Donna Shelley

Professor of Public Health Policy and Management

Co-Director of the Global Center for Implementation Science

Professional overview

Dr. Shelley is a tenured Professor in the Department of Public Health Policy and Management and the founding Co-Director of the Global Center for Implementation Science at the NYU School of Global Public Health. She conducts translational, population-based, and policy-relevant research that aims to accelerate dissemination and implementation of tobacco use treatment in safety net health care delivery systems and implementation of tobacco control policies. This research has been funded by the National Cancer Institute (NCI), National Institute of Drug Abuse, National Heart, Lung, and Blood Institute, the Agency for Healthcare Research and Quality, and the New York State Department of Health.

Dr. Shelley’s implementation research focuses on building the evidence for effective theory-driven strategies that target barriers to implementation and sustainability of evidence-based tobacco use treatment in primary care settings in the U.S. and Viet Nam. Her research is also addressing the growing dual burden of noncommunicable and communicable diseases in LMICs and, specifically, the health impact on people living with HIV/AIDS.  Her policy research includes a completed NCI-funded study that evaluated the impact of the US federally mandated smoke-free public housing policy on exposure to secondhand smoke and explored the implementation process to identify strategies with the potential to improve the process and maximize public health impact.

Education

BS, University of Pennsylvania, PA

MD, Mount Sinai School of Medicine, NY

MPH, Health Policy and Management, Columbia University's Mailman School of Public Health, NY

Areas of research and study

Health Systems Strengthening

Implementation science

Tobacco Cessation

Tobacco Policy

Current Research

Policy

Purtle J, Moucheraud C, Yang LH, Shelley D. Four very basic ways to think about policy in implementation science. Implement Sci Commun. 2023 Sep 12;4(1):11

Shelley D. Kyriakas C, McNeill A, Murray R, Nilan K, Sherman SE, Raw M. Challenges to implementing the WHO Framework Convention on Tobacco Control guidelines on tobacco cessation treatment: a qualitative analysis. Addiction. 2020;115:527-533

Thorpe L, Anastasiou E, Wyka K, Tovar A, Gill E, Rule A, Elbel B, Kaplan SA, Jiang N, Gordon T, Shelley D. Evaluation of Secondhand Smoke Exposure in New York City Public Housing After Implementation of the 2018 Federal Smoke-Free Housing Policy. JAMA Netw Open. 2020 Nov 2;3(11):e2024385

Tobacco cessation 

Hoang THL … Shelley D. Factors Influencing Tobacco Smoking and Cessation Among People Living  with HIV: A Systematic Review and Meta‑analysis. AIDS and Behavior. 2024 https://doi.org/10.1007/s10461-024-04279-1

Shelley et al. WHO Knowledge Summary: Tobacco and HIV https://iris.who.int/bitstream/handle/10665/378509/9789240096868-eng.pdf

Ostroff JS, Shelley DR, Chichester LA, King JC, Li Y, Schofield E, Ciupek A, Criswell A, Acharya R, Banerjee SC, Elkin EB, Lynch K, Weiner BJ, Orlow I, Martin CM, Chan SV, Frederico V, Camille P, Holland S, Kenney J. Study protocol of a multiphase optimization strategy trial (MOST) for delivery of smoking cessation treatment in lung cancer screening settings. Trials. 2022 Aug 17;23(1):664.

Health systems improvement and Implementation Science

Nwaozuru U, Murphy P, Richard A, …Shelley D, Airhihenbuwa C, Ogedegbe G, Ezechi O, Iwelunmor J. The sustainability of health interventions implemented in Africa: an updated systematic review on evidence and future research perspectives. Implement Sci Commun. 2025 Apr 8;6(1):39. https://pmc.ncbi.nlm.nih.gov/articles/PMC11980204/ 

Gaeta Gazzola M, Torsiglieri A, Velez L, Blaufarb S, Hernandez P, O'Grady MA, Blackburn J, Florick J, Cleland CM, Shelley D, Doran KM A community-academic partnership to develop an implementation support package for overdose prevention in permanent supportive housing. J Subst Use Addict Treat. 2025 Jan;168:209533. doi: 10.1016/j.josat.2024.209533. Epub 2024 Oct 9.PMID: 39389548

Kilbourne AM, Geng E, Eshun-Wilson I, Sweeney S, Shelley D, Cohen DJ, Kirchner JE, Fernandez ME, Parchman ML. How does facilitation in healthcare work? Using mechanism mapping to illuminate the black box of a meta-implementation strategy. Implement Sci Commun. 2023 May 16;4(1):53. 

Parascandola M, Neta G, Salloum RG, Shelley D, Rositch AF.JCO Glob Oncol. Role of Local Evidence in Transferring Evidence-Based Interventions to Low- and Middle-Income Country Settings: Application to Global Cancer Prevention and Control.2022 Aug;8:e2200054.

Shelley D, Alvarez GG, Nguyen T, Nguyen N, Goldsamt L, Cleland C, Tozan Y, Shuter J, Armstrong-Hough M. Adapting a tobacco cessation treatment intervention and implementation strategies to enhance implementation effectiveness and clinical outcomes in the context of HIV care in Vietnam: a case study. Implement Sci Commun. 2022 Oct 17;3(1):112. 

Shelley D, Wang VH, Taylor K, Williams R, Toll B, Rojewski A, Foley KL, Rigotti N, Ostroff JS. Accelerating integration of tobacco use treatment in the context of lung cancer screening: Relevance and application of implementation science to achieving policy and practice. Transl Behav Med. 2022 Nov 21;12(11):1076-1083.

Shelley D, Cleland CM, Nguyen T, VanDevanter N, Siman N, Van Minh H, Nguyen N. Nicotine Tob Res. Effectiveness of a Multicomponent Strategy for Implementing Guidelines for Treating Tobacco Use in Vietnam Commune Health Centers 2022 Feb 1;24(2):196-203.

Hennein R, Ggita J, Ssuna B, Shelley D, Akiteng AR, Davis JL, Katamba A, Armstrong-Hough M. Implementation, interrupted: Identifying and leveraging factors that sustain after a programme interruption. Glob Public Health. 2022 Aug-Sep;17(9):1868-1882

Publications

Publications

Qualitative evaluation to explain success of multifaceted technology-driven hypertension intervention

Millery, M., Shelley, D., Wu, D., Ferrari, P., Tseng, T. Y., & Kopal, H. (n.d.).

Publication year

2011

Journal title

American Journal of Managed Care

Volume

17

Issue

SPEC. ISSUE

Page(s)

SP95-SP102

Abstract

Abstract

Objectives: This study sought to examine the implementation of an electronic health record-based intervention to improve quality of hypertension care in community health centers. The primary goal was to use qualitative analysis to explain how different components of the intervention contributed to positive patient-level outcomes. Study Design: Qualitative process evaluation. Methods: The intervention included alerts, order sets, templates, clinical reminder algorithms, and provider performance feedback. Semi-structured interviews were conducted with primary care providers before (n = 16) and after (n = 16) intervention, and with key staff and leadership involved in the implementation (n = 6). The research team applied an iterative systematic qualitative coding process to identify salient themes. Several constructs from IT implementation theories guided the analysis. Results: The analysis focused on: (1) satisfaction and perceived usefulness of intervention components, (2) perceived proximal changes resulting from intervention, and (3) perceived facilitators of change. Different participants found different components useful. Proximal impact manifested in multiple ways (eg, more aggressive follow-up appointments and prescribing) and in increased overall attention to hypertension. Facilitators of success included leadership, organizational culture, provider engagement, rigorous implementation process, framing of intervention as quality improvement (QI), and health center capacity to process data. Conclusions: We attribute the success of the intervention to a multifaceted approach where the combination of multiple intervention components resulted in across-the-board change in hypertension care practices. In contrast with research that attempts to isolate the impact of circumscribed health information technology (HIT) tools, our experience suggests that HIT can achieve success in patient outcomes when rigorously implemented as a multifaceted intervention and framed as QI activity.

Quality in women's health : the organizing principles for the NAWH (National Association for Women's Health) trade association.

Shelley, D., Shelley, D., Hoffman, E., Menitoff, R., & Maraldo, P. (n.d.).

Publication year

2000

Journal title

Quality management in health care

Volume

8

Issue

4

Page(s)

65-74

10.1097/00019514-200008040-00007

Abstract

Abstract

Quality in women's health care has been assessed with preventive measures such as mammograms and pap smears, and obstetrical measures, such as prenatal care. Although awareness about sex and gender differences among researchers, health professionals, and women themselves has grown dramatically over the last 10 years, health care policy and medical education have not been influenced to any significant degree. Sex and gender differences have not been developed for a wider range of services, such as diagnosis and treatment of acute or chronic conditions, outside of reproductive health. This article reviews contemporary women's health issues and discusses the need for collaboration among multiple stakeholder groups within the health care industry to address quality in women's health care.

Quality of cardiovascular disease care in small urban practices

Shelley, D., Blechter, B., Siman, N., Jiang, N., Cleland, C., Ogedegbe, G., Williams, S., Wu, W., Rogers, E., & Berry, C. (n.d.).

Publication year

2018

Journal title

Annals of family medicine

Volume

16

Page(s)

S21-S28

10.1370/afm.2174

Abstract

Abstract

PURPOSE We wanted to describe small, independent primary care practices’ performance in meeting the Million Hearts ABCSs (aspirin use, blood pressure control, cholesterol management, and smoking screening and counseling), as well as on a composite measure that captured the extent to which multiple clinical targets are achieved for patients with a history of arteriosclerotic cardiovascular disease (ASCVD). We also explored relationships between practice characteristics and ABCS measures. METHODS We conducted a cross-sectional, bivariate analysis using baseline data from 134 practices in New York City. ABCS data were extracted from practices’ electronic health records and aggregated to the site level. Practice characteristics were obtained from surveys of clinicians and staff at each practice. RESULTS The proportion of at-risk patients meeting clinical goals for each of the ABCS measures was 73.0% for aspirin use, 69.6% for blood pressure, 66.7% for cholesterol management, and 74.2% screened for smoking and counseled. For patients with a history of ASCVD, only 49% were meeting all ABC (aspirin use, blood pressure control, cholesterol management) targets (ie, composite measure). Solo practices were more likely to meet clinical guidelines for aspirin (risk ratio [RR ] = 1.17, P = .007) and composite (RR = 1.29, P = .011) than practices with multiple clinicians. CONCLUSION Achieving targets for ABCS measures varied considerably across practices; however, small practices were meeting or exceeding Million Hearts goals (ie, 70% or greater). Practices were less likely to meet consistently clinical targets that apply to patients with a history of ASCVD risk factors. Greater emphasis is needed on providing support for small practices to address the complexity of managing patients with multiple risk factors for primary and secondary ASCVD.

Rapid Community Engagement in Response to SARS-CoV-2 Funding Opportunities : New York City, 2020‒2021

Williams, N. J., Gill, E., Punter, M. A., Reiss, J., Goodman, M., Shelley, D., & Thorpe, L. E. (n.d.).

Publication year

2022

Journal title

American journal of public health

Volume

112

Issue

S9

Page(s)

S904-S908

10.2105/AJPH.2022.307072

Abstract

Abstract

In response to fast-turnaround funding opportunities, collaborations have been forming across the country to address severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disparities. Here we describe the process, notes from the field, and evaluation results from a new collaboration involving multiple partners, formed in October 2020 in New York City as part of the Rapid Acceleration of Diagnostics initiative. We used the validated Research Engagement Survey Tool to evaluate the partnership. Results can inform future research and improve engagement efforts aimed at reducing SARS-CoV-2 disparities. (Am J Public Health. 2022;112(S9):S904-S908. https://doi.org/10.2105/AJPH.2022.307072).

Rapid Transition to Telehealth and the Digital Divide : Implications for Primary Care Access and Equity in a Post-COVID Era

Chang, J. E., Lai, A. Y., Gupta, A., Nguyen, A. M., Berry, C. A., & Shelley, D. (n.d.).

Publication year

2021

Journal title

Milbank Quarterly

Volume

99

Issue

2

Page(s)

340-368

10.1111/1468-0009.12509

Abstract

Abstract

Policy Points Telehealth has many potential advantages during an infectious disease outbreak such as the COVID-19 pandemic, and the COVID-19 pandemic has accelerated the shift to telehealth as a prominent care delivery mode. Not all health care providers and patients are equally ready to take part in the telehealth revolution, which raises concerns for health equity during and after the COVID-19 pandemic. Without proactive efforts to address both patient- and provider-related digital barriers associated with socioeconomic status, the wide-scale implementation of telehealth amid COVID-19 may reinforce disparities in health access in already marginalized and underserved communities. To ensure greater telehealth equity, policy changes should address barriers faced overwhelmingly by marginalized patient populations and those who serve them. Context: The COVID-19 pandemic has catalyzed fundamental shifts across the US health care delivery system, including a rapid transition to telehealth. Telehealth has many potential advantages, including maintaining critical access to care while keeping both patients and providers safe from unnecessary exposure to the coronavirus. However, not all health care providers and patients are equally ready to take part in this digital revolution, which raises concerns for health equity during and after the COVID-19 pandemic. Methods: The study analyzed data about small primary care practices’ telehealth use and barriers to telehealth use collected from rapid-response surveys administered by the New York City Department of Health and Mental Hygiene's Bureau of Equitable Health Systems and New York University from mid-April through mid-June 2020 as part of the city's efforts to understand how primary care practices were responding to the COVID-19 pandemic following New York State's stay-at-home order on March 22. We focused on small primary care practices because they represent 40% of primary care providers and are disproportionately located in low-income, minority or immigrant areas that were more severely impacted by COVID-19. To examine whether telehealth use and barriers differed based on the socioeconomic characteristics of the communities served by these practices, we used the Centers for Disease Control and Prevention Social Vulnerability Index (SVI) to stratify respondents as being in high-SVI or low-SVI areas. We then characterized respondents’ telehealth use and barriers to adoption by using means and proportions with 95% confidence intervals. In addition to a primary analysis using pooled data across the five waves of the survey, we performed sensitivity analyses using data from respondents who only took one survey, first wave only, and the last two waves only. Findings: While all providers rapidly shifted to telehealth, there were differences based on community characteristics in both the primary mode of telehealth used and the types of barriers experienced by providers. Providers in high-SVI areas were almost twice as likely as providers in low-SVI areas to use telephones as their primary telehealth modality (41.7% vs 23.8%; P

Readiness of Lung Cancer Screening Sites to Deliver Smoking Cessation Treatment : Current Practices, Organizational Priority, and Perceived Barriers

Shelley, D., Ostroff, J. S., Copeland, A., Li, Y., Shelley, D. S., & Henschke, C. I. (n.d.).

Publication year

2016

Journal title

Nicotine and Tobacco Research

Volume

18

Issue

5

Page(s)

1067-1075

10.1093/ntr/ntv177

Abstract

Abstract

Introduction: Lung cancer screening represents an opportunity to deliver smoking cessation advice and assistance to current smokers. However, the current tobacco treatment practices of lung cancer screening sites are unknown. The purpose of this study was to describe organizational priority, current practice patterns, and barriers for delivery of evidence-based tobacco use treatment across lung cancer screening sites within the United States. Methods: Guided by prior work examining readiness of health care providers to deliver tobacco use treatment, we administered a brief online survey to a purposive national sample of site coordinators from 93 lung cancer screening sites. Results: Organizational priority for promoting smoking cessation among lung cancer screening enrollees was high. Most sites reported that, at the initial visit, patients are routinely asked about their current smoking status (98.9%) and current smokers are advised to quit (91.4%). Fewer (57%) sites provide cessation counseling or refer smokers to a quitline (60.2%) and even fewer (36.6%) routinely recommend cessation medications. During follow-up screening visits, respondents reported less attention to smoking cessation advice and treatment. Lack of patient motivation and resistance to cessation advice and treatment, lack of staff training, and lack of reimbursement were the most frequently cited barriers for delivering smoking cessation treatment. Conclusions: Although encouraging that lung cancer screening sites endorsed the importance of smoking cessation interventions, greater attention to identifying and addressing barriers for tobacco treatment delivery is needed in order to maximize the potential benefit of integrating smoking cessation into lung cancer screening protocols. Implications: This study is the first to describe practice patterns, organizational priority, and barriers for delivery of smoking cessation treatment in a national sample of lung cancer screening sites.

Reimbursing dentists for smoking cessation treatment : Views from dental insurers

Shelley, D., Wright, S., McNeely, J., Rotrosen, J., Winitzer, R. F., Pollack, H., Abel, S., & Metsch, L. (n.d.).

Publication year

2012

Journal title

Nicotine and Tobacco Research

Volume

14

Issue

10

Page(s)

1180-1186

10.1093/ntr/nts010

Abstract

Abstract

Introduction: Screening and delivery of evidence-based interventions by dentists is an effective way to reduce tobacco use. However, dental visits remain an underutilized opportunity for the treatment of tobacco dependence. This is, in part, because the current reimbursement structure does not support expansion of dental providers ' role in this arena. The purpose of this study was to interview dental insurers to assess attitudes toward tobacco use treatment in dental practice, pros and cons of offering dental provider reimbursement, and barriers to instituting a tobacco use treatment-related payment policy for dental providers. Methods: Semi-structured interviews were conducted with 11 dental insurance company executives. Participants were identified using a targeted sampling method and represented viewpoints from a significant share of companies within the dental insurance industry. Results: All insurers believed that screening and intervention for tobacco use was an appropriate part of routine care during a dental visit. Several indicated a need for more evidence of clinical and cost-effectiveness before reimbursement for these services could be actualized. Lack of purchaser demand, questionable returns on investment, and segregation of the medical and dental insurance markets were cited as additional barriers to coverage. Conclusions: Dissemination of findings on efficacy and additional research on financial returns could help to promote uptake of coverage by insurers. Wider issues of integration between dental and medical care and payment systems must be addressed in order to expand opportunities for preventive services in dental care settings.

Role of Local Evidence in Transferring Evidence-Based Interventions to Low- and Middle-Income Country Settings : Application to Global Cancer Prevention and Control

Parascandola, M., Neta, G., Salloum, R. G., Shelley, D., & Rositch, A. F. (n.d.).

Publication year

2022

Journal title

JCO Global Oncology

Volume

8

Page(s)

e2200054

10.1200/GO.22.00054

Abstract

Abstract

PURPOSE: Although the global burden of cancer falls increasingly on low- and middle-income countries (LMICs), much of the evidence for cancer prevention and control comes from high-income countries and may not be directly applicable to LMIC settings. In this paper, we focus on the following question: When the majority of the evidence supporting an evidence-based intervention or implementation strategy comes from high-income countries, what local, contextual evidence is needed when transferring and adapting an intervention or strategy to a specific LMIC setting? METHODS: We draw on an existing framework (the Population, Intervention, Environment, Transfer-T process model) for assessing transferability of interventions between distinct settings and apply the model to two case studies as learning examples involving implementation of tobacco use treatment guidelines and self sampling for human papillomavirus DNA in cervical cancer screening. RESULTS: These two case studies illustrate how researchers, policymakers, practitioners, and consumers may approach the need for local evidence from different perspectives and with different priorities. As uses and expectations around local evidence may be different for different groups, aligning these priorities through multistakeholder engagement in which all parties participate in defining the questions and cocreating the solutions is critical, along with promoting standardized reporting of contextual factors. CONCLUSION: Local, contextual evidence can be important for both researchers and practitioners, and its absence may hinder translation of research and implementation efforts across different settings. However, it is essential for researchers, practitioners, and other stakeholders to be able to clearly articulate the type of data needed and why it is important. In particular, where resources are limited, evidence generation should be prioritized to address real needs and gaps in knowledge.

Role of Pediatric Nurse Practitioners in Oral Health Care

Hallas, D. M., & Shelley, D. (n.d.).

Publication year

2009

Journal title

Academic Pediatrics

Volume

9

Issue

6

Page(s)

462-466

10.1016/j.acap.2009.09.009

Abstract

Abstract

Dental caries remain the most prevalent unmet health need in US children. Access to care is particularly problematic for poor children and is compounded by the shortage of dentists to meet the needs of this patient population. Expanding the roles of pediatricians, family physicians, and pediatric nurse practitioners (PNPs) who provide primary care services to children may be a strategy to address in this issue. Enhancements in current PNP education and certification processes are needed to support the expansion of oral health-related clinical responsibilities. Although oral health is included in the published curriculum for PNPs and certification exams require specific oral health knowledge, gaps in postgraduate training persist and few data document the extent to which current oral health-related educational goals are being achieved. We recommend enhancements in oral health education and research to evaluate curriculum innovations, the development of partnerships between stakeholder groups to leverage existing resources, and ongoing surveillance of oral health-related practice patterns among PNPs. Leadership at the national level is needed to develop policies that support curriculum changes and the implementation of oral health practice guidelines for PNPs that will improve access and reduce health disparities.

Same strategy different industry : Corporate influence on public policy

Shelley, D., Ogedegbe, G., & Elbel, B. (n.d.).

Publication year

2014

Journal title

American journal of public health

Volume

104

Issue

4

Page(s)

e9-e11

10.2105/AJPH.2013.301832

Abstract

Abstract

In March 2013 a state judge invalidated New York City's proposal to ban sales of sugar-sweetened beverages larger than 16 ounces; the case is under appeal. This setback was attributable in part to opposition from the beverage industry and racial/ethnic minority organizations they support. We provide lessons from similar tobacco industry efforts to block policies that reduced smoking prevalence. We offer recommendations that draw on the tobacco control movement's success in thwarting industry influence and promoting public health policies that hold promise to improve population health.

Secondhand smoke exposure in public and private high-rise multiunit housing serving low-income residents in New York City prior to federal smoking ban in public housing, 2018

Anastasiou, E., Feinberg, A., Tovar, A., Gill, E., Ruzmyn Vilcassim, M. J., Wyka, K., Gordon, T., Rule, A. M., Kaplan, S., Elbel, B., Shelley, D., & Thorpe, L. E. (n.d.).

Publication year

2020

Journal title

Science of the Total Environment

Volume

704

10.1016/j.scitotenv.2019.135322

Abstract

Abstract

BACKGROUND: Tobacco remains the leading cause of preventable death in the United States, with 41,000 deaths attributable to secondhand smoke (SHS) exposure. On July 30, 2018, the U.S. Department of Housing and Urban Development passed a rule requiring public housing authorities to implement smoke-free housing (SFH) policies.OBJECTIVES: Prior to SFH policy implementation, we measured self-reported and objective SHS incursions in a purposeful sample of 21 high-rise buildings (>15 floors) in New York City (NYC): 10 public housing and 11 private sector buildings where most residents receive federal housing subsidies (herein 'Section 8' buildings).METHODS: We conducted a baseline telephone survey targeting all residents living on the 3rd floor or higher of selected buildings: NYC Housing Authority (NYCHA) residents were surveyed in April-July 2018 (n = 559), and residents in 'Section 8' buildings in August-November 2018 (n = 471). We invited non-smoking household participants to enroll into a longitudinal air monitoring study to track SHS exposure using: (1) nicotine concentration from passive, bisulfate-coated nicotine filters and (2) particulate matter (PM 2.5) from low-cost particle monitors. SHS was measured for 7-days in non-smoking households (NYCHA n = 157, Section 8 n = 118 households) and in building common areas (n = 91 hallways and stairwells). RESULTS: Smoking prevalence among residents in the 21 buildings was 15.5%. Two-thirds of residents reported seeing people smoke in common areas in the past year (67%) and 60% reported smelling smoke in their apartments coming from elsewhere. Most stairwells (88%) and hallways (74%) had detectable nicotine levels, but nicotine was detected in only 9.9% of non-smoking apartments. Substantial variation in nicotine and PM 2.5 was observed between and within buildings; on average nicotine concentrations were higher in NYCHA apartments and hallways than in Section 8 buildings (p < 0.05), and NYCHA residents reported seeing smokers in common areas more frequently. CONCLUSIONS: SFH policies may help in successfully reducing SHS exposure in public housing, but widespread pre-policy incursions suggest achieving SFH will be challenging.

Self-reported Secondhand Marijuana Smoke (SHMS) Exposure in Two New York City (NYC) Subsidized Housing Settings, 2018 : NYC Housing Authority and Lower-Income Private Sector Buildings

Anastasiou, E., Chennareddy, S., Wyka, K., Shelley, D., & Thorpe, L. E. (n.d.).

Publication year

2020

Journal title

Journal of Community Health

Volume

45

Issue

3

Page(s)

635-639

10.1007/s10900-019-00783-x

Abstract

Abstract

The percentage of adults in the United States reporting current marijuana use has more than doubled, from 4 to 9% between 2002 and 2018, suggesting that exposure to secondhand marijuana smoke (SHMS) has probably increased. Few studies have characterized the extent to which residents experience SHMS, particularly those living in multi-unit housing. It remains unknown how recently-implemented smoke-free housing policies (SFH) targeting cigarette smoke in public housing authorities (PHAs) will affect SHMS exposure. We sought to characterize prevalence of self-reported SHMS exposure among residents living in two different subsidized housing settings prior to SFH policy implementation in PHAs: New York City Housing Authority (NYCHA) buildings and private sector buildings where most residents receive Section 8 subsidy vouchers (herein ‘Section 8’ buildings). Residents were recruited from 21 purposefully-selected buildings: 10 NYCHA and 11 Section 8 buildings (> 15 floors). Survey responses were collected during April-July 2018 for NYCHA residents (n = 559) and August-November 2018 for Section 8 residents (n = 471). Of 4628 eligible residents, 1030 participated (response rates, 35% NYCHA, 32% Section 8). Overall, two-thirds of residents reported smelling marijuana smoke (67%) in their home over the past year, higher than reports of smelling cigarette smoke (60%). Smoking status and smelling SHS were both strong predictors of smelling SHMS (p < 0.05). Nearly two thirds of residents perceived smoking marijuana and smelling SHMS as harmful to health. Our findings suggest that, immediately prior to SFH rule implementation in PHAs, SHMS was pervasive in low-income multi-unit housing, suggesting SFH policies should expand to cover marijuana use.

Shelley et al. respond

Shelley, D., Cantrell, M. J., Moon-Howard, J., Ramjohn, D. Q., & VanDevanter, N. (n.d.).

Publication year

2008

Journal title

American journal of public health

Volume

98

Issue

1

Page(s)

5

10.2105/AJPH.2007.122960

Abstract

Abstract

~

Smoking-Cessation Interventions for Urban Hospital Patients : A Randomized Comparative Effectiveness Trial

Sherman, S. E., Link, A. R., Rogers, E. S., Krebs, P., Ladapo, J. A., Shelley, D., Fang, Y., Wang, B., & Grossman, E. (n.d.).

Publication year

2016

Journal title

American journal of preventive medicine

Volume

51

Issue

4

Page(s)

566-577

10.1016/j.amepre.2016.06.023

Abstract

Abstract

Introduction Hospitalization is a unique opportunity for smoking cessation, but prior interventions have measured efficacy with narrowly defined populations. The objective of this study was to enroll smokers admitted to two “safety net” hospitals and compare the effectiveness of two post-discharge cessation interventions. Design A randomized comparative effectiveness trial was conducted. Setting/participants At two New York City public hospitals, every hospitalized patient identified as a smoker (based on admission records) was approached. Inclusion criteria were: smoked cigarettes in the past 30 days; spoke English, Spanish, or Mandarin; had a U.S. phone number; not discharged to an institution where follow-up or smoking was limited; and not pregnant/breastfeeding. Of 18,797 patients identified as current smokers between July 2011 and April 2014, a total of 3,047 (16%) were discharged before being approached, 3,273 (17%) were not current smokers, 4,026 (21%) had no U.S. phone number, 2,831 (15%) were ineligible for other reasons, and 3,983 (21%) refused participation. In total, 1,618 (9%) participants enrolled in the study. During follow-up, 69% of participants were reached at 2 months and 68% at 6 months. Intervention At discharge, participants were randomized to multisession telephone counseling from study staff (n=804) or referral to the state quitline for proactive outreach and counseling (n=814). Main outcome measures Self-reported abstinence at 6 months was measured. Analyses were conducted in late 2015. Results One quarter of participants were homeless or in unstable housing, 60% had a history of substance abuse, 43% reported current hazardous drinking, and half had a psychiatric diagnosis other than substance abuse. At follow-up, the rate of abstinence (30-day point prevalence) was higher in the intensive counseling arm than the quitline arm at 2 months (29.0% vs 20.7%; relative risk=1.40; 95% CI=1.13, 1.73) and 6 months (37.4% vs 31.5%; relative risk=1.19; 95% CI=1.01, 1.40). Conclusions Intensive counseling was more effective than referral to the state quitline. Long-term abstinence was excellent in both groups. Many patients were not eligible for enrollment despite minimal exclusion criteria. Trial Registration This study is registered at www.clinicaltrials.gov NCT01363245.

Social network alcohol use is associated with individual-level alcohol use among Black sexually minoritized men and gender-expansive people : Findings from the Neighborhoods and Networks (N2) cohort study

Shrader, C. H., Duncan, D., Santoro, A., Geng, E., Kranzler, H. R., Hasin, D., Shelley, D., Kutner, B., Sherman, S., Chen, Y. T., Durrell, M., Eavou, R., Hillary, H., Goedel, W., Schneider, J. A., & Knox, J. R. (n.d.).

Publication year

2025

Journal title

Alcohol, Clinical and Experimental Research

10.1111/acer.70009

Abstract

Abstract

Introduction: Black sexually minoritized men and gender-expansive people (SGM), including transgender women, have higher levels of alcohol use and experience greater negative consequences from alcohol consumption than the general population. We investigated the role of multilevel factors contributing to alcohol use among these groups. Methods: We analyzed data collected from HIV-negative participants in the Neighborhoods and Network (N2) cohort study in Chicago, IL (N = 138). Participants completed a social network inventory (November 2018–April 2019) and reported alcohol use (frequency, quantity, and frequency of binge drinking) during a quantitative assessment. We used stepwise negative binomial regression to identify associations with social network and individual-level alcohol use while controlling for sociodemographic variables. Results: Most participants drank alcohol in the past month (68%), with a mean of 2.5 drinks (SD = 1.9) per drinking day. Participants nominated 377 confidants (Mnominated = 2.7), of whom 93% were Black and 78% were friends/family. Among the confidants, 30% drank alcohol at least several times per week. Identifying as Latine (RR = 2.21; 95% CI: 1.44–3.10), having a higher Generalized Anxiety Disorder-7 score (RR = 1.03; 95%CI: 1.00–1.05), living with a problem drinker during one's childhood (RR = 1.80; 95% CI: 1.39–2.34), and having a greater proportion of regular drinkers in one's social network (RR = 1.49; 95% CI: 1.02–2.17) were positively associated with alcohol use. Conclusion: Black SGM exposed to social network alcohol use during childhood and adulthood reported increased alcohol use. Interventions targeting Black SGM should address social norms around alcohol, intersectional discrimination, and mental health.

Social network alcohol use is associated with individual-level alcohol use among Black sexually minoritized men and gender-expansive people : Findings from the Neighborhoods and Networks (N2) cohort study

Shrader, C. H., Duncan, D., Santoro, A., Geng, E., Kranzler, H. R., Hasin, D., Shelley, D., Kutner, B., Sherman, S., Chen, Y. T., Durrell, M., Eavou, R., Hillary, H., Goedel, W., Schneider, J. A., & Knox, J. R. (n.d.).

Publication year

2025

Journal title

Alcohol, Clinical and Experimental Research

Volume

49

Issue

4

Page(s)

783-791

10.1111/acer.70009

Abstract

Abstract

Introduction: Black sexually minoritized men and gender-expansive people (SGM), including transgender women, have higher levels of alcohol use and experience greater negative consequences from alcohol consumption than the general population. We investigated the role of multilevel factors contributing to alcohol use among these groups. Methods: We analyzed data collected from HIV-negative participants in the Neighborhoods and Network (N2) cohort study in Chicago, IL (N = 138). Participants completed a social network inventory (November 2018–April 2019) and reported alcohol use (frequency, quantity, and frequency of binge drinking) during a quantitative assessment. We used stepwise negative binomial regression to identify associations with social network and individual-level alcohol use while controlling for sociodemographic variables. Results: Most participants drank alcohol in the past month (68%), with a mean of 2.5 drinks (SD = 1.9) per drinking day. Participants nominated 377 confidants (Mnominated = 2.7), of whom 93% were Black and 78% were friends/family. Among the confidants, 30% drank alcohol at least several times per week. Identifying as Latine (RR = 2.21; 95% CI: 1.44–3.10), having a higher Generalized Anxiety Disorder-7 score (RR = 1.03; 95%CI: 1.00–1.05), living with a problem drinker during one's childhood (RR = 1.80; 95% CI: 1.39–2.34), and having a greater proportion of regular drinkers in one's social network (RR = 1.49; 95% CI: 1.02–2.17) were positively associated with alcohol use. Conclusion: Black SGM exposed to social network alcohol use during childhood and adulthood reported increased alcohol use. Interventions targeting Black SGM should address social norms around alcohol, intersectional discrimination, and mental health.

Social norms and self-efficacy to quit waterpipe use : Findings from a tobacco study among male smokers in rural Viet Nam

Kumar, P. C., Cleland, C. M., Latkin, C., VanDevanter, N., Siman, N., Nguyen, T., Nguyen, L., Nguyen, N., & Shelley, D. (n.d.).

Publication year

2018

Journal title

Journal of Smoking Cessation

Volume

13

Issue

3

Page(s)

154-161

10.1017/jsc.2017.20

Abstract

Abstract

Introduction: Waterpipe use is a significant health concern in low- A nd middle-income countries like Viet Nam, yet there is a lack of research on factors that may influence use and self-efficacy to quit among adults. Aims: This study examined the relationship between social norms related to waterpipe use and self-efficacy to quit among male waterpipe smokers in Viet Nam. Methods: A cross-sectional survey was conducted with 214 adult male waterpipe smokers enrolled in a large cluster-randomised controlled trial conducted in a rural province in Viet Nam. Associations between social norms related to waterpipe smoking and the participants' confidence to quit waterpipes were assessed using hierarchical regression models to account for differences among study sites and other covariates. Results: Self-efficacy to quit smoking was positively associated with immediate family members' not minding participants smoking and with extended family's encouragement to quit smoking. Conclusions: The findings suggest the need for a more comprehensive understanding of the functions and characteristics of the social context of waterpipe smoking, including the social networks of waterpipe smokers, to inform effective cessation interventions for waterpipe smokers.

Social relationships, homelessness, and substance use among emergency department patients

Jurewicz, A., Padgett, D. K., Ran, Z., Castelblanco, D. G., McCormack, R. P., Gelberg, L., Shelley, D., & Doran, K. M. (n.d.).

Publication year

2022

Journal title

Substance Abuse

Volume

43

Issue

1

Page(s)

573-580

10.1080/08897077.2021.1975869

Abstract

Abstract

Background: Emergency department (ED) patients commonly experience both substance use and homelessness, and social relationships impact each in varied ways not fully captured by existing quantitative research. This qualitative study examines how social relationships can precipitate or ameliorate homelessness and the connection (if any) between substance use and social relationships among ED patients experiencing homelessness. Methods: As part of a broader study to develop ED-based homelessness prevention interventions, we conducted in-depth interviews with 25 ED patients who used alcohol or drugs and had recently become homeless. We asked patients about the relationship between their substance use and homelessness. Interviews were recorded, transcribed, and coded line-by-line by investigators. Final codes formed the basis for thematic analysis through consensus discussions. Results: Social relationships emerged as focal points for understanding the four major themes related to the intersection of homelessness and substance use: (1) Substance use can create strain in relationships; (2) Help is there until it’s not; (3) Social relationships can create challenges contributing to substance use; and (4) Reciprocal relationship of substance use and isolation. Sub-themes were also identified and described. Conclusions: The association between substance use and homelessness is multifaceted and social relationships are a complex factor linking the two. Social relationships are often critical for homelessness prevention, but they are impacted by and reciprocally affect substance use. ED-based substance use interventions should consider the high prevalence of homelessness and the impact of social relationships on the interaction between homelessness and substance use.

Staff views on overdose prevention in permanent supportive housing

Doran, K. M., Torsiglieri, A., Moran, J., Blaufarb, S., Liu, A. Y., Ringrose, E., Urban, C., Velez, L., Hernandez, P., O’Grady, M. A., Shelley, D., & Cleland, C. M. (n.d.).

Publication year

2025

Journal title

Harm Reduction Journal

Volume

22

Issue

1

10.1186/s12954-025-01215-x

Abstract

Abstract

Background: Permanent supportive housing (PSH) is the gold standard intervention for chronic homelessness, but PSH tenants face high risk for overdose due to a combination of individual and environmental risk factors. Little research has examined overdose prevention in PSH. Methods: We conducted baseline surveys with staff from 20 New York PSH buildings participating in an overdose prevention technical assistance intervention study. PSH staff from participating buildings were invited via email to complete a brief online survey about their knowledge of overdose and perspectives on implementing overdose prevention practices in PSH. Results: Surveys were completed by 178 staff of 286 invitations sent (response rate 62.2%). Average score on the Brief Opioid Overdose Knowledge (BOOK) questionnaire was 8.62 (SD 2.64) out of 12 points. Staff felt very positively (91.6–97.2% agreed or completely agreed) regarding the appropriateness and acceptability of implementing overdose prevention practices in PSH, but less certain about the feasibility of implementing these practices (62.4–65.5% agreed or completely agreed). Most (77.3%) felt it was mostly or definitely true that overdose prevention was a top priority in their building. Most PSH staff (median = 85.0%) but fewer tenants (median = 22.5%) had received a naloxone kit and training in overdose response. Conclusion: Staff feel positively about the acceptability and appropriateness of implementing overdose response practices in PSH, but somewhat more uncertain about the feasibility of implementing these practices. This study’s results help hone targets for interventions to help PSH buildings take steps to reduce tenant overdose risk.

State of the Science of Scale-Up of Cancer Prevention and Early Detection Interventions in Low- and Middle-Income Countries : A Scoping Review

Friebel-Klingner, T. M., Alvarez, G. G., Lappen, H., Pace, L. E., Huang, K. Y., Fernández, M. E., Shelley, D., & Rositch, A. F. (n.d.).

Publication year

2024

Journal title

JCO Global Oncology

Volume

10

Page(s)

e2300238

10.1200/GO.23.00238

Abstract

Abstract

PURPOSE: Cancer deaths in low- and middle-income countries (LMICs) will nearly double by 2040. Available evidence-based interventions (EBIs) for cancer prevention and early detection can reduce cancer-related mortality, yet there is a lack of evidence on effectively scaling these EBIs in LMIC settings. METHODS: We conducted a scoping review to identify published literature from six databases between 2012 and 2022 that described efforts for scaling cancer prevention and early detection EBIs in LMICs. Included studies met one of two definitions of scale-up: (1) deliberate efforts to increase the impact of effective intervention to benefit more people or (2) an intervention shown to be efficacious on a small scale expanded under real-world conditions to reach a greater proportion of eligible population. Study characteristics, including EBIs, implementation strategies, and outcomes used, were summarized using frameworks from the field of implementation science. RESULTS: This search yielded 3,076 abstracts, with 24 studies eligible for inclusion. Included studies focused on a number of cancer sites including cervical (67%), breast (13%), breast and cervical (13%), liver (4%), and colon (4%). Commonly reported scale-up strategies included developing stakeholder inter-relationships, training and education, and changing infrastructure. Barriers to scale-up were reported at individual, health facility, and community levels. Few studies reported applying conceptual frameworks to guide strategy selection and evaluation. CONCLUSION: Although there were relatively few published reports, this scoping review offers insight into the approaches used by LMICs to scale up cancer EBIs, including common strategies and barriers. More importantly, it illustrates the urgent need to fill gaps in research to guide best practices for bringing the implementation of cancer EBIs to scale in LMICs.

Strauss et al. respond

Strauss, S. M., Alfano, M. C., Shelley, D., & Fulmer, T. (n.d.).

Publication year

2012

Journal title

American journal of public health

Volume

102

Issue

9

Page(s)

e5-e6

10.2105/AJPH.2012.300866

Abstract

Abstract

~

Study protocol for a pragmatic trial of the Consult for Addiction Treatment and Care in Hospitals (CATCH) model for engaging patients in opioid use disorder treatment

McNeely, J., Troxel, A. B., Kunins, H. V., Shelley, D., Lee, J. D., Walley, A., Weinstein, Z. M., Billings, J. C., Davis, N. J., Marcello, R. K., Schackman, B. R., Barron, C., & Bergmann, L. (n.d.).

Publication year

2019

Journal title

Addiction science &amp; clinical practice

Volume

14

Issue

1

Page(s)

5

10.1186/s13722-019-0135-7

Abstract

Abstract

BACKGROUND: Treatment for opioid use disorder (OUD) is highly effective, yet it remains dramatically underutilized. Individuals with OUD have disproportionately high rates of hospitalization and low rates of addiction treatment. Hospital-based addiction consult services offer a potential solution by using multidisciplinary teams to evaluate patients, initiate medication for addiction treatment (MAT) in the hospital, and connect patients to post-discharge care. We are studying the effectiveness of an addiction consult model [Consult for Addiction Treatment and Care in Hospitals (CATCH)] as a strategy for engaging patients with OUD in treatment as the program rolls out in the largest municipal hospital system in the US. The primary aim is to evaluate the effectiveness of CATCH in increasing post-discharge initiation and engagement in MAT. Secondary aims are to assess treatment retention, frequency of acute care utilization and overdose deaths and their associated costs, and implementation outcomes. METHODS: A pragmatic trial at six hospitals, conducted in collaboration with the municipal hospital system and department of health, will be implemented to study the CATCH intervention. Guided by the RE-AIM evaluation framework, this hybrid effectiveness-implementation study (Type 1) focuses primarily on effectiveness and also measures implementation outcomes to inform the intervention's adoption and sustainability. A stepped-wedge cluster randomized trial design will determine the impact of CATCH on treatment outcomes in comparison to usual care for a control period, followed by a 12-month intervention period and a 6- to 18-month maintenance period at each hospital. A mixed methods approach will primarily utilize administrative data to measure outcomes, while interviews and focus groups with staff and patients will provide additional information on implementation fidelity and barriers to delivering MAT to patients with OUD. DISCUSSION: Because of their great potential to reduce the negative health and economic consequences of untreated OUD, addiction consult models are proliferating in response to the opioid epidemic, despite the absence of a strong evidence base. This study will provide the first known rigorous evaluation of an addiction consult model in a large multi-site trial and promises to generate knowledge that can rapidly transform practice and inform the potential for widespread dissemination of these services. TRIAL REGISTRATION: NCT03611335.

Study protocol of a multiphase optimization strategy trial (MOST) for delivery of smoking cessation treatment in lung cancer screening settings

Ostroff, J. S., Shelley, D., Chichester, L. A., King, J. C., Li, Y., Schofield, E., Ciupek, A., Criswell, A., Acharya, R., Banerjee, S. C., Elkin, E. B., Lynch, K., Weiner, B. J., Orlow, I., Martin, C. M., Chan, S. V., Frederico, V., Camille, P., Holland, S., & Kenney, J. (n.d.).

Publication year

2022

Journal title

Trials

Volume

23

Issue

1

10.1186/s13063-022-06568-3

Abstract

Abstract

Background: There is widespread agreement that the integration of cessation services in lung cancer screening (LCS) is essential for achieving the full benefits of LCS with low-dose computed tomography (LDCT). There is a formidable knowledge gap about how to best design feasible, effective, and scalable cessation services in LCS facilities. A collective of NCI-funded clinical trials addressing this gap is the Smoking Cessation at Lung Examination (SCALE) Collaboration. Methods: The Cessation and Screening to Save Lives (CASTL) trial seeks to advance knowledge about the reach, effectiveness, and implementation of tobacco treatment in lung cancer screening. We describe the rationale, design, evaluation plan, and interventions tested in this multiphase optimization strategy trial (MOST). A total of 1152 screening-eligible current smokers are being recruited from 18 LCS sites (n = 64/site) in both academic and community settings across the USA. Participants receive enhanced standard care (cessation advice and referral to the national Quitline) and are randomized to receive additional tobacco treatment components (motivational counseling, nicotine replacement patches/lozenges, message framing). The primary outcome is biochemically validated, abstinence at 6 months follow-up. Secondary outcomes are self-reported smoking abstinence, quit attempts, and smoking reduction at 3 and 6 months. Guided by the Implementation Outcomes Framework (IOF), our evaluation includes measurement of implementation processes (reach, fidelity, acceptability, appropriateness, sustainability, and cost). Conclusion: We will identify effective treatment components for delivery by LCS sites. The findings will guide the assembly of an optimized smoking cessation package that achieves superior cessation outcomes. Future trials can examine the strategies for wider implementation of tobacco treatment in LDCT-LCS sites. Trial registration: ClinicalTrials.govNCT03315910

Substance use and homelessness among emergency department patients

Doran, K. M., Rahai, N., McCormack, R. P., Milian, J., Shelley, D., Rotrosen, J., & Gelberg, L. (n.d.).

Publication year

2018

Journal title

Drug and alcohol dependence

Volume

188

Page(s)

328-333

10.1016/j.drugalcdep.2018.04.021

Abstract

Abstract

Background: Homelessness and substance use often coexist, resulting in high morbidity. Emergency department (ED) patients have disproportionate rates of both homelessness and substance use, yet little research has examined the overlap of these issues in the ED setting. We aimed to characterize alcohol and drug use in a sample of homeless vs. non-homeless ED patients. Methods: A random sample of urban hospital ED patients were invited to complete an interview regarding housing, substance use, and other health and social factors. We compared substance use characteristics among patients who did vs. did not report current literal (streets/shelter) homelessness. Additional analyses were performed using a broader definition of homelessness in the past 12-months. Results: Patients who were currently homeless (n = 316, 13.7%) versus non-homeless (n = 1,993, 86.3%) had higher rates of past year unhealthy alcohol use (44.4% vs. 30.5%, p

Substance-use screening and interventions in dental practices : Survey of practice-based research network dentists regarding current practices, policies and barriers

McNeely, J., Wright, S., Matthews, A. G., Rotrosen, J., Shelley, D., Buchholz, M. P., & Curro, F. A. (n.d.).

Publication year

2013

Journal title

Journal of the American Dental Association

Volume

144

Issue

6

Page(s)

627-638

10.14219/jada.archive.2013.0174

Abstract

Abstract

Background: Dental visits represent an opportunity to identify and assist patients with unhealthy substance use, but little is known about how dentists are addressing patients' use of tobacco, alcohol and illicit drugs. The authors surveyed dentists to learn about the role their practices might play in providing substance-use screening and interventions. Methods: The authors distributed a 41-item Web-based survey to all 210 dentists active in the Practitioners Engaged in Applied Research and Learning Network, a practice-based research network. The questionnaire assessed dental practices' policies and current practices, attitudes and perceived barriers to providing services for tobacco, alcohol and illicit drug use. Results: One hundred forty-three dentists completed the survey (68 percent response rate). Although screening was common, fewer dentists reported that they were providing follow-up counseling or referrals for substance use. Insufficient knowledge or training was the most frequently cited barrier to intervention. Many dentists reported they would offer assistance for use of tobacco (67 percent) or alcohol or illicit drugs (52 percent) if reimbursed; respondents who treated publicly insured patients were more likely to reply that they would offer this assistance. Conclusions: Dentists recognize the importance of screening for substance use, but they lack the clinical training and practice-based systems focused on substance use that could facilitate intervention. Practical Implications: The results of this study indicate that dentists may be willing to address substance use among patients, including use of alcohol and illicit drugs in addition to tobacco, if barriers are reduced through changes in reimbursement, education and systems-level support.