Danielle C Ompad
Danielle C. Ompad
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Professor of Epidemiology
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Professional overview
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Dr. Danielle Ompad is an epidemiologist whose work is focused in the areas of urban health, HIV, illicit drug use, and adult access to vaccines. With respect to illicit drug use, her work has spanned the entire natural history of addiction – from initiation to cessation, with particular attention paid to risk for infectious diseases such as HIV, hepatitis B and C, and STIs. She has primarily worked with people who use heroin, crack, cocaine, and/or club drugs.
In New York City, she has been examining heroin cessation among current, former, and relapsed heroin users. Working with Alliance for Public Health and the Ukrainian Institute on Public Health Policy, she analyzes harm reduction service utilization among people who inject drugs, in order to optimize service delivery in Ukraine. Since 2013, she has served as faculty for the Fogarty-funded New York State International Training and Research Program with the goal of building research capacity in Ukraine.
Dr. Ompad’s National Institute of Allergy and Infectious Diseases-funded study aims to determine if herpes simplex 1 and 2 infections explain racial disparities in HIV incidence among a cohort of young gay, bisexual, and other men who have sex with men (YMSM). In addition, Dr. Ompad and colleagues are assessing HPV infection prevalence, persistence, and clearance among this same cohort.
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Education
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BS, Biology, Bowie State University, Bowie, MDMHS, Epidemiology, Johns Hopkins University, Baltimore, MDPhD, Epidemiology, Johns Hopkins University, Baltimore, MD
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Honors and awards
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Excellence in Public Health Teaching Award, New York University (2014)Excellence in Public Health Teaching Award, New York University (2013)National Hispanic Science Network on Drug Abuse Scientific Development Travel Fellowship (2010)Delta Omega Honorary Society, Alpha Chapter (2002)
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Areas of research and study
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EpidemiologyHIV/AIDSInfectious DiseasesSocial Determinants of HealthSTIsSubstance AbuseVaccines
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Publications
Publications
Intimate partner violence and consistent condom use among drug-using heterosexual women in New York City
AbstractPanchanadeswaran, S., Frye, V., Nandi, V., Galea, S., Vlahov, D., & Ompad, D. (n.d.).Publication year
2010Journal title
Women and HealthVolume
50Issue
2Page(s)
107-124AbstractThe present study examined the associations of relationship factors, partner violence, relationship power, and condom-use related factors with condom use with a main male partner among drug-using women. Over two visits, 244 heterosexual drug-using women completed a cross-sectional survey. Multivariate logistic regression models indicated that women who expected positive outcomes and perceived lower condom-use barriers were more likely to report condom use with their intimate partners. The findings suggest that future interventions aiming at reducing HIV risk among drug-using women should focus on women's subjective appraisals of risks based on key relationship factors in addition to the occurrence of partner violence.Reducing drug use, human immunodeficiency virus risk, and recidivism among young men leaving jail: Evaluation of the real men re-entry program
AbstractFreudenberg, N., Ramaswamy, M., Daniels, J., Crum, M., Ompad, D. C., & Vlahov, D. (n.d.).Publication year
2010Journal title
Journal of Adolescent HealthVolume
47Issue
5Page(s)
448-455AbstractPurpose: This study assesses the impact of REAL MEN (Returning Educated African-American and Latino Men to Enriched Neighborhoods), an intervention designed to reduce drug use, risky sexual behavior and criminal activity among 16-18-year-old males leaving New York City jails. Methods: Participants (N = 552) were recruited in city jails and randomly assigned to receive an intensive 30-hour jail/community-based intervention or a single jail-based discharge planning session. All participants were also referred to optional services at a community-based organization (CBO). One year after release from jail, 397 (72%) participants completed a follow-up interview. Logistic and ordinary least squares regression was used to evaluate the impact of the intervention on drug use, risky sexual behavior, criminal justice involvement, and school/work involvement post release. Results: Assignment to REAL MEN and, independently, use of CBO services, significantly reduced the odds of substance dependence (odds ratio [OR] = .52, p ≤ .05; OR = .41, p ≤ .05, respectively) 1 year after release. Those assigned to the intervention spent 29 fewer days in jail compared with the comparison group (p ≤ .05). Compared to non-CBO visitors, those who visited the CBO were more likely to have attended school or found work in the year after release (OR = 2.02, p ≤ .01). Conclusions: Jail and community services reduced drug dependence 1 year after release and the number of days spent in jail after the index arrest. While these findings suggest that multifaceted interventions can improve outcomes for young men leaving jail, rates of drug use, risky sexual behavior, and recidivism remained high for all participants after release from jail, suggesting the need for additional policy and programmatic interventions.Sexual risk reduction among non-injection drug users: Report of a randomized controlled trial
AbstractCastor, D., Pilowsky, D. J., Hadden, B., Fuller, C., Ompad, D. C., De Leon, C. L., Neils, G., Hoepner, L., Andrews, H. F., Latkin, C., & Hoover, D. R. (n.d.).Publication year
2010Journal title
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIVVolume
22Issue
1Page(s)
62-70AbstractWe conducted a randomized controlled trial of a sexual risk-reduction intervention targeting non-injection drug users (NIDUs) and members of their drug-use/sexual networks (N=270). The intervention was based primarily on the social-influencing approach, and was delivered in four sessions. Sexual risk behaviors were examined at baseline, and 3, 6, 9, and 12 months after the completion of the intervention using the vaginal equivalent episodes (VEE), a weighted sexual risk behavior index. VEE scores decreased in both the active and control conditions in the first six months post-intervention and continued to decline in the control group. However, in the active condition, VEE scores increased after the nine-month assessment and approached baseline levels by the 12-month assessment. There was no evidence of significant differences in high-risk sexual behaviors between the intervention and control conditions. Future studies are needed to improve behavioral interventions in this population.Vaccinating high-risk patients against influenza: Doing more to protect patients with asthma
Ompad, D., Rohde, G., Wisnivesky, J., Van Essen, G., & Barnes, B. (n.d.).Publication year
2010Journal title
Annals of Respiratory MedicinePage(s)
11-17Neighborhood characteristics and disability in older adults
AbstractBeard, J. R., Blaney, S., Cerda, M., Frye, V., Lovasi, G. S., Ompad, D., Rundle, A., & Vlahov, D. (n.d.).Publication year
2009Journal title
Journals of Gerontology - Series B Psychological Sciences and Social SciencesVolume
64Issue
2Page(s)
252-257AbstractObjective To characterize the influence of the residential neighborhood of older adults on the prevalence of disability.MethodsWe combined Census data on disability in older adults living in New York City with environmental information from a comprehensive geospatial database. We used factor analysis to derive dimensions of compositional and physical neighborhood characteristics and linear regression to model their association with levels of disability. Measures of neighborhood collective efficacy were added to these models to explore the impact of the social environment.ResultsLow neighborhood socioeconomic status, residential instability, living in areas with low proportions of foreign born and high proportions of Black residents, and negative street characteristics were associated with higher prevalence of both "physical" disability and "going outside the home" disability. High crime levels were additionally associated with physical disability, although this relationship disappeared when misdemeanor arrests were removed from the crime variable. Low levels of collective efficacy were associated with more going-outside-the-home disability, with racial/ethnic composition dropping out of this model to be replaced by an interaction term.ConclusionThe urban environment may have a substantial impact on whether an older adult with a given level of functional impairment is able to age actively and remain independent.Protection of racial/ethnic minority populations during an influenza pandemic
AbstractHutchins, S. S., Fiscella, K., Levine, R. S., Ompad, D. C., & McDonald, M. (n.d.).Publication year
2009Journal title
American journal of public healthVolume
99Page(s)
S261-S270AbstractRacial/ethnic minority populations experience worse health outcomes than do othergroups during and after disasters. Evidence for a differential impact from pandemic influenza includes both higher rates of underlying health conditions in minority populations, increasing their risk of influenza-related complications, and larger socioeconomic (e.g., access to health care), cultural, educational, and linguistic barriers to adoption of pandemic interventions. Implementation of pandemic interventions could be optimized by (1) culturally competent preparedness and response that address specific needs of racial/ethnic minority populations, (2) improvements in public health and community health safety net systems, (3) social policies that minimize economic burdens and improve compliance with isolation and quarantine, and (4) relevant, practical, and culturally and linguistically tailored communications.The prevalence and types of gambling among undocumented mexican immigrants in New York City
AbstractMomper, S. L., Nandi, V., Ompad, D. C., Delva, J., & Galea, S. (n.d.).Publication year
2009Journal title
Journal of Gambling StudiesVolume
25Issue
1Page(s)
49-65AbstractObjectives To examine the prevalence of gambling and types of gambling activities in a sample of undocumented Mexican immigrants. Design Non-probability cross-sectional design. Setting New York City. Sample The 431 respondents ranged in age from 18 to 80 (mean age 32), 69.7% were male. Results More than half (53.8%) reported gambling in their lifetime and of those most (43.9%) played scratch and win tickets or the lottery. In multivariate analyses men reported gambling more than women [2.13, 95% CI = (1.03, 4.38)]. The odds of gambling in their lifetime were higher among those reporting sending money to family or friends in the home country [2.65, 95% CI = 1.10, 6.38)], and those who reported 1-5 days as compared to no days of poor mental health in the past 30 days [2.44, 95% CI = 1.22, 4.89)]. Conversely, those who reported entering the U.S. to live after 1996 were less likely to report gambling [0.44, 95% CI = (0.22, 0.89)] as compared to those who had lived in the U.S. longer. Conclusion There is a need to further explore both the prevalence and the severity of gambling amongst the growing population of undocumented Mexican immigrants in the U.S.Access to and use of health services among undocumented Mexican immigrants in a US urban area
AbstractNandi, A., Galea, S., Lopez, G., Nandi, V., Strongarone, S., & Ompad, D. C. (n.d.).Publication year
2008Journal title
American journal of public healthVolume
98Issue
11Page(s)
2011-2020AbstractObjectives. We assessed access to and use of health services among Mexican-born undocumented immigrants living in New York City in 2004. Methods. We used venue-based sampling to recruit participants from locations where undocumented immigrants were likely to congregate. Participants were 18 years or older, born in Mexico, and current residents of New York City. The main outcome measures were health insurance coverage, access to a regular health care provider, and emergency department care. Results. In multivariable models, living in a residence with fewer other adults, linguistic acculturation, higher levels of formal income, higher levels of social support, and poor health were associated with health insurance coverage. Female gender, fewer children, arrival before 1997, higher levels of formal income, health insurance coverage, greater social support, and not reporting discrimination were associated with access to a regular health care provider. Higher levels of education, higher levels of formal income, and poor health were associated with emergency department care. Conclusions. Absent large-scale political solutions to the challenges of undocumented immigrants, policies that address factors shown to limit access to care may improve health among this growing population.Correlates of illicit methadone use in New York City: A cross-sectional study
AbstractOmpad, D. C., Fuller, C. M., Chan, C. A., Frye, V., Vlahov, D., & Galea, S. (n.d.).Publication year
2008Journal title
BMC public healthVolume
8AbstractBackground. Despite growing concern about illicit methadone use in the US and other countries, there is little data about the prevalence and correlates of methadone use in large urban areas. We assessed the prevalence and examined correlates of lifetime and recent illicit methadone use in New York City (NYC). Methods. 1,415 heroin, crack, and cocaine users aged 15-40 years were recruited in NYC between 2000 and 2004 to complete interviewer-administered questionnaires. Results. In multivariable logistic regression, non-injection drug users who used illicit methadone were more likely to be heroin dependent, less than daily methamphetamine users and to have a heroin using sex partner in the last two months. Injection drug users who used illicit methadone were more likely to use heroin daily, share injection paraphernalia and less likely to have been in a detoxification program and to have not used marijuana in the last six months. Conclusion. The results overall suggest that illicit (or street) methadone use is likely not a primary drug of choice, but is instead more common in concert with other illicit drug use.Hunger and health among undocumented Mexican migrants in a US urban area
AbstractHadley, C., Galea, S., Nandi, V., Nandi, A., Lopez, G., Strongarone, S., & Ompad, D. (n.d.).Publication year
2008Journal title
Public Health NutritionVolume
11Issue
2Page(s)
151-158AbstractObjectives: To measure the occurrence and correlates of hunger and to evaluate the association between hunger and three health indicators among undocumented Mexican immigrants. Design: Non-probability cross-sectional sample. Setting: Neighbourhoods within New York City. Subjects: Four hundred and thirty-one undocumented Mexican immigrants living in the USA. Results: Hunger was indicated by approximately 28% of respondents. In a multivariate model, working as a day labourer was associated with hunger (odds ratio (OR) 3.33, 95% confidence interval (CI) 1.83-6.06) while receiving public assistance protected against hunger (OR 0.23, 95% CI 0.06-0.88). In multivariate models, respondents who reported experiencing hunger also reported poorer overall health (OR 1.69, 95% CI 0.95-3.02) and more days of poor mental (P = 0.045) and physical health (P < 0.0001). Greater amount of time lived in the USA was also associated with worse overall health (P = 0.054) and more days of poor mental and physical health (P < 0.01). Conclusions: The present study shows that food insecurity and hunger may be problems among undocumented migrants living in the USA. Uncertain and unpredictable work schedules and limited access to public assistance may contribute to high levels of hunger, which in turn may also negatively affect mental and physical health. Increasing amount of time lived in the USA is also associated with poorer health indicators. Programmes that provide undocumented migrants with emergency access to resources may reduce food insecurity and lead to improved health outcomes among this vulnerable population.Mortality risk among recent-onset injection drug users in five U.S. cities
AbstractVlahov, D., Wang, C., Ompad, D., Fuller, C. M., Caceres, W., Ouellet, L., Kerndt, P., Jarlais, D. C. D., & Garfein, R. S. (n.d.).Publication year
2008Journal title
Substance Use and MisuseVolume
43Issue
3Page(s)
413-428AbstractTo quantify the risk of death among recent-onset (< 5 years) injection drug users, we enrolled 2089 injection drug users (IDUs) age ≤ 35 years (minimum age = 18 years) between 1997 and 1999. Median age was 24 years, 62.4% were male, 54.5% were non-Hispanic White, mean duration of injecting was 3 years, and 45.4% injected daily within the prior 6 months. Using the National Death Index, we identified 68 deaths over a follow-up period through December 2002 with a mortality rate of 7.10/1000 person years. Using age-, sex-, and race-adjusted data to the census and mortality, we calculated standardized mortality ratios (SMRs) over time. The adjusted SMR (with national data as the reference) for IDUs was 3.66 for 1997, which increased to 9.78 by 1998, decreased slightly to 7.08 by 1999, and continuously declined to 2.54 by 2002. These data confirm considerable excess mortality among recent onset injection drug users compared to non-IDU peers in the general population and indicate need for interventions such as increased quality and accessibility to drug abuse** treatment and overdose prevention to prevent premature death among young IDUs.Predictors of influenza vaccination in an urban community during a national shortage
AbstractPhillips-Caesar, E., Coady, M. H., Blaney, S., Ompad, D. C., Sisco, S., Glidden, K., Vlahov, D., & Galea, S. (n.d.).Publication year
2008Journal title
Journal of health care for the poor and underservedVolume
19Issue
2Page(s)
611-624AbstractLittle is known about the impact of vaccine shortages on vaccination rates among disadvantaged populations in the United States. We compared factors associated with influenza vaccination rates during a vaccine shortage (2004-2005) and a non-shortage (2003-2004) year among adults in predominantly minority New York City neighborhoods. Thirty-one percent of participants received influenza vaccine during the non-shortage year compared with 18% during the shortage. While fewer people received the influenza vaccine during the shortage, a higher proportion of the vaccinated were in a high-risk group (68% vs. 52%, respectively). People were less likely to have been vaccinated during the shortage if they were Black. This study suggests that vaccination rates were lower during the shortage period among Blacks and those who are not explicitly a focus of national vaccination outreach campaigns. Such groups are less likely to be vaccinated when vaccines are scarce.Prevalence and correlates of previous hepatitis B vaccination and infection among young drug-users in New York City
AbstractAmesty, S., Ompad, D. C., Galea, S., Fuller, C. M., Wu, Y., Koblin, B., & Vlahov, D. (n.d.).Publication year
2008Journal title
Journal of Community HealthVolume
33Issue
3Page(s)
139-148AbstractHepatitis B (HBV) vaccination coverage remains low among drug users. In 1997, ACIP made hepatitis B vaccine available for persons aged 0-18 years and many states began requiring HBV vaccination for entry into middle school; these programs might affect HBV vaccination and infection rates in younger DUs. We were interested in determining correlates of immunization among younger (<25 years) and older (25 and older) DUs. Methods: A community-based sample of 1,211 heroin, crack, and cocaine users 18 or older was recruited from Harlem and the Bronx. We assessed previous HBV vaccination and infection and correlates using bivariate analyses. Results: The sample was predominantly male (74.0%), aged ≥25 years (67.1%) and Hispanic (59.9%). In terms of socioeconomic status, 57.1% had less than a high school education, 84.5% had been homeless in their lifetime, and 48.0% had an illegal main income source. Among 399 DUs younger than 25 years of age, 30% demonstrated serological evidence of previous vaccination, 49.9% were susceptible to HBV at baseline, and 20% showed evidence of infection. In our model, previous HBV infection and vaccination status were associated with being 22 years old or younger (AOR = 1.40 and 1.66). Compared to susceptible individuals, those vaccinated were significantly less likely to be born in other countries (AOR = 0.50). Among 812 DUs 25 and older, 10.6% demonstrated serological evidence of previous vaccination, 59.2% were susceptible to HBV at baseline, and 30.2% showed evidence of infection. Conclusion: Existing interventions to increase HBV vaccination among adolescents should target high risk groups.Project VIVA: A multilevel community-based intervention to increase influenza vaccination rates among hard-to-reach populations in New York City
AbstractCoady, M. H., Galea, S., Blaney, S., Ompad, D. C., Sisco, S., & Vlahov, D. (n.d.).Publication year
2008Journal title
American journal of public healthVolume
98Issue
7Page(s)
1314-1321AbstractObjectives. We sought to determine whether the work of a community-based participatory research partnership increased interest in influenza vaccination among hard-to-reach individuals in urban settings. Methods. A partnership of researchers and community members carried out interventions for increasing acceptance of influenza vaccination in disadvantaged urban neighborhoods, focusing on hard-to-reach populations (e.g., substance abusers, immigrants, elderly, sex workers, and homeless persons) in East Harlem and the Bronx in New York City. Activities targeted the individual, community organization, and neighborhood levels and included dissemination of information, presentations at meetings, and provision of street-based and door-to-door vaccination during 2 influenza vaccine seasons. Participants were recruited via multiple modalities. Multivariable analyses were performed to compare interest in receiving vaccination pre- and postintervention. Results. There was increased interest in receiving the influenza vaccine postintervention (P<.01). Being a member of a hard-to-reach population (P=.03), having ever received an influenza vaccine (P<.01), and being in a priority group for vaccination (P<.01) were also associated with greater interest in receiving the vaccine. Conclusions. Targeting underserved neighborhoods through a multilevel community-based participatory research intervention significantly increased interest in influenza vaccination, particularly among hard-to-reach populations. Such interventions hold promise for increasing vaccination rates annually and in pandemic situations.Sampling and recruitment in multilevel studies among marginalized urban populations: The IMPACT studies
AbstractOmpad, D. C., Galea, S., Marshall, G., Fuller, C. M., Weiss, L., Beard, J. R., Chan, C., Edwards, V., & Vlahov, D. (n.d.).Publication year
2008Journal title
Journal of Urban HealthVolume
85Issue
2Page(s)
268-280AbstractIllicit drug use in urban settings is a major public health problem. A range of individual level factors are known to influence drug use and its consequences, and a number of recent studies have suggested that the neighborhood in which an individual lives may also play a role. However, studies seeking to identify neighborhood-level determinants of drug use, particularly among marginalized urban populations, need to overcome significant challenges, particularly in the area of sampling and recruitment. One key issue is defining functional neighborhoods that are relevant to local residents. Another arises from the need to sample a representative or even a diverse population when studying marginalized groups such as illicit drug users. These are common problems that raise particular challenges when both need to be addressed in the same study. For example, many sampling approaches for neighborhood-level studies have included some form of random sample of households, but this may systematically overlook marginalized populations. On the other hand, the sampling approaches commonly used in studies of hidden populations such as chain referral, snow ball, and more recently, respondent-driven sampling, typically expand beyond a geographic "neighborhood." We describe the organization and rationale for the IMPACT Studies in New York City as a case illustration on how such issues may be addressed.Urban health issues
Boslaugh, S., Ompad, D., Galea, S., & Vlahov, D. (n.d.). In Encyclopedia of epidemiology (1–).Publication year
2008Volume
2Page(s)
1058-1063Urban health systems
AbstractOmpad, D. C., Galea, S., & Vlahov, D. (n.d.). In International Encyclopedia of Public Health: Overview (1–).Publication year
2008Page(s)
463-470AbstractUrban health is the study of urban characteristics that can influence health and disease in the urban context. These characteristics include features of the social and physical environment as well as of the urban resource infrastructure. Features of the social and physical environment and the urban resource infrastructure in turn are shaped by municipal, national, and global forces and trends. This article introduces the reader to urban health concepts, including the definition of 'urban,' features of the urban environment that may influence health, and a selection of methods for evaluating the impact of urban living on health. © 2008Access to influenza vaccine in East Harlem and the Bronx during a national vaccine shortage
AbstractOmpad, D. C., Galea, S., Blaney, S., Coady, M. H., Sisco, S., Glidden, K., & Vlahov, D. (n.d.).Publication year
2007Journal title
Journal of Community HealthVolume
32Issue
3Page(s)
195-202AbstractIn October 2004, one of the major producers of the U.S. influenza vaccine supply announced that their vaccine would not be available because of production problems, resulting in approximately half of the anticipated supply suddenly becoming unavailable. This study was part of a larger effort using community-based participatory research (CBPR) principles to distribute influenza vaccine to hard-to-reach populations. Given the extant literature suggesting economic and racial disparities in influenza vaccine access in times of adequate supply and our inability to distribute vaccine due to the shortage, we sought to examine vaccine access as well as awareness of the vaccine shortage and its impact on health-seeking behaviors in eight racially-diverse and economically-disadvantaged neighborhoods in New York City (NYC) during the shortage. In our study few people had been vaccinated, both among the general community and among high risk groups; vaccination rates for adults in priority groups and non-priority groups were 21.0% and 3.5%. Awareness of the 2004 vaccine shortage was widespread with over 90% being aware of the shortage. While most attributed the shortage to production problems, almost 20% said that it was due to the government not wanting to make the vaccine available. Many respondents said they would be more likely to seek vaccination during the current and subsequent influenza seasons because of the shortage. The target neighborhoods were significantly affected by the national influenza vaccine shortage. This study highlights the challenges of meeting the preventive health care needs of hard-to-reach populations in times of public health crisis.Convenience is the key to hepatitis A and B vaccination uptake among young adult injection drug users
AbstractCampbell, J. V., Garfein, R. S., Thiede, H., Hagan, H., Ouellet, L. J., Golub, E. T., Hudson, S. M., Ompad, D. C., & Weinbaum, C. (n.d.).Publication year
2007Journal title
Drug and alcohol dependenceVolume
91Page(s)
S64-S72AbstractBackground: Despite CDC recommendations to vaccinate injection drug users (IDUs) against hepatitis A virus (HAV) and hepatitis B virus (HBV) infections, coverage remains low. Vaccination programs convenient to IDUs have not been widely implemented or evaluated. We assessed whether convenience and monetary incentives influenced uptake of free vaccine by 18-30-year-old IDUs in five U.S. cities. Methods: IDUs recruited from community settings completed risk behavior self-interviews and testing for antibodies to HAV (anti-HAV) and hepatitis B core antigen (anti-HBc). Vaccine was offered presumptively at pre-test (except in Chicago); on-site availability and incentives for vaccination differed by site, creating a quasi-experimental design. Results: Of 3181 participants, anti-HAV and anti-HBc seroprevalence was 19% and 23%, respectively. Although 83% of participants were willing to be vaccinated, only 36% received ≥1 dose, which varied by site: Baltimore (83%), Seattle (33%), Los Angeles (18%), New York (17%), and Chicago (2%). Participation was highest when vaccine was available immediately on-site and lowest when offered only after receiving results. Monetary incentives may have increased participation when on-site vaccination was not available. Conclusion: IDUs were willing to be vaccinated but immediate, on-site availability was critical for uptake. Convenience should be a key consideration in designing strategies to increase vaccine coverage among IDUs.Defining Neighborhood Boundaries for Urban Health Research
AbstractWeiss, L., Ompad, D., Galea, S., & Vlahov, D. (n.d.).Publication year
2007Journal title
American journal of preventive medicineVolume
32Issue
6Page(s)
S154-S159AbstractAbstract: The body of literature exploring neighborhood effects on health has increased rapidly in recent years, yet a number of methodologic concerns remain, including preferred methods for identification and delineation of study neighborhoods. In research combining census or other publicly available data with surveys of residents and/or street-level observations, questions regarding neighborhood definition take on added significance. Neighborhoods must be identified and delineated in such a way as to optimize quality and availability of data from each of these sources. IMPACT (Inner-City Mental Health Study Predicting HIV/AIDS, Club and Other Drug Transitions), a multilevel study examining associations among features of the urban environment and mental health, drug use, and sexual behavior, utilized a multistep neighborhood definition process including development of census block group maps, review of land use and census tract data, and field visits and observation in each of the targeted communities. Field observations were guided by a preidentified list of environmental features focused on the potential for recruitment (e.g., pedestrian volume), characteristics commonly used to define neighborhood boundaries (e.g., obstructions to pedestrian traffic, changes in land use), and characteristics that have been associated in the literature with health behaviors and health outcomes (such as housing type and maintenance and use of open spaces). This process, implemented in February through July 2005, proved feasible and offered the opportunity to identify neighborhoods appropriate to study objectives and to collect descriptive information that can be used as a context for understanding study results.Identifying Injection Drug Users at Risk of Nonfatal Overdose
AbstractCoffin, P. O., Tracy, M., Bucciarelli, A., Ompad, D., Vlahov, D., & Galea, S. (n.d.).Publication year
2007Journal title
Academic Emergency MedicineVolume
14Issue
7Page(s)
616-623AbstractObjectives: Drug overdose is the second leading cause of accidental deaths among U.S. adults aged 15-64 years. Emergency physicians have a unique opportunity to provide overdose prevention interventions, because habitual drug users are in frequent need of medical care. The authors evaluated associations between individual-level risk factors and experiencing an overdose in the past six months to determine which characteristics and behaviors may be most predictive of overdose. Methods: The authors used data from a sample of street-recruited habitual drug users who participated in face-to-face interviews about overdose from November 2001 to February 2004. This analysis was restricted to 772 respondents who had been injecting for at least one year and who had injected heroin within the past two months. Results: A total of 16.6% of participants had overdosed in the past six months. Characteristics and behaviors that were independently associated with an increased risk of a recent overdose were having had a prior overdose (odds ratio [OR], 28.58; 95% confidence interval [CI] = 14.10 to 57.96), using cocaine/crack in the past six months (OR, 2.07; 95% CI = 1.25 to 3.45), using alcohol in the past six months (OR, 1.90; 95% CI = 1.01 to 3.57), experiencing serious withdrawal symptoms in the past two months (OR, 2.70; 95% CI = 1.58 to 4.61), and younger age. Conclusions: Drug users who have previously experienced a nonfatal overdose are at very high risk of experiencing future overdoses. Further longitudinal studies are needed to identify robust predictors of overdose risk over time in habitual drug users, but these data suggest that drug users who have overdosed warrant aggressive prevention efforts such as agonist maintenance treatment or provision of take-home naloxone.Impact of social network characteristics on high-risk sexual behaviors among non-injection drug users
AbstractPilowsky, D. J., Hoover, D., Hadden, B., Fuller, C., Ompad, D. C., Andrews, H. F., De Leon, C. L., Hoepner, L., Xia, Q., & Latkin, C. (n.d.).Publication year
2007Journal title
Substance Use and MisuseVolume
42Issue
11Page(s)
1629-1649AbstractSexually active non-injection drug users in New York City and their sexual partners or fellow drug users (N = 264) were recruited from 2002 to 2005, and associations between social network characteristics and sexual risk behaviors were examined. We assessed social networks, sexual practices, and drug use. Results suggest having a drug-centered social network, i.e., a network that includes a high proportion of individuals who provide, receive, or use drugs, increases the risk of engaging in high-risk sexual behaviors. The study's limitations are noted and longitudinal studies are needed to ascertain whether these associations are causal. Funding was provided by the National Institute on Drug Abuse.Pandemic preparedness and hard to reach populations.
Vlahov, D., Coady, M. H., Galea, S., Ompad, D. C., & Barondess, J. A. (n.d.).Publication year
2007Journal title
American journal of disaster medicineVolume
2Issue
6Page(s)
281-283Perceived stress among a workforce 6 months following hurricane Katrina
AbstractLeon, K. A., Hyre, A. D., Ompad, D., DeSalvo, K. B., & Muntner, P. (n.d.).Publication year
2007Journal title
Social psychiatry and psychiatric epidemiologyVolume
42Issue
12Page(s)
1005-1011AbstractTo determine stress levels among a workforce 6 months after hurricane Katrina made landfall, a web-based survey that included the four-item Perceived Stress Scale was administered to employees of the largest employer in New Orleans. An overall Perceived Stress Scale score was obtained by pooling responses for the four items. Among 1,542 adult respondents, 24.1% stated they felt that they were "fairly often" or "very often" unable to control the important things in their life and 21.4% considered that their difficulties were "fairly often" or "very often" piling up so high that they could not overcome them. Also, 6.1% reported that they "almost never" or "never" felt confident about their ability to handle their personal problems and 15.2% indicated that things were "almost never" or "never" going their way. The overall mean Perceived Stress Scale score was 6.3 (standard deviation = 3.1; range = 0-16). Higher stress scale scores, indicating more stress, were present for women, and for participants with lower income, displaced longer than 3 months, who were more afraid of losing their life during hurricane Katrina and its immediate aftermath, and who knew someone that died during the storm. Additionally, participants who were living in a relative of friend's house or in a temporary trailer at the time of the survey had higher stress scores compared to their counterparts who had returned to live in their pre-hurricane residence. There was a direct association between higher stress scores and symptoms of post-traumatic stress disorder. Employers and health care providers should be apprised of the need for monitoring stress and offering counseling opportunities for returning workforces following future large-scale disasters.Rapid vaccine distribution in nontraditional settings: lessons learned from project VIVA
AbstractCoady, M. H., Weiss, L., Galea, S., Ompad, D. C., Glidden, K., & Vlahov, D. (n.d.).Publication year
2007Journal title
Journal of Community Health NursingVolume
24Issue
2Page(s)
79-85AbstractWith growing fear of a worldwide influenza pandemic, programs that can rapidly vaccinate a broad range of persons are urgently needed. Vaccination rates are low among disadvantaged and hard-to-reach populations living within urban communities, and delivering vaccines to these groups may prove challenging. Project VIVA1 (Venue-Intensive Vaccination for Adults), staffed by teams of nurses and outreach workers, aimed to deliver vaccines rapidly within disadvantaged neighborhoods in New York City. Project VIVA nurses offered free influenza vaccine door-to-door and on street corners over 10 days in October, 2005. A total of 1,648 people were vaccinated, exceeding expectation. Careful selection and training of project staff, community involvement in project development, community outreach, and prioritizing street-based distribution may be key factors in an effective rapid vaccination program. In conclusion, this project may be replicated in other communities and utilized for annual vaccination campaigns and in the event of a pandemic.