Farzana Kapadia
Farzana Kapadia
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Professor of Epidemiology
Director of Undergraduate Programs
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Professional overview
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Dr. Farzana Kapadia is Professor of Epidemiology and Population Health at the NYU School of Global Public Health and at the NYU Grossman School of Medicine, Department of Population Health. Dr. Kapadia is also affiliated with the Institute of Human Development and Social Change and Population Center at NYU.
Dr. Kapadia has long standing research interests in understanding the social and structural drivers of HIV/STIs as well as sexual and reproductive health outcomes in underserved and marginalized populations. Dr. Kapadia has over 20 years of experience in the design, development, and implementation of observational studies and HIV/STI intervention and prevention trials in underserved and marginalized populations in urban settings, both in the US and in Africa (Ghana and Kenya).
Dr. Kapadia has a passion for teaching and mentoring. She teaches the core Epidemiology for in-coming MPH students and has also taught key epidemiology courses, including Intermediate Epidemiology and Outbreak Epidemiology at GPH as well as an HIV-related course at NYU London. The overarching goal of Dr. Kapadia’s teaching is to train students to become epidemiologists and public health practitioners who are critical and creative thinkers as well as champions and advocates for inclusive solutions to our local and global public health challenges.
In addition to her research and teaching responsibilities, Dr. Kapadia serves as the Deputy Editor for the American Journal of Public Health.
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Education
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BS, Biology and History, SUNY Binghamton, Binghamton, NYMPH, Community Public Health, New York University, New York, NYPhD, Epidemiology, Columbia University, New York, NY
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Honors and awards
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Excellence in Public Health Faculty Award, New York University (2012)Steinhardt Goddard Award (2011)Community Collaborative Award, Steinhardt School of Culture, Education and Human Development (2009)Elected Member, American College of Epidemiology (2007)
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Areas of research and study
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Behavioral Determinants of HealthBehavioral ScienceEpidemiologyHIV/AIDSReproductive HealthSocial BehaviorsSocial Determinants of HealthSocial epidemiologySubstance Abuse
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Publications
Publications
A mixed-methods evaluation of an HIV pre-exposure prophylaxis educational intervention for healthcare providers in a NYC safety-net hospital-based obstetrics and gynecology clinic
AbstractOot, A., Kapadia, F., Moore, B., Greene, R. E., Katz, M., Denny, C., & Pitts, R. (n.d.).Publication year
2024Journal title
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIVVolume
36Issue
10Page(s)
1537-1544AbstractCisgender women and transgender men are less likely to be assessed for PrEP eligibility, prescribed PrEP, or retained in PrEP care. Thus, this pilot PrEP educational intervention was tailored for healthcare providers (HCPs) in obstetrics/gynecology who provide care to cisgender women and transgender men in an academically-affiliated, public hospital women’s health clinic. The three-lecture educational curriculum designed for HCPs focused on PrEP eligibility and counseling, formulations and adherence, and prescription and payment assistance programs. Pre- and post-intervention surveys assessed HCP knowledge and barriers to PrEP counseling and prescription. Among n = 49 participants (mean age = 32.8 years; 85.7% cisgender women, mean years practicing = 4.2 years) pre-intervention, 8.7% had prior PrEP training and 61.2% felt very/somewhat uncomfortable prescribing PrEP. Post-intervention, knowledge of PrEP contraindications, eligibility, follow-up care, and assistance programs all increased. HCPs identified key barriers to PrEP care including lack of a dedicated PrEP navigator, culturally and linguistically appropriate patient materials on PrEP resources/costs, and PrEP-related content integrated into EHRs. Ongoing PrEP educational sessions can provide opportunities to practice PrEP counseling, including information on financial assistance. At the institutional level, incorporating PrEP screening in routine clinical practice via EMR prompts, facilitating PrEP medication monitoring, and enhancing telehealth for follow-up care could enhance PrEP prescription.ACCULTURATION, PERCEPTIONS ABOUT SEEKING MENTAL HEALTH CARE, AND UTILIZATION OF MENTAL HEALTH SERVICES AMONG US-BASED SOUTH ASIANS
AbstractKapur, R., Badsa, K., & Kapadia, F. (n.d.).Publication year
2024Journal title
Ethnicity and DiseaseVolume
34Issue
4Page(s)
199-206AbstractObjectives: To examine the relationship between acculturation, cultural perceptions surrounding mental health (MH) burden and utilization of MH services among South Asian (SA) adults in the United States. Design: Cross-sectional study. Setting: Online survey. Participants: Four hundred five SA adults (≥18 years old) residing in the United States. Methods: Cross-sectional study of acculturation, attitudes toward MH burden, and MH service utilization was conducted via online survey. Multivariate logistic regression models were employed to understand how these factors were associated with MH service utilization. Main outcome measure: Utilization of MH services. Results: Among the 405 participants, 49.0% identified as immigrants (75.1% Indian, 8% Bangladeshi, 5.5% Pakistani, and 3.8% from other SA countries). Current utilization of MH services was associated with comfort conversing in English (odds ration [OR]¼5.99; 95% confidence interval [CI]¼1.63, 27.02), having English-speaking peers (OR¼3.80; 95% CI¼1.12, 12.93), and having family (OR¼2.37; 95% CI¼1.21, 4.64) and peers (OR¼5.64; 95% CI¼1.71, 18.66) who used MH services. Participants with mostly SA peers (OR¼0.48; 95% CI¼0.23, 0.97) reported lower lifetime MH service utilization, and those with positive perceptions about MH burden reported higher lifetime utilization (OR¼1.04; 95% CI¼1.01, 1.09). Conclusions: Comfort expressing emotions in English, knowledge of family/peer MH service use, and type of social connections were associated with MH service utilization among SA immigrants. Interventions should aim to increase SA languages in which MH services are offered and to engage with SA communities to increase acceptance of MH service utilization. Ethn Dis.Adolescent Mental Health and Well-Being: A Public Health of Consequence, February 2024
Kapadia, F. (n.d.).Publication year
2024Journal title
American journal of public healthVolume
114Issue
2Page(s)
158-160Adult Attachment Anxiety Is Protective Against the Effects of Internalized Homophobia on Condomless Sex Among Young Sexual Minority Men: The P18 Cohort Study
AbstractCook, S. H., Wood, E. P., Kapadia, F., & Halkitis, P. N. (n.d.).Publication year
2024Journal title
Journal of Sex ResearchVolume
61Issue
5Page(s)
742-749AbstractInternalized homophobia, or the internalization of negative attitudes toward one’s sexual minority identity, is associated with sexual risk behaviors among young sexual minority men (YSMM). However, the formation and maintenance of secure or insecure socio-emotional bonds with friends, family members, and intimate partners (i.e., adult attachment) may mitigate or exacerbate the negative effects of exposure to internalized homophobia. Nevertheless, little is known about how adult attachment influences the association between internalized homophobia and sexual risk behaviors (e.g., condomless anal sex) among YSMM. Thus, this study examined the potential moderating effect of adult attachment on the association between internalized homophobia and condomless anal sex (CAS) behaviors (i.e., insertive CAS and receptive CAS) among a sample of N = 268 YSMM who participated in the study between June 2015-March 2017 using zero-inflated Poisson regression models. We found that adult attachment anxiety, but not adult attachment avoidance, significantly moderated the association between internalized homophobia and receptive CAS behaviors such that those higher on adult attachment anxiety and internalized homophobia had fewer receptive CAS events over the preceding 30 days as compared to those lower on adult attachment anxiety and internalized homophobia. Research efforts should focus on unpacking the complex associations between adult attachment, internalized homophobia, and sexual risk behaviors among YSMM.Assessing how frailty and healthcare delays mediate the association between sexual and gender minority status and healthcare utilization in the All of Us Research Program
AbstractWong, C. N., Smith, L. H., Cavanaugh, R., Kim, D. H., Streed, C. G., Kapadia, F., & Olivieri-Mui, B. (n.d.).Publication year
2024Journal title
Journal of the American Medical Informatics AssociationVolume
31Issue
12Page(s)
2916-2923AbstractObjectives To understand how frailty and healthcare delays differentially mediate the association between sexual and gender minority older adults (OSGM) status and healthcare utilization. Materials and Methods Data from the All of Us Research Program participants ≥50 years old were analyzed using marginal structural modelling to assess if frailty or healthcare delays mediated OSGM status and healthcare utilization. OSGM status, healthcare delays, and frailty were assessed using survey data. Electronic health record (EHR) data was used to measure the number of medical visits or mental health (MH) visit days, following 12 months from the calculated All of Us Frailty Index. Analyses adjusted for age, race and ethnicity, income, HIV, marital status ± general MH (only MH analyses). Results Compared to non-OSGM, OSGM adults have higher rates of medical visits (adjusted rate ratio [aRR]: 1.14; 95% CI: 1.03, 1.24) and MH visits (aRR: 1.85; 95% CI: 1.07, 2.91). Frailty mediated the association between OSGM status medical visits (Controlled direct effect [Rcde] aRR: 1.03, 95% CI [0.87, 1.22]), but not MH visits (Rcde aRR: 0.37 [95% CI: 0.06, 1.47]). Delays mediated the association between OSGM status and MH visit days (Rcde aRR: 2.27, 95% CI [1.15, 3.76]), but not medical visits (Rcde aRR: 1.06 [95% CI: 0.97, 1.17]). Discussion Frailty represents a need for medical care among OSGM adults, highlighting the importance of addressing it to improve health and healthcare utilization disparities. In contrast, healthcare delays are a barrier to MH care, underscoring the necessity of targeted strategies to ensure timely MH care for OSGM adults.Life Expectancy in the United States: A Public Health of Consequence, June 2024
Kapadia, F. (n.d.).Publication year
2024Journal title
American journal of public healthVolume
114Issue
6Page(s)
556-558Mass Incarceration and Health Inequities: A Public Health of Consequence, September 2024
Kapadia, F. (n.d.).Publication year
2024Journal title
American journal of public healthVolume
114Issue
9Page(s)
856-858Our Public Health Workforce, Our Future: A Public Health of Consequence, May 2024
Kapadia, F. (n.d.).Publication year
2024Journal title
American journal of public healthVolume
114Issue
5Page(s)
461-462Polarization, Partisanship, and Political Alignment Threaten Public Health: A Public Health of Consequence, October 2024
Kapadia, F. (n.d.).Publication year
2024Journal title
American journal of public healthVolume
114Issue
10Page(s)
974-976Protecting Immigrant Children: A Public Health of Consequence, March 2024
Kapadia, F. (n.d.).Publication year
2024Journal title
American journal of public healthVolume
114Issue
3Page(s)
267-269Safeguarding the Health of Mothers: A Public Health of Consequence, July 2024
Kapadia, F. (n.d.).Publication year
2024Journal title
American journal of public healthVolume
114Issue
7Page(s)
672-673School-Based Health Centers Are a Critical Component of Health Care for Children: A Public Health of Consequence, August 2024
Kapadia, F. (n.d.).Publication year
2024Journal title
American journal of public healthVolume
114Issue
8Page(s)
769-771Social Justice and Public Health: A Public Health of Consequence, April 2024
Kapadia, F. (n.d.).Publication year
2024Journal title
American journal of public healthVolume
114Issue
4Page(s)
364-365Understanding the Post-Dobbs Landscape for Abortion Care in the United States
Kapadia, F., Ferguson, L., & Parmet, W. E. (n.d.).Publication year
2024Journal title
American journal of public healthVolume
114Issue
10Page(s)
994-996Climate Justice and Health Equity: A Public Health of Consequence, October 2023
Kapadia, F. (n.d.).Publication year
2023Journal title
American journal of public healthVolume
113Issue
10Page(s)
1053-1054Environmental Justice From Pennsylvania to Paris: A Public Health of Consequence, January 2023
Kapadia, F. (n.d.).Publication year
2023Journal title
American journal of public healthVolume
113Issue
1Page(s)
12-14EquiPrEP: An implementation science protocol for promoting equitable access and uptake of long-acting injectable HIV preexposure prophylaxis (LAI-PrEP)
AbstractKaul, C. M., Moore, B. E., Kaplan-Lewis, E., Casey, E., Pitts, R. A., Pirallo, P. P., Lim, S., Kapadia, F., Cohen, G. M., Khan, M., & Mgbako, O. (n.d.).Publication year
2023Journal title
PloS oneVolume
18Issue
9AbstractBackground Long-acting injectable HIV pre-exposure prophylaxis (LAI-PrEP) was approved by the U.S. Food and Drug Administration in December 2021. This initial phase of implementation represents a prime opportunity to ensure equitable LAI-PrEP provision to communities often underrepresented in PrEP care before disparities in access and uptake emerge. Herein, we describe the EquiPrEP Project which utilizes an equity-oriented implementation science framework to optimize LAI-PrEP rollout in an urban safety-net clinic in New York City. Methods The primary objectives of this project are to: (1) increase LAI-PrEP initiation overall; (2) increase uptake among groups disproportionately impacted by the HIV epidemic; (3) preserve high PrEP retention while expanding use; and (4) identify barriers and facilitators to LAI-PrEP use. EquiPrEP will enroll 210 PrEP-eligible participants into LAI-PrEP care with planned follow-up for one year. We will recruit from the following priority populations: Black and/or Latine men who have sex with men, Black and/or Latine cisgender women, and transgender women and nonbinary individuals. To evaluate implementation of LAI-PrEP, we will utilize equity-focused iterations of the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework and the Consolidated Framework for Implementation Research (CFIR), in addition to longitudinal surveys and qualitative interviews. Discussion Novel LAI-PrEP formulations carry tremendous potential to revolutionize the field of HIV prevention. Implementation strategies rooted in equity are needed to ensure that marginalized populations have access to LAI-PrEP and to address the structural factors that hinder initiation and retention in care.Maternal health and maternal health service utilization among female sex workers: A scoping review
AbstractMoore, B. E., Govaerts, L., & Kapadia, F. (n.d.).Publication year
2023Journal title
Women's HealthVolume
19AbstractBackground: High proportions of female sex workers (FSWs) become pregnant and have children. Many FSWs are at increased risk of maternal health complications due to factors such as poverty, violence, and healthcare barriers. Despite this, FSWs’ maternal health and use of maternal health services (MHS) receive limited attention. Objectives: The objectives of this scoping review are to (1) synthesize existing data on FSWs’ maternal health and MHS utilization and (2) assess the state of peer-reviewed literature on FSWs’ maternal health in regard to methodological approaches and reported outcomes. Eligibility criteria: Included articles were peer-reviewed, published in English, and reported empirical data on FSWs for outcomes related to antenatal care, pregnancy, and labor complications, postnatal and delivery care, and/or barriers to MHS. Sources of evidence: Article searches were conducted in PubMed, Web of Science, Global Health, Sociological Abstracts, Sociological Index, PsychInfo, and CINAHL Charting methods: Information extracted from eligible articles included publication year, study design, location, sample size, outcome measures, and findings. The “Three Delays” model was used to synthesize findings on barriers to MHS as relevant to phase I, II, or III delays. Results: Eighteen publications met the eligibility criteria. Studies were conducted in 11 countries and primarily reported quantitative data from cross-sectional surveys. The most frequently reported outcome was antenatal care utilization (n = 14), whereas few studies reported findings related to postnatal care and breastfeeding counseling (n = 2). Across publications, there was a substantial range in the proportion of FSWs who reported accessing different types of MHS. Conclusion: Literature on FSWs’ maternal health is limited and heterogenous. More research is needed that specifically focuses on measuring outcomes related to FSWs’ maternal health and examines associated factors. Such work can inform future research directions and public health interventions for FSWs—a population of marginalized women whose maternal health has been overlooked in existing efforts.Mental health burdens among North American Asian adults living with chronic conditions: a systematic review
AbstractIslam, J. Y., Parikh, N. S., Lappen, H., Venkat, V., Nalkar, P., & Kapadia, F. (n.d.).Publication year
2023Journal title
Epidemiologic ReviewsVolume
45Issue
1Page(s)
82-92AbstractAsians are likely to experience a high burden of chronic conditions, including, but not limited to, diabetes, cardiovascular disease, and cancer, due to differences in biologic, genetic, and environmental factors across Asian ethnic groups. A diagnosis of any chronic condition can contribute to increased mental health burdens, including depression, psychological distress, and posttraumatic stress disorder (PTSD). However, few studies have examined these comorbid conditions across distinct Asian ethnic groups—an important limitation given the differences in social, cultural, and behavioral drivers of mental health burdens within and across Asian ethnicities. To understand the disparities in mental health burdens among Asians living with a chronic health condition, we conducted a systematic literature review of relevant, peer-reviewed publication databases to identify studies reporting on mental health burdens (e.g., depression, anxiety, distress, PTSD) in distinct Asian ethnic groups in North America. Thirteen studies met the inclusion criteria for this review and collectively demonstrated a high burden of depression, psychological distress, and PTSD among Asians living with chronic conditions. Moreover, there were distinct disparities in mental health burdens across chronic conditions and across Asian ethnic groups. Despite the detrimental impact of poor mental health on chronic disease–specific outcomes, such as death and poor quality of life, few data exist that characterize mental health outcomes among Asian ethnicities living in North America with chronic conditions. Future work should prioritize estimating the national prevalence of mental health outcomes among adults with chronic conditions, by Asian ethnicities, to inform culturally tailored interventions to address this public health burden.PREVALENCE AND CORRELATES OF HIV-ASSOCIATED HEALTH BEHAVIORS IN A POPULATION-BASED SAMPLE OF PUERTO RICAN ADULTS, 2019
AbstractRivera-Castellar, G., Moore, B. E., & Kapadia, F. (n.d.).Publication year
2023Journal title
Ethnicity and DiseaseVolume
33Issue
1Page(s)
17-25AbstractIntroduction: High incidence and prevalence of HIV persist in Puerto Rico. To inform HIV prevention efforts, this study examines factors linked to HIV-associated behaviors in the territory. Methods: Using data from the 2019 Behavioral Risk Factor Surveillance System, multivariable logistic regression models were constructed to explore factors related to HIV-associated behaviors. Results: Among Puerto Rican residents (n¼4446), 5.6% reported engaging in ≥1 HIV-associated behavior (past 12 months), and 39.2% had never been tested for HIV. Reporting HIV-associated behaviors was associated with male sex (adjusted odds ratio [aOR], 1.74; 95% confidence interval [CI], 1.30-2.33), higher household income (aOR, 1.71; 95% CI, 1.14-2.58), heavy alcohol use (aOR, 2.67; 95% CI, 1.68-4.25), and ever receiving an HIV test (aOR, 2.00; 95% CI, 1.40-2.86) in a multivariable model. Conversely, being married (aOR, 0.51; 95% CI, 0.35-0.72), having a recent routine checkup (aOR, 0.48; 95% CI, 0.32-0.72), and reporting 0 days of poor mental health (aOR, 0.61; 95% CI, 0.45-0.81) were associated with decreased odds of engaging in HIV-associated behaviors. Conclusions: Future surveys should incorporate measures of social and structural determinants that would provide greater context for understanding behavioral factors associated with HIV vulnerability as well as for developing appropriate HIV interventions in Puerto Rico.Public Health Data of the People, by the People, for the People: A Public Health of Consequence, June 2023
Kapadia, F. (n.d.).Publication year
2023Journal title
American journal of public healthVolume
113Issue
6Page(s)
618-619Public Health Practice and Health Equity for Vulnerable Workers: A Public Health of Consequence, May 2023
Kapadia, F. (n.d.).Publication year
2023Journal title
American journal of public healthVolume
113Issue
5Page(s)
480-481Structural Racism and Health Inequities: Moving From Evidence to Action
Kapadia, F., & Borrell, L. N. (n.d.).Publication year
2023Journal title
American journal of public healthVolume
113Page(s)
S6-S9Structural Racism and Public Health
Kapadia, F., & Borrell, L. N. (n.d.).Publication year
2023Journal title
American journal of public healthVolume
113Page(s)
S4Sustaining PrEP Prescriptions at a Safety-Net Hospital in New York City During COVID-19: Lessons Learned
AbstractPitts, R. A., Ban, K., Greene, R. E., Kapadia, F., & Braithwaite, R. S. (n.d.).Publication year
2023Journal title
AIDS and BehaviorVolume
27Issue
8Page(s)
2507-2512AbstractTo understand the impact of COVID-19-related disruptions on PrEP services, we reviewed PrEP prescriptions at NYC Health + Hospitals/Bellevue from July 2019 through July 2021. PrEP prescriptions were examined as PrEP person-equivalents (PrEP PE) in order to account for the variable time of refill duration (i.e., 1–3 months). To assess “PrEP coverage”, we calculated PrEP medication possession ratios (MPR) while patients were under study observation. Pre-clinic closure, mean PrEP PE = 244.2 (IQR 189.2, 287.5; median = 252.5) were observed. Across levels of clinic closures, mean PrEP PE = 247.3, (IQR 215.5, 265.4; median = 219.9) during 100% clinic closure, 255.4 (IQR 224, 284.3; median = 249.0) during 80% closure, and 274.6 (IQR 273.0, 281.0; median = 277.2) during 50% closure were observed. Among patients continuously prescribed PrEP pre-COVID-19, the mean MPR mean declined from 83% (IQR 72–100%; median = 100%) to 63% (IQR 35–97%; median = 66%) after the onset of COVID-19. For patients newly initiated on PrEP after the onset of COVID-19, the mean MPR was 73% (IQR 41–100%; median = 100%). Our ability to sustain PrEP provisions, as measured by both PrEP PE and MPR, can likely be attributed to our pre-COVID-19 system for PrEP delivery, which emphasizes navigation, same-day initiation, and primary care integration. In the era of COVID-19 as well as future unforeseen healthcare disruptions, PrEP programs must be robust and flexible in order to sustain PrEP delivery.