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

Oral health care and smoking cessation practices of interprofessional home care providers for their patients with HIV

VanDevanter, N., Dorsen, C. G., Messeri, P., Shelley, D., & Person, A. (n.d.).

Publication year

2012

Journal title

Journal of Interprofessional Care

Volume

26

Issue

4

Page(s)

339-340

10.3109/13561820.2012.676107

Abstract

Abstract

The need for oral health services among patients with HIV, especially those in advanced stages of disease and those who smoke, has been well documented. Patients receiving HIV-related home care services provide an opportunity for assessment of oral health and smoking cessation needs; however, the majority of home care providers lack formal training to provide these services, thus interprofessional collaborations may be of value. This study assessed the oral health and smoking cessation practices of a random sample of 81 HIV home care providers. Results showed very favorable attitudes toward providing these services with some differences across disciplines. More than 70% of nurses would like to receive additional training in comprehensive oral health assessment by dental professionals. The study provides evidence for the potential of expanding these services for patients with HIV through interprofessional collaboration, in particular with nurses and dentists.

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.

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

~

Ethnic disparities in self-reported oral health status and access to care among older adults in NYC

Shelley, D., Russell, S. L., Parikh, N. S., & Fahs, M. (n.d.).

Publication year

2011

Journal title

Journal of Urban Health

Volume

88

Issue

4

Page(s)

651-662

10.1007/s11524-011-9555-8

Abstract

Abstract

There is a growing burden of oral disease among older adults that is most significantly borne by minorities, the poor, and immigrants. Yet, national attention to oral heath disparities has focused almost exclusively on children, resulting in large gaps in our knowledge about the oral health risks of older adults and their access to care. The projected growth of the minority and immigrant elderly population as a proportion of older adults heightens the urgency of exploring and addressing factors associated with oral health-related disparities. In 2008, the New York City Health Indicators Project (HIP) conducted a survey of a representative sample of 1,870 adults over the age of 60 who attended a random selection of 56 senior centers in New York City. The survey included questions related to oral health status. This study used the HIP database to examine differences in self-reported dental status, dental care utilization, and dental insurance, by race/ethnicity, among community-dwelling older adults. Non-Hispanic White respondents reported better dental health, higher dental care utilization, and higher satisfaction with dental care compared to all other racial/ethnic groups. Among minority older adults, Chinese immigrants were more likely to report poor dental health, were less likely to report dental care utilization and dental insurance, and were less satisfied with their dental care compared to all other racial/ethnic groups. Language fluency was significantly related to access to dental care among Chinese immigrants. Among a diverse community-dwelling population of older adults in New York City, we found significant differences by race/ethnicity in factors related to oral health. Greater attention is needed in enhancing the cultural competency of providers, addressing gaps in oral health literacy, and reducing language barriers that impede access to care.

Guest editorial : Tobacco-use treatment in dental practice: How healthy people 2020 aligns federal policy with the evidence

Shelley, D., Jannat-Khah, D., & Wolff, M. (n.d.).

Publication year

2011

Journal title

Journal of the American Dental Association

Volume

142

Issue

6

Page(s)

592-596

10.14219/jada.archive.2011.0229

Abstract

Abstract

~

Implementing tobacco use treatment guidelines in public health dental clinics in New York City

Shelley, D., Anno, J., Tseng, T. Y., Calip, G., Wedeles, J., Lloyd, M., & Wolff, M. S. (n.d.).

Publication year

2011

Journal title

Journal of dental education

Volume

75

Issue

4

Page(s)

527-533

Abstract

Abstract

In this study we evaluated the effect of a multicomponent intervention to implement the Public Health Service (PHS) guideline Treating Tobacco Use and Dependence in six randomly selected dental clinics in New York University's College of Dentistry. The main outcome measure-provider adherence to tobacco use treatment guidelines-was assessed by auditing a random selection of patient charts pre (698) and post (641) intervention. The intervention components included a chart reminder and referral system, free nicotine replacement therapy (NRT), and provider training and feedback. The results showed that rates of screening for tobacco use did not change between pre and post test chart audits. However, providers were significantly more likely to offer advice (28.4 percent pre, 49 percent post), assess readiness to quit (17.8 percent pre, 29.9 percent post), and offer assistance (6.5 percent pre and 15.6 percent post) in the post test period. Increases in NRT distribution were associated with booster training sessions but declined in the time periods between those trainings. Research is needed to further define sustainable strategies for implementing tobacco use treatment in dental clinics. The results of this study suggest the feasibility and effectiveness of using a tailored multicomponent approach to implement tobacco use treatment guidelines in dental clinics.

Predictors of blood pressure control among hypertensives in community health centers

Shelley, D., Tseng, T. Y., Andrews, H., Ravenell, J., Wu, D., Ferrari, P., Cohen, A., Millery, M., & Kopal, H. (n.d.).

Publication year

2011

Journal title

American Journal of Hypertension

Volume

24

Issue

12

Page(s)

1318-1323

10.1038/ajh.2011.154

Abstract

Abstract

Background The correlates of blood pressure (BP) control among hypertensive individuals who have access to care in community-based health-care settings are poorly characterized, particularly among minority and immigrant populations. Methods Using data extracted from electronic medical records in four federally qualified health centers in New York, we investigated correlates of hypertension (HTN) control in cross-sectional analyses. The sample consisted of adult, nonobstetric patients with a diagnosis of HTN and a clinic visit between June 2007 and October 2008 (n = 2,585). Results Forty-nine percent of hypertensive patients had controlled BP at their last visit. Blacks had a higher prevalence of HTN (B, 32.8%; W, 16.2%; H, 11.5%) and were less likely to have controlled BP (B, 42.2%; W, 50.9%; H, 50.8%) compared with Hispanics and whites. Medication intensification did not differ by race/ethnicity. In multivariate analyses higher body mass index (BMI), black race, diabetes, fewer clinical encounters, and male gender were associated with poor BP control. However, when we applied the Seventh Report of the Joint National Committee (JNC 7) definition for BP control for nondiabetic patients (systolic blood pressure (SBP)

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.

Increasing access to evidence-based smoking cessation treatment : Effectiveness of a free nicotine patch program among chinese immigrants

Shelley, D., Nguyen, N., Peng, C. H., Chin, M., Chang, M. D., & Fahs, M. (n.d.).

Publication year

2010

Journal title

Journal of Immigrant and Minority Health

Volume

12

Issue

2

Page(s)

198-205

10.1007/s10903-008-9194-7

Abstract

Abstract

Pharmacotherapy substantially increases smoking cessation rates. However, programs to reduce barriers to this evidence-based treatment may not improve access among high risk immigrant non English speaking populations. This study estimates the effectiveness of a tailored free nicotine patch (NRT) program among Chinese American smokers living in New York City (NYC). Between July 2004 and May 2005 NRT was distributed to 375 smokers through two community-based organizations that serve the Asian American population in NYC. Participants completed an in person baseline survey and a 4- month follow-up telephone survey. Using an intention to treat analysis the abstinence rate at 4 months was 26.7% (100/375). Predictors of cessation included higher levels of self efficacy at baseline, not smoking while using the patch and concern about personal health risks. Distribution through easy to access, culturally competent local community organizations increased the reach of a free nicotine patch program and assisted smokers in quitting.

Assessing the impact of behavioral risk factors and known-groups validity of the SF-12 in a US Chinese immigrant population

Hung, D. Y., Lubetkin, E. I., Fahs, M. C., & Shelley, D. (n.d.).

Publication year

2009

Journal title

Medical care

Volume

47

Issue

2

Page(s)

262-267

10.1097/MLR.0b013e3181844de4

Abstract

Abstract

Background: Health status measures are being used in increasingly diverse populations. However, there are no known studies to date that examine the SF-12 in US Chinese populations. This study reports on the performance and validity of the SF-12 among Chinese immigrants residing in New York City, and evaluates the impact of multiple behavioral risk factors on physical and mental health status. Methods: We used cross-sectional survey data from a multistage probability sample of 2537 Chinese adults. SF-12 scores were examined according to sociodemographic, cultural, and clinical characteristics. Regression analyses were used to examine associations between health status and co-occurring behavioral risk factors of smoking, risky drinking, physical inactivity, and overweight/obesity. Results: SF-12 scores were significantly lower among women, those with less education, lower incomes, and more health problems (P < 0.001). Older adults had worse physical but better mental health (P < 0.05). Individuals with 1, 2, 3, and 4 behavioral risk factors reported decreases of 1.91, 2.92, 4.86, and 9.21 points on the PCS-12, respectively, in comparison with the reference group having zero risk factors (P < 0.01). Similar trends up to 2 co-occurring risks were observed with MCS-12 scores (P < 0.01). Conclusions: The SF-12 exhibited known-groups validity in a US Chinese immigrant population. Co-occurring behavioral risk factors were associated with progressive declines in physical health, independent of sociodemographic and clinical characteristics traditionally associated with impairments in health status. Targeting patients with multiple risks for behavior change may be effective in improving health across diverse populations.

Body weight and length of residence in the US among Chinese Americans

Yeh, M. C., Fahs, M., Burton, D., Yerneni, R., Parikh, N. S., & Shelley, D. (n.d.).

Publication year

2009

Journal title

Journal of Immigrant and Minority Health

Volume

11

Issue

5

Page(s)

422-427

10.1007/s10903-007-9113-3

Abstract

Abstract

Background: It has been shown that as immigrants' length of residence increases, so does their weight. However, little is known about factors associated with weight status among Chinese Americans, one of the fastest growing immigrant populations in the US. Methods: Baseline datafrom a National Cancer Institute-funded longitudinal study involving a multi-stage probability sample of Chinese Americans residing in two communities in New York City were collected. Results: Chinese Americans had a low BMI (mean = 22.81) and a lower proportion of obese individuals compared with other ethnic groups in the US reported in the literature. While the prevalence of being overweight (21%) and obese (2%) was low, length of residence was positively associated with weight status (P < 0.005). Conclusions: Innovative strategies to help Chinese Americans maintain healthy weight status and to prevent them from becoming overweight and obese are needed.

Disparities in access to over-the-counter nicotine replacement products in New York City pharmacies

Bernstein, S. L., Cabral, L., Maantay, J., Peprah, D., Lounsbury, D., Maroko, A., Murphy, M., & Shelley, D. (n.d.).

Publication year

2009

Journal title

American journal of public health

Volume

99

Issue

9

Page(s)

1699-1704

10.2105/AJPH.2008.149260

Abstract

Abstract

Objectives. We surveyed the availability of tobacco products and nonprescription nicotine replacement therapy (NRT) in pharmacies in New York City, stratified by the race, ethnicity, and socioeconomic status (SES) of the surrounding neighborhoods to determine whether disparities in availability existed. Methods. Surveyors visited a random sample of retail pharmacies to record the availability of tobacco products and nonprescription NRT. We used census data and geographic information systems analysis to determine the SES of each neighborhood. We used logistic modeling to explore relations between SES and the availability of NRT and tobacco products. Results. Of 646 pharmacies sampled, 90.8% sold NRT and 46.9% sold cigarettes. NRT and cigarettes were slightly more available in pharmacies in neighborhoods with a higher SES. NRT was more expensive in poorer neighborhoods. Conclusions. Small disparities existed in access to nonprescription NRT and cigarettes. The model did not adequately account for cigarette access, because of availability from other retail outlets. These results may explain some of the excess prevalence of cigarette use in low-SES areas.

Health behaviors of older Chinese adults living in New York City

Parikh, N. S., Fahs, M. C., Shelley, D., & Yerneni, R. (n.d.).

Publication year

2009

Journal title

Journal of Community Health

Volume

34

Issue

1

Page(s)

6-15

10.1007/s10900-008-9125-5

Abstract

Abstract

The dramatic increase in the number of older immigrants living in the U.S. presents new challenges to policy makers concerned with promoting healthy aging. To date, however, strikingly little is known regarding the health and health trajectories of older immigrants. This paper examines the prevalence and predictors of important health behaviors associated with chronic disease prevention, including current smoking status, physical activity, alcohol use, and body mass index (BMI). We analyzed data from the 2003 New York City Chinese Health Survey (NYC CHS), the largest probability-based sample of Chinese immigrants residing in two distinct communities. In-person interviews were conducted with 517 representative men and women aged 55-75. Logistic regression modeling was used to test the influence of demographic, socioeconomic status, acculturation, and health characteristics on selected health behaviors. Results revealed that having more education and better physical health status were associated with greater participation in physical activity. Gender-specific analyses indicated that the effect of selected predictors varied between the sexes. For example, among older Chinese women, acculturation was negatively associated with alcohol use. This study provides some of the first evidence on health behaviors of one of the fastest growing older immigrant groups in the U.S. Study results add to the emerging literature on the complex nature of immigrant health trajectories, and demonstrate that contrary to prior research, living a greater proportion of time in the U.S. can be associated with selected positive health behaviors. Further longitudinal studies are needed to help inform policy initiatives to encourage healthy aging among diverse older immigrant groups.

Multilevel analysis of the chronic care model and 5A services for treating tobacco use in urban primary care clinics

Hung, D. Y., & Shelley, D. (n.d.).

Publication year

2009

Journal title

Health Services Research

Volume

44

Issue

1

Page(s)

103-127

10.1111/j.1475-6773.2008.00896.x

Abstract

Abstract

Objective. To examine the chronic care model (CCM) as a framework for improving provider delivery of 5A tobacco cessation services. Methods. Cross-sectional surveys were used to obtain data from 497 health care providers in 60 primary care clinics serving low-income patients in New York City. A hierarchical generalized linear modeling approach to ordinal regression was used to estimate the probability of full 5A service delivery, adjusting for provider covariates and clustering effects. We examined associations between provider delivery of 5A services, clinic implementation of CCM elements tailored for treating tobacco use, and the degree of CCM integration in clinics. Principal Findings. Providers practicing in clinics with enhanced delivery system design, clinical information systems, and self-management support for cessation were 2.04-5.62 times more likely to perform all 5A services (p

Preliminary steps toward creating an interprofessional international public health program

Shelley, D., Mevi, A., Abu-Rish, E., Haber, J., & Hirsch, S. M. (n.d.).

Publication year

2009

Journal title

Journal of Interprofessional Care

Volume

23

Issue

4

Page(s)

417-419

10.1080/13561820802561378

Abstract

Abstract

~

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.

Effectiveness of tobacco control among Chinese Americans : A comparative analysis of policy approaches versus community-based programs

Shelley, D., Fahs, M., Yerneni, R., Das, D., Nguyen, N., Hung, D., Burton, D., Chin, M., Chang, M. d., & Cummings, K. M. (n.d.).

Publication year

2008

Journal title

Preventive Medicine

Volume

47

Issue

5

Page(s)

530-536

10.1016/j.ypmed.2008.07.009

Abstract

Abstract

Objective: To estimate the effectiveness of a tailored multicomponent community-based smoking cessation intervention among Chinese immigrants living in New York City, implemented within the context of state and city-wide tobacco control policy initiatives for the general population. Methods: A pre-post-test quasi-experimental design with representative samples from Chinese populations living in two communities in New York City: Flushing, Queens, the intervention community and Sunset Park, Brooklyn, the comparison community. From November 2002 to August 2003 baseline interviews were conducted with 2537 adults aged 18-74. In early 2006, 1384 participants from the original cohort completed the follow-up interview. During the intervention period (October 2003 to September 2005), both communities were exposed to tobacco control public policy changes. However, only Flushing received additional linguistically and culturally-specific community-level tobacco control interventions. Results: From 2002 to 2006 overall smoking prevalence among Chinese immigrants declined from 17.7% to 13.6%, a relative 23% decrease. After controlling for socio-demographic characteristics, there was an absolute 3.3% decrease in smoking prevalence attributed to policy changes with an additional absolute decline in prevalence of 2.8% in the intervention community relative to the control community. Conclusion: City-wide tobacco control policies are effective among high-risk urban communities, such as Chinese immigrants. In addition, community-based tailored tobacco control interventions may increase the reduction in smoking prevalence rates beyond that achieved from public policies.

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

~

Tobacco use behaviors and household smoking bans among Chinese Americans

Shelley, D., Nguyen, N., Yerneni, R., & Fahs, M. (n.d.).

Publication year

2008

Journal title

American Journal of Health Promotion

Volume

22

Issue

3

Page(s)

168-175

10.4278/ajhp.22.3.168

Abstract

Abstract

Purpose. To assess the relationship between household smoking restrictions and smoking patterns among Chinese American adults. Design. This is a cross-sectional analysis based on a National Institutes of Health-funded population-based household and telephone survey of 2537 Chinese American adults. Setting. Two communities in New York City. Subjects. The analyses focused on male current smokers (N = 600). Measures. Demographic characteristics, smoking status, household smoking restrictions, cigarettes smoked per day, and past quit attempts were based on self-reported data. Results. Among current smokers, 37% reported living in a home with a compute smoking ban. Smokers with a full household smoking ban smoked fewer cigarettes on weekdays and weekends than smokers with no household smoking ban (p ≤ .05) and were 3.4 times (p < .01) more likely to report having at least one quit attempt in the past 12 months. Smokers with knowledge of the dangers of environmental tobacco smoke (ETS) exposure were 2.8 times (p ≤ .01) more likely to have at least one quit attempt in the last 12 months compared with those who were unaware of the danger of ETS and more likely to live in a smoke-free household. Conclusions. Smoke-free home policies and interventions to raise awareness among smokers of the dangers of ETS have the potential to significantly reduce tobacco use and exposure to household ETS among this immigrant population.

Erratum : The relative effect of household and workplace smoking restriction on health status among Chinese Americans living in New York City (Journal of Urban Health DOI: 10.1007/s11524-007-9190-6)

Shelley, D., Yerneni, R., Hung, D., Das, D., & Fahs, M. (n.d.).

Publication year

2007

Journal title

Journal of Urban Health

Volume

84

Issue

4

Page(s)

633

10.1007/s11524-007-9204-4

Abstract

Abstract

~

The relative effect of household and workplace smoking restriction on health status among Chinese Americans living in New York City

Shelley, D., Yerneni, R., Hung, D., Das, D., & Fahs, M. (n.d.).

Publication year

2007

Journal title

Journal of Urban Health

Volume

84

Issue

3

Page(s)

360-371

10.1007/s11524-007-9190-6

Abstract

Abstract

Households and workplaces are the predominant location for exposure to secondhand smoke. The purpose of this study is to examine the association between health status and smoking restrictions at home and work and to compare the relative effect of household and workplace smoking restrictions on health status. This study uses data from a cross sectional representative probability sample of 2,537 Chinese American adults aged 18-74 living in New York City. The analysis was limited to 1,472 respondents who work indoors for wages. Forty-three percent of respondents reported a total smoking ban at home and the workplace, 20% at work only, 22% home only, and 15% reported no smoking restriction at home or work. Smokers who live under a total household smoking ban only or both a total household and total workplace ban were respectively 1.90 and 2.61 times more likely to report better health status compared with those who reported no smoking ban at work or home. Before the NYC Clean Indoor Air Act second-hand smoke (SHS) exposure among this immigrant Chinese population at home and work was high. This study finds that household smoking restrictions are more strongly associated with better health status than workplace smoking restrictions. However, better health status was most strongly associated with both a ban at work and home. Public health efforts should include a focus on promoting total household smoking bans to reduce the well-documented health risks of SHS exposure.

Correlates of household smoking bans among Chinese Americans

Shelley, D., Fahs, M. C., Yerneni, R., Qu, J., & Burton, D. (n.d.).

Publication year

2006

Journal title

Nicotine and Tobacco Research

Volume

8

Issue

1

Page(s)

103-112

10.1080/14622200500431825

Abstract

Abstract

No population-based data are available on the degree to which Chinese Americans have adopted smoke-free household policies and whether these policies are effective in reducing environmental tobacco smoke (ETS) exposure. The present study examines the prevalence of smoke-free home rules among Chinese Americans living in New York City, describes predictors of adopting full smoking bans in the home, and explores the association between household smoking restrictions and ETS exposure at home. In-person interviews using a comprehensive household-based survey were conducted with 2,537 adults aged 18-74 years. Interviews were conducted in Mandarin, Cantonese, and other Chinese dialects. A total of 66% of respondents reported that smoking was not allowed inside the home, 22% reported a partial ban on smoking in the home, and 12% reported no smoking ban. Among current smokers, 38% reported a full household smoking ban. Current smoking status was the strongest predictor of less restrictive household smoking policies. Knowledge of the dangers of ETS, support of smoke-free air legislation, years in the United States, gender, income, and marital status also were associated with household smoking bans. Those living with a total household smoking ban were significantly less likely to report 30-day exposure to ETS than were those living in homes with a partial ban or no ban (7% vs. 68% and 73%, respectively). In homes of smokers and nonsmokers alike, exposure to ETS remains high. Smoke-free home rules and interventions among smokers and nonsmokers to raise awareness of the dangers of ETS have the potential to significantly reduce exposure to household ETS among this immigrant population.

The fourth pillar of the Framework Convention on Tobacco Control : Harm reduction and the international human right to health

Meier, B. M., & Shelley, D. (n.d.).

Publication year

2006

Journal title

Public Health Reports

Volume

121

Issue

5

Page(s)

494-500

10.1177/003335490612100503

Abstract

Abstract

The Framework Convention on Tobacco Control (FCTC), while successful in its execution, fails to acknowledge the harm reduction strategies necessary to help those incapable of breaking their dependence on tobacco. Based on the human right to health embodied in Article 12 of the International Covenant on Economic, Social and Cultural Rights, this article contends that international law supports a harm reduction approach to tobacco control. Analyzing the right to health as an autonomy-enhancing right, countries must prioritize health interventions to promote those treatments most likely to increase autonomy among those least able to control their own health behaviors. Harm reduction can involve the use of novel, purportedly less hazardous tobacco products. By dissociating nicotine from the ancillary carbon monoxide and myriad carcinogens of smoking, these tobacco harm-reduction products may allow the individual smoker to retain addictive behaviors while limiting their concomitant harms. These less hazardous products, while not offering the preferred benefits of abstaining from tobacco entirely, might nevertheless become a viable strategy for buttressing individual autonomy in controlling health outcomes. Working through the FCTC framework, countries can create the international regulatory and research capacity necessary to assess harm-reduction products and programs. The harms of smoking are truly global in scope. More than 1.1 billion people smoke worldwide, resulting in cardiovascular diseases, various cancers, and obstructive lung diseases.1 Approximately one-quarter of all lifelong smokers willdie in middle age (between 35 and 69) as a result of smoking, losing between 20 and 25 years of life. Another quarter of these smokers will die in their latter years as a result of smoking.2,3 Globally, this "quiet pandemic" claims the lives of approximately 5 million persons per year, a figure that will rise to 10 million by 2030, with the burden of death increasingly being felt by developing countries.4 With globalization's dismantling of trade barriers permitting the burgeoning initiation of smoking in unsated developing countries - particularly among the children and adolescents of these countries - tobacco is projected to become the world's leading cause of avoidable death.5

What can community organizations do for tobacco control?

Ransom, P., & Shelley, D. (n.d.).

Publication year

2006

Journal title

Journal of Health and Human Services Administration

Volume

29

Issue

1

Page(s)

51-82

Abstract

Abstract

Community based organizations can play a vital role in widespread involvement on health promotion through a range of activities. Little research to date has focused on the process of government agencies accessing the readiness of these organizations for engaging in tobacco control activities. Because tobacco is the number one cause of preventable death in the United States and impacts on African American communities are particularly severe, opinions of leaders and key management personnel in a variety of CBO's in minority communities may be seen as an important starting point for receptivity to future tobacco control activity by the organization. The purpose of this analysis is a pilot examination of these issues among a small group of organizations in two minority neighborhoods in New York City. The paper develops a methodology utilizing a "rapid appraisal" technique of key informant interviews for assessing these organizations receptivity to partnerships with government on tobacco control. Attitudes and beliefs about smoking including views about tobacco policies, government role and interest in working with government on tobacco control are assessed.

Acculturation and Tobacco Use among Chinese Americans

Shelley, D., Fahs, M., Scheinmann, R., Swain, S., Qu, J., & Burton, D. (n.d.).

Publication year

2004

Journal title

American journal of public health

Volume

94

Issue

2

Page(s)

300-307

10.2105/AJPH.94.2.300

Abstract

Abstract

Objectives: We examined the relationship between acculturation and tobacco use behaviors among Chinese Americans. Methods: Using a Chinese-language instrument based on validated questions from several national surveys, we conducted in-person, household-based interviews with 712 representative adults aged 18-74 years. Results: Observed smoking prevalence was 29% for men and 4% for women. Predictors of smoking cessation included being 35 years and older and having a high level of tobacco-related knowledge. Acculturation was positively associated with a history of never smoking, as was being younger than 35 years and having a high level of tobacco-related knowledge. Conclusions: Acculturation was positively associated with never smoking among men but not with smoking cessation. However, knowledge of tobacco-related health risks was associated with both. Results indicate a need for language-specific educational interventions.