In American journal of public health (1–).Publication year
2003Volume
93Issue
8Page(s)
1201-1202Reconsidering community-based health promotion: Promise, performance, and potential
AbstractMerzel, C., & D’Afflitti, J. (n.d.).Publication year
2003Journal title
American journal of public healthVolume
93Issue
4Page(s)
557-574AbstractContemporary public health emphasizes a community-based approach to health promotion and disease prevention. The evidence from the past 20 years indicates, however, that many community-based programs have had only modest impact, with the notable exception of a number of HIV prevention programs. To better understand the reasons for these outcomes, we conducted a systematic literature review of 32 community-based prevention programs. Reasons for poor performance include methodological challenges to study design and evaluation, concurrent secular trends, smaller-than-expected effect sizes, limitations of the interventions, and limitations of theories used. The effectiveness of HIV programs appears to be related in part to extensive formative research and an emphasis on changing social norms.Access to health services in an urban community: Does source of care make a difference?
AbstractMerzel, C., & Moon-Howard, J. (n.d.).Publication year
2002Journal title
Journal of Urban HealthVolume
79Issue
2Page(s)
186-199AbstractThe importance of having a usual source of medical care is well established. Few studies, however, examine whether there are differences in health care utilization associated with the type of site used and whether having a primary clinician is more important than site in influencing utilization. The aim of this study was to examine these issues and assess the relative importance of usual source of care characteristics in determining access to a variety of health services. The study was based on a cross-sectional survey of a household probability sample of 695 adults from Central Harlem in New York City. Outcomes examined included use of hospitals as the regular source of care compared with other types of providers, having a usual clinician, receipt of various preventive health services, and illness-related utilization. Multiple logistic regression analysis indicated that men and people of lower socioeconomic status were significantly (P ≤ .05) more likely to rely on hospitals alone as the usual source of care. People who exclusively used hospitals for ambulatory services were 72% less likely to have a primary clinician compared with those using other types of medical care sources. Having a usual source of care of any type was a significant predictor of receipt of five of eight health care services examined; having a main clinician was associated with four of the services. However, type of site used was unrelated to utilization. The impact of having a usual source of care appears to be independent of the effect of having a primary clinical provider, suggesting that having an initial portal into the health care system is as important as possessing an ongoing relationship with a clinician in ensuring access to services. Socioeconomic factors remain important influences on gaining entry into the health care system.Effect of an STD/HIV behavioral intervention on women's use of the female condom
AbstractVan Devanter, N., Gonzales, V., Merzel, C., Parikh, N. S., Celantano, D., & Greenberg, J. (n.d.).Publication year
2002Journal title
American journal of public healthVolume
92Issue
1Page(s)
109-115AbstractObjectives. This study assessed the effectiveness of a sexually transmitted disease (STD)/HIV behavior change intervention in increasing women's use of the female condom. Methods. A total of 604 women at high risk for STDs and HIV in New York City, Baltimore, Md, and Seattle, Wash, enrolled in a randomized controlled trial of a small-group, skills-training intervention that included information and skills training in the use of the female condom. Results. In a logistic regression, the strongest predictors of use were exposure to the intervention (odds ratio [OR] = 5.5; 95% confidence interval [CI] = 2.8, 10.7), intention to use the female condom in the future (OR= 4.5; 95% CI = 2.4, 8.5), having asked a partner to use a condom in the past 30 days (OR= 2.3; 95% CI = 1.3, 3.9), and confidence in asking a partner to use a condom (OR = 1.9; 95% CI= 1.1, 3.5). Conclusions. Clinicians counseling women in the use of the female condom need to provide information, demonstrate its correct use with their clients, and provide an opportunity for their clients to practice skills themselves.Tailoring interventions to the local context and working with community partners: Lessons learned from a multi-site, multi-component intervention study
Middlestadt, S. E., St. Lawrence, J., Merzel, C., Hogben, M., & Bleakley, A. (n.d.).Publication year
2001Journal title
Social Marketing QuarterlyVolume
7Issue
3Page(s)
67-71Gender differences in health care access indicators in an urban, low- income community
AbstractMerzel, C. (n.d.).Publication year
2000Journal title
American journal of public healthVolume
90Issue
6Page(s)
909-916AbstractObjectives. This study examined factors associated with gender differences in health insurance coverage and having a usual source of medical care. Methods. In-person interviews were conducted with a community sample of 695 residents of Central Harlem, New York City. Predictors of the 2 outcome variables and the interaction of key variables with gender were analyzed via logistic regression. Results. No strong patterns emerged to explain gender differentials in having insurance coverage and having a usual provider. However, women employed full time had increased odds of insurance coverage, whereas employment had no similar effect among men. Public assistance evidenced a strong relationship with insurance coverage among both men and women. Socioeconomic factors and health insurance were important independent predictors of having a usual source of health care for men but had little effect among women. Conclusions. Expanding the availability of both public insurance and affordable private coverage for men living in low-income communities is an important means of reducing gender disparities in access to health care. Public assistance is an important means of enabling access to health care for men as well as women.The adolescent years: An academic-community partnership in Harlem comes of age.
AbstractNorthridge, M. E., Vallone, D., Merzel, C., Greene, D., Shepard, P., Cohall, A. T., & Healton, C. G. (n.d.).Publication year
2000Journal title
Journal of public health management and practice : JPHMPVolume
6Issue
1Page(s)
53-60AbstractMuch has been written about the potential benefits in health promotion that are possible through partnerships between academic institutions and community-based organizations, but little practical advice has been provided on how to sustain these relationships when the original grant funds have been exhausted. Here we document our experiences in Harlem, New York City, a community with grave social, structural, and physical environmental inequities, and describe the successes and failings of a partnership now in its "adolescence" between researchers at the Joseph L. Mailman School of Public Health of Columbia University and community activists at West Harlem Environmental Action (WE ACT).Factors influencing participation in weekly support groups among women completing an HIV/STD intervention program
AbstractVandevanter, N., Parikh, N. S., Cohall, R. M., Merzel, C., Faber, N., Litwak, E., Gonzales, V., Kahn-Krieger, S., Messeri, P., Weinberg, G., & Greenberg, J. (n.d.).Publication year
1999Journal title
Women and HealthVolume
30Issue
1Page(s)
15-34AbstractOver the past three decades, the influence and importance of social support has been well documented and the findings have suggested a beneficial effect on stress-related situations, mental and physical health, and social functioning. More recently, small group/skills training behavioral interventions have demonstrated success in changing behaviors which affect the transmission of sexually transmitted diseases, including HIV among populations at risk for these diseases. Studies of support groups to date have been conducted exclusively in research settings where women are offered financial incentives for participation. Little is known about the willingness of women to participate in ongoing support groups after successfully completing a skills training intervention. The present study examines the factors that may influence participation among women in a weekly support group after completing a structured, six session HIV/STD intervention. Both quantitative and qualitative data are collected from 265 women in the intervention arm of a multi-site randomized controlled behavioral intervention trial. Results reveal that less than a quarter (22%) of women participated in at least one support group. Participation varied significantly by site, ranging from 34% to 15% (p =.008). Participation was also strongly linked to recent use of domestic violence services. Qualitative data indicated that although monetary incentives play some role in the woman's decision to participate, other factors are also important. These include program outreach, support group size, salience of the group content, consistency of group leadership from the intervention to the support group, and use of peer leaders along with professional facilitators. Implications for design of post-intervention support groups programs are discussed.The diffusion of innovation in AIDS treatment: Zidovudine use in two New Jersey cohorts
AbstractCrystal, S., Sambamoorthi, U., & Merzel, C. (n.d.).Publication year
1995Journal title
Health Services ResearchVolume
30Issue
4Page(s)
593-614AbstractObjective. This study investigates patterns of utilization of zidovudine (ZDV) by gender, race, risk group, and other respondent characteristics following approval of this treatment. Study Population. Longitudinal observational data were used on a demographically diverse population participating in New Jersey's Medicaid waiver program for persons with symptomatic HIV disease. Data Extraction Methods. Claims data were merged with administrative data on demographic characteristics, risk group, and functional status. Periods of ZDV utilization were determined by analysis of pharmacy claims. Design. The proportion of respondents ever using ZDV (treatment incidence) and the proportion of time on ZDV among users (treatment persistence) were analyzed for a cohort enrolling in 1987 and 1988, and for a cohort enrolling in 1989 and 1990, with follow-up of utilization through August 1992. For each cohort, bivariate analyses were used to compare incidence and persistence by patient subgroup; logistic regression was used to investigate the predictors of incidence in a multivariate model; and OLS regression was used to analyze proportion of time on ZDV among those with any ZDV use. Principal Findings. For the 1987-1988 cohort, substantial race, gender, and risk group differences in utilization were observed, even though all participants in this Medicaid population had financial coverage for ZDV treatment. Treatment incidence was significantly lower for blacks than for others in bivariate comparison (45 percent versus 63 percent had any use of ZDV) and in a logistic regression controlling for a variety of demographic and health status indicators (relative risk .46, CI .31 to .69). Treatment persistence differences were also substantial in the 1987-1988 cohort: among ZDV users, women, blacks, and injection drug users (IDUs) had significantly less persistence in use, and the gender and risk group differences were significant in a multivariate model. In the 1989-1990 cohort, however, both incidence and persistence of treatment converged: no significant differences were observed across demographic groups. Conclusions. Less-advantaged subgroups lagged in access to this new therapy, suggesting the presence of nonfinancial barriers to care. However, these initial differences subsequently converged. Relevance/Impact. Socioeconomic differences have been observed in access to newly introduced treatments for a variety of diseases, reflecting nonfinancial as well as financial barriers to care. Such differences may or may not disappear as use of therapies becomes institutionalized. Monitoring patterns of treatment initiation as well as persistence of treatment over time, using merged data from claims and administrative files, can provide important information on the diffusion of treatments and the extent to which initial disparities are or are not reduced over time.Rethinking Empowerment.
McKenzie, N. F., & Merzel, C. (n.d.). In Beyond crisis (1–).Publication year
1994Page(s)
409-411New Jersey's medicaid waiver for acquired immunodeficiency syndrome
AbstractMerzel, C., Crystal, S., Sambamoorthi, U., Karus, D., & Kurland, C. (n.d.).Publication year
1992Journal title
Health Care Financing ReviewVolume
13Issue
3Page(s)
27-44AbstractThis article contains data from a study of New Jersey's home and community-based Medicaid waiver program for persons with symptomatic human immunodeficiency virus illness. Major findings include lower hospital costs and utilization for waiver participants compared with general Medicaid acquired immunodeficiency syndrome admissions in New Jersey. Average program expenditures were $2,400 per person per month. Based on study findings, it is evident that the waiver program is an important means of providing financial benefits and access to services and that comprehensive case management is a critical factor in assuring program quality.Home care of HIV illness
Crystal, S., Merzel, C., & Kurland, C. (n.d.).Publication year
1990Journal title
Family and Community HealthVolume
13Issue
2Page(s)
29-37Health through three life stages: A longitudinal study of urban black adolescents
AbstractBrunswick, A. F., & Merzel, C. R. (n.d.).Publication year
1988Journal title
Social Science and MedicineVolume
27Issue
11Page(s)
1207-1213AbstractThis is a study of life stage coherence and change in perceived health status and morbidity reports over a 15 year interval bounding adolescence. Data were obtained through personal home interviews with a representative sample (N = 426) of urban black youths who were interviewed at three successive life stages: first when they were adolescents ages 12-17, 6-8 years later when they were ages 18-23, and 7-8 years after that when they were ages 26-31. Results showed that health decline was neither continuous nor progressive over the three life stages. Instead, a dramatic increase in morbidity reports occurring between adolescent and post adolescent measurement was succeeded by stabilization in the following 7 year interval. One interpretation of these findings is that they reflect the stressfulness of the adolescent life stage in the urban black youth cohort. The congruence of this interpretation with Mechanic and Angel's theory of differential health synchrony over the life course and also with Antonovsky's theory of sense of coherence in explaining variations in perceived health is discussed. The study, finally, pointed up a serious methodological impediment to attempting comparative life span health studies such as this, namely, the difficulty in arriving at equivalently comprehensive and sensitive health symptom indicators at different life stages.Biopsychosocial and Epidemiologic Perspectives in Adolescent Health
Krasnegor, N. A., Arasteh, J. D., Cataldo, M. F., Merzel, C., & Brunswick, A. F. (n.d.). In Child health behavior (1–).Publication year
1986Page(s)
94-112Challenging the CON game.
Merzel, C. (n.d.).Publication year
1986Journal title
Health PAC bulletinVolume
16Issue
5Page(s)
13-14Drug use initiation among urban Black youth: A seven-year follow-up of developmental and secular influences
Brunswick, A. F., Merzel, C. R., & Messeri, P. A. (n.d.).Publication year
1985Journal title
Youth & SocietyVolume
17Issue
2Page(s)
189-216