Melody Goodman
Melody Goodman
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Dean, School of Global Public Health
Professor of Biostatistics
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Professional overview
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Dr. Melody S. Goodman is a biostatistician and research methodologist. Her work is anchored upon moving beyond defining problems and focuses on developing solutions using partner-engaged research approaches. Dr. Goodman’s research efforts seek to develop a more rigorous understanding of the social risk factors contributing to urban health outcomes. Her work aims to develop solutions for improving health in high-risk populations. She conducts translational research that bridges the gap between research and practice. Through rigorous attention to study design, measurement, and the use of cutting-edge statistical analysis methods, her contributions have spanned the areas of prevention, treatment, intervention, and policy.
Dr. Goodman led the team that developed and comprehensively evaluated the Research Engagement Survey Tool, a quantitative survey measure to assess the level of partner engagement in research studies from the non-academic partner perspective. With numerous funders supporting her work (e.g., National Institutes of Health, Robert Wood Johnson Foundation, Verizon Foundation, Long Island Community Foundation, Patient-Centered Outcomes Research Institute, and Susan G. Komen), she has published over 150 peer-reviewed journal articles and two books (2018 Routledge/Taylor & Francis Group): 1) Public Health Research Methods for Partnerships and Practice and 2) Biostatistics for Clinical and Public Health Research, which now has a second edition (2026 Routledge/Taylor & Francis Group). She is a Fellow of the American Statistical Association, New York Academy of Medicine, and the inaugural recipient of the Societal Impact Award from the Caucus for Women in Statistics.
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Education
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BS, Economics and Applied Mathematics & Statistics, State University of New York at Stony Brook, Stony Brook, NYMS, Biostatistics, Harvard University, Cambridge, MAPhD, Biostatistics, Harvard University, Cambridge, MA
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Honors and awards
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Fellow, American Statistical Association (2021)Societal Impact Award, Caucus for Women in Statistics (2021)Network Builder Award, Robert Wood Johnson Foundation New Connections (2019)Siteman Cancer Center “Rock Doc” (2013)Satcher Health Leadership Institute - Morehouse School of Medicine, Community Health Leadership Institute Intensive Cohort II (2013)Women of the Year - Health, National Coalition of 100 Black Women, Inc. - Suffolk Chapter (2010)President’s Award for Teaching Excellence - Stony Brook University (2009)President’s Award for Excellence in Team Achievement - Stony Brook University (2008)
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Areas of research and study
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BiostatisticsCommunity HealthCommunity-based Participatory ResearchDissemination and Implementation of Evidence-based ProgramsQuantitative Research
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Publications
Publications
A Community Coalition to Address Cancer Disparities : Transitions, Successes and Challenges
AbstractThompson, V. L., Drake, B., James, A. S., Norfolk, M., Goodman, M., Ashford, L., Jackson, S., Witherspoon, M., Brewster, M., & Colditz, G. (n.d.).Publication year
2015Journal title
Journal of Cancer EducationVolume
30Issue
4Page(s)
616-622AbstractCommunity-based participatory (CBP) strategies are considered important to efforts to eliminate disparities. This paper outlines how the Program for the Elimination of Cancer Disparities (PECaD) uses CBP strategies as a part of a long-term cancer education, prevention, and control strategy in an urban community. Community partnerships have proved to be vital resources to inform PECaD’s agenda and the research practice of academic partners. We begin with a description of PECaD governance and partnership structures. The paper then describes programmatic activities and successes, including efforts to monitor clinical trials, deployment of mammography resources, anti-smoking, and prostate and colorectal cancer (CRC) screening education. The influence of changes in funding priorities, preventive screening policy, and community partner development on the partnership process over time is discussed. PECaD community partners have grown and expanded beyond the Program’s mission and developed additional partnerships, resulting in a reevaluation of relationships. The impact of these external and internal changes and pressures on the partnerships are noted. The evolution of the evaluation process and what it has revealed about needed improvements in PECaD activities and operations is presented. A summary of the lessons learned and their implications for CBP practice are provided.A Community-Based Partnership to Successfully Implement and Maintain a Breast Health Navigation Program
AbstractDrake, B. F., Tannan, S., Anwuri, V. V., Jackson, S., Sanford, M., Tappenden, J., Goodman, M., & Colditz, G. A. (n.d.).Publication year
2015Journal title
Journal of Community HealthVolume
40Issue
6Page(s)
1216-1223AbstractBreast cancer screening combined with follow-up and treatment reduces breast cancer mortality. However, in the study clinic, only 12 % of eligible women ≥40 years received a mammogram in the previous year. The objective of this project was to implement patient navigation, in our partner health clinic to (1) identify women overdue for a mammogram; and (2) increase mammography utilization in this population over a 2-year period. Women overdue for a mammogram were identified. One patient navigator made navigation attempts over a 2-year period (2009–2011). Navigation included working around systems- and individual-level barriers to receive a mammogram as well as the appropriate follow-up post screening. Women were contacted up to three times to initiate navigation. The proportion of women navigated and who received a mammogram during the study period were compared to women who did not receive a mammogram using Chi square tests for categorical variables and t tests for continuous variables with an α = 0.05. Barriers to previous mammography were also assessed. With 94.8 % of eligible women navigated and 94 % of these women completing mammography, the implementation project reached 89 % of the target population. This project was a successful implementation of an evidence-based patient navigation program that continues to provide significant impact in a high-need area. Cost was the most commonly cite barrier to mammography. Increasing awareness of resources in the community for mammography and follow-up care remains a necessary adjunct to removing structural and financial barriers to accessing preventive services.A Comparison of Methods for Coding Race in Linear and Logistic Regression Models
AbstractGoodman, M. (n.d.).Abstract~A pilot pragmatic trial of a “what matters most”-based intervention targeting intersectional stigma related to being pregnant and living with HIV in Botswana
AbstractYang, L. H., Eschliman, E. L., Mehta, H., Misra, S., Poku, O. B., Entaile, P., Becker, T. D., Melese, T., Brooks, M. J., Eisenberg, M., Stockton, M. A., Choe, K., Tal, D., Li, T., Go, V. F., Link, B. G., Rampa, S., Jackson, V. W., Manyeagae, G. D., … Blank, M. B. (n.d.).Publication year
2022Journal title
AIDS Research and TherapyVolume
19Issue
1AbstractWe conducted a pilot trial of an intervention targeting intersectional stigma related to being pregnant and living with HIV while promoting capabilities for achieving ‘respected motherhood’ (‘what matters most’) in Botswana. A pragmatic design allocated participants to the intervention (N = 44) group and the treatment-as-usual (N = 15) group. An intent-to-treat, difference-in-difference analysis found the intervention group had significant decreases in HIV stigma (d = − 1.20; 95% CI − 1.99, − 0.39) and depressive symptoms (d = − 1.96; 95% CI − 2.89, − 1.02) from baseline to 4-months postpartum. Some, albeit less pronounced, changes in intersectional stigma were observed, suggesting the importance of structural-level intervention components to reduce intersectional stigma.A quasi-experimental study of New York City's sodium warning regulation and hypertension prevalence, 2005–2020
AbstractMaxey, N. J., Pagán, J. A., Rhodes-Bratton, B., Phalke, A., Wizentier, M. M., Kaphingst, K. A., Goodman, M., & Bather, J. R. (n.d.).Publication year
2025Journal title
Preventive Medicine ReportsVolume
56AbstractObjective: To quantify temporal trends in age-adjusted hypertension prevalence in New York City before and after implementation of a menu labeling regulation requiring sodium warning icons at chain restaurants. Methods: Using data from the New York City Community Health Survey, segmented regression models assessed: (1) the average annual percent change (AAPC) of age-adjusted hypertension prevalence during the pre-regulation period (2005–2015), (2) the annual percent change (APC) from 2015 to 2016 (regulation onset association), (3) the AAPC of age-adjusted hypertension prevalence during the regulation period (2016–2020), and (4) the percentage-point difference between the AAPCs of the pre-regulation and regulation periods. Results: We found a statistically significant average annual percent increase in the age-adjusted hypertension prevalence among the Hispanic population during the pre-regulation period (2005–2015 AAPC: 1.3 %, 95 % CI: 0.3 % to 2.3 %). The regulation's onset was significantly associated with a 4.2 % (95 % CI: 0.4 % to 8.0 %) increase in the age-adjusted hypertension prevalence among females from 2015 to 2016. During the regulation era, we observed statistically significant average annual percent decreases in age-adjusted hypertension prevalence among Black (2016–2020 AAPC: −1.9 %; 95 % CI: −2.5 % to −1.3 %) and female (2016–2020 AAPC: −3.5 %; 95 % CI: −5.0 % to −2.1 %) subgroups. Conclusions: Findings suggest a potential positive impact of the sodium warning regulation on hypertension prevalence. The decreasing trends in hypertension prevalence among female and Black populations suggest that sodium reduction policies may have differential impacts across subgroups. These empirical insights underscore the importance of sustained sodium reduction policies.A randomized implementation trial to increase adoption of evidence-informed consent practices
AbstractSolomon, E. D., Mozersky, J., Goodman, M., Parsons, M. V., Baldwin, K., Friedrich, A. B., Harris, J. K., & DuBois, J. M. (n.d.).Publication year
2022Journal title
Journal of Clinical and Translational ScienceAbstractIntroduction: Several evidence-informed consent practices (ECPs) have been shown to improve informed consent in clinical trials but are not routinely used. These include optimizing consent formatting, using plain language, using validated instruments to assess understanding, and involving legally authorized representatives when appropriate. We hypothesized that participants receiving an implementation science toolkit and a social media push would have increased adoption of ECPs and other outcomes. Methods: We conducted a one-year trial with clinical research professionals in the US (N=1284) who have trials open to older adults or focus on Alzheimer's disease. We randomized participants to receive information on ECPs via receiving a toolkit with a social media push (intervention) or receiving an online learning module (active control). Participants completed a baseline survey and a follow-up survey after one year. A subset of participants were interviewed (n=43). Results: Participants who engaged more with the toolkit were more likely to have tried to implement an ECP during the trial than participants less engaged with the toolkit or the active control group. However, there were no significant differences on adoption of ECPs, intention to adopt, or positive attitudes. Participants reported the toolkit and social media push were satisfactory, and participating increased their awareness of ECPs. However, they reported lacking the time needed to engage with the toolkit more fully. Conclusions: Using an implementation science approach to increase the use of ECPs was only modestly successful. Data suggest that having IRBs recommend or require ECPs may be an effective way to increase their use.A Study Examining the Usefulness of a New Measure of Research Engagement
AbstractBowen, D. J., Ackermann, N., Thompson, V. S., Nederveld, A., & Goodman, M. (n.d.).Publication year
2022Journal title
Journal of general internal medicineVolume
37Page(s)
50-56AbstractIntroduction: Engagement of relevant stakeholders’ ideas, opinions, and concerns is critical to the success of modern research projects. We have developed a tool to measure stakeholder engagement, called the Research Engagement Survey Tool (REST). The purpose of this paper is to present the implementation and uptake of the stakeholder engagement measure REST among research teams, including the assessment of barriers and facilitating factors for use of the new research engagement measure in practice. Methods: In this implementation study, project team members participated in baseline and follow-up web-based surveys. Web-based interviews were conducted with a subset of project teams that implemented the REST. On the baseline survey, project teams were asked to provide details about up to three ongoing or recently completed projects, were asked if they agreed with compensation for REST completion, and were asked if they would like to send the survey to stakeholders or would prefer our project team to email their project stakeholders. Follow-up surveys contained questions on reactions to implementing REST and results of REST. Results: Project team members/researchers who completed the baseline survey (n=86) were mostly female (79%) and Non-Hispanic/Latino(a) White (76%). Those who implemented REST were also mostly female (86%) and Non-Hispanic/Latino(a) White (71%), with an average of 11 years in academic research. About 98% of all participants completing the baseline survey had the capacity to survey partners, while 100% of all teams who implemented REST did. A small portion of respondents indicated the time commitment of REST would be a barrier (29% of baseline survey respondents, 10% of those who implemented REST) and indicated workload would be a barrier (31% of baseline survey respondents, 14% of those who implemented REST). Discussion: The data presented here indicate that REST implementation is feasible in a volunteer group of ongoing research projects.A tale of two community networks program centers : Operationalizing and assessing CBPR principles and evaluating partnership outcomes
AbstractArroyo-Johnson, C., Allen, M. L., Colditz, G. A., Ali Hurtado, G., Davey, C. S., Thompson, V. L., Drake, B. F., Svetaz, M. V., Rosaslee, M., & Goodman, M. (n.d.).Publication year
2015Journal title
Progress in Community Health Partnerships: Research, Education, and ActionVolume
9Page(s)
61-69AbstractBackground: Community Networks Program (CNP) centers are required to use a community-based participatory research (CBPR) approach within their specific priority communities. Not all communities are the same and unique contextual factors and collaborators’ priorities shape each CBPR partnership. There are also established CBPR and community engagement (CE) principles shown to lead to quality CBPR in any community. However, operationalizing and assessing CBPR principles and partnership outcomes to understand the conditions and processes in CBPR that lead to achieving program and project level goals is relatively new in the science of CBPR. Objectives: We sought to describe the development of surveys on adherence to and implementation of CBPR/CE principles at two CNP centers and examine commonalities and differences in program- versus project-level CBPR evaluation. Methods: A case study about the development and application of CBPR/CE principles for the Missouri CNP, Program for the Elimination of Cancer Disparities, and Minnesota CNP, Padres Informados/Jovenes Preparados, surveys was conducted to compare project versus program operationalization of principles. Survey participant demographics were provided by CNP. Specific domains found in CBPR/CE principles were identified and organized under an existing framework to establish a common ground. Operational definitions and the number of survey items were provided for each domain by CNP. Conclusion: There are distinct differences in operational definitions of CBPR/CE principles at the program and project levels of evaluation. However, commonalities support further research to develop standards for CBPR evaluation across partnerships and at the program and project levels.A training protocol compliance of 13% was observed in a research study of clinical research professionals
AbstractSolomon, E. D., Mozersky, J., Parsons, M. V., Baldwin, K., Goodman, M., & DuBois, J. M. (n.d.).Publication year
2024Journal title
BMC research notesVolume
17Issue
1AbstractObjective: We attempted to conduct a randomized controlled trial of three different informed consent training formats to evaluate their effectiveness. We recruited 503 clinical research professionals, who received $50 for participation. Incidental findings showed unexpectedly low rates of compliance with completing the study training protocols, resulting in insufficient statistical power to test our original hypotheses. In this report, we conducted a secondary analysis of the data in which we characterize and evaluate the observed low compliance. This involved using literature on average reading times, speed-reading times, and video play speeds to calculate the timeframes required to complete the three training formats. Results: Only 13% of participants completed the training in a reasonable timeframe. Furthermore, only 46% of participants completed the training in the minimum possible timeframe. These findings lead us to ask whether online research training is effective, since no training can be effective if participants do not actually complete the training. Given extensive requirements for educational training among clinical research professionals, we feel the burden of proof is on training programs to demonstrate that they have positive effects.Acculturation and Depressive Symptoms Among Dominicans in New York City
AbstractHagen, D., Goldmann, E., Parikh, N. S., Goodman, M., & Boden-Albala, B. M. (n.d.).Publication year
2022Journal title
Journal of Immigrant and Minority HealthVolume
24Issue
5Page(s)
1186-1195AbstractLittle is known about the association between acculturation and mental health among Dominican populations in the United States. Data came from a community survey of Dominican residents of New York City (n = 2744). Associations between two indicators of acculturation, proportion of life spent in the U.S. and interview language (English/Spanish), with lifetime depressive symptoms (Patient Health Questionnaire-9 score ≥ 5) were examined using logistic regression overall and by gender. In adjusted models, respondents with English-language interview and above-median proportion of life spent in the U.S. had 77% higher odds (95% CI 1.28, 2.44) of lifetime depressive symptoms than those with Spanish-language interview and below-median proportion of life spent in the U.S. There was some evidence of elevated odds of depressive symptoms among men with English-language interview and below-median proportion of life spent in the U.S. Additional research is needed to elucidate gender-specific impacts of acculturation on mental health in this population.Achieving the Health Equity Agenda Through Transformative Community-Engaged Strategies
AbstractGilbert, K. L., Shaw, M., Siddiqi, A., & Goodman, M. (n.d.).Publication year
2023Journal title
Preventing Chronic DiseaseVolume
20Abstract~Adaptation, Implementation, and Evaluation of a Public Health Research Methods Training for Youth
AbstractGoodman, M., Gbaje, E., Yassin, S. M., Johnson DIas, J., Gilbert, K., & Thompson, V. (n.d.).Publication year
2018Journal title
Health EquityVolume
2Issue
1Page(s)
349-355AbstractPurpose: To adapt, implement, and evaluate a public health research methods training program for youth. The Community Research Fellows Training Program is an evidence-based public health research methods training program for adults (18 years and older). The Youth Research Fellows Training (YRFT) is an adaptation of this program for youth. Methods: University faculty facilitate didactic training sessions and experiential small group activities in biweekly sessions conducted as part of an existing 4-week summer camp. Participants were African American girls (n=11) ranging from ages 10 to 14 years (most recent grade completed 4th-8th). To evaluate participant knowledge gain and satisfaction pre-tests were administered before each session, and post-test and evaluations were administered after each session. In addition, faculty completed web-based evaluation surveys on their experience teaching in the program. Results: Mean and median post-test scores were higher than pre-test scores for most (6 of the 7) of the training sessions; one session had no difference in scores. Participants rated the sessions well, on average overall session ratings of 4.3-4.8 on a 5-point Likert scale. Faculty rated their experience teaching in the program as excellent or very good and would be willing to teach in the program again (n=7; 100%). Conclusion: This pilot implementation of the YRFT program proved highly successful in terms of participant and faculty experience. The program evaluation demonstrates increased knowledge of public health research methods. This program has the potential to prepare youth to engage in public health research as partners not just participants.Age differences in genetic knowledge, health literacy and causal beliefs for health conditions
AbstractGoodman, M., Ashida, S., Goodman, M., Pandya, C., Koehly, L. M., Lachance, C., Stafford, J., & Kaphingst, K. A. (n.d.).Publication year
2011Journal title
Public Health GenomicsVolume
14Issue
4-5Page(s)
307-316AbstractObjectives: This study examined the levels of genetic knowledge, health literacy and beliefs about causation of health conditions among individuals in different age groups. Methods: Individuals (n = 971) recruited through 8 community health centers in Suffolk County, New York, completed a one-time survey. Results: Levels of genetic knowledge were lower among individuals in older age groups (26-35, p = 0.011; 36-49, p = 0.002; 50 years and older, pAge-specific trends in pregnancy-associated suicide and homicide rates by race/ethnicity, 2005–2021
AbstractBather, J. R., Mautner Wizentier, M., Cowan, S. K., Peipert, J. F., Furr-Holden, D., & Goodman, M. (n.d.).Publication year
2025Journal title
American Journal of Obstetrics and Gynecology MFMVolume
7Issue
2Abstract~An empirical analysis of White privilege, social position and health
AbstractKwate, N. O., & Goodman, M. (n.d.).Publication year
2014Journal title
Social Science and MedicineVolume
116Page(s)
150-160AbstractAccumulated evidence has demonstrated that social position matters for health. Those with greater socioeconomic resources and greater perceived standing in the social hierarchy have better health than those with fewer resources and lower perceived standing. Race is another salient axis by which health is stratified in the U.S., but few studies have examined the benefit of White privilege. In this paper, we investigated how perceptions of inequality and subjective and objective social status affected the health and well-being of N=630 White residents in three Boston neighborhoods lying on a social gradient differentiated by race, ethnicity, income and prestige. Outcomes were self-rated health, dental health, and happiness. Results suggested that: neighborhood residence was not associated with health after controlling for individual level factors (e.g., positive ratings of the neighborhood, education level); objective measures of socioeconomic status were associated with better self-reported and dental health, but subjective assessments of social position were more strongly associated; and White residents living in the two wealthiest neighborhoods, and who perceived Black families as welcome in their neighborhoods enjoyed better health than those who believed them to be less welcome. However, those who lived in the least wealthy and most diverse neighborhood fared worse when reporting Black families to be welcome. These results suggest that White privilege and relative social position interact to shape health outcomes.An evaluation of multiple behavioral risk factors for cancer in a working class, multi-ethnic population
AbstractGoodman, M., Li, Y., Bennett, G. G., Stoddard, A. M., & Emmons, K. (n.d.).Publication year
2006Journal title
Journal of Data ScienceVolume
4Page(s)
291Abstract~An Immediate but Fleeting Interest in MPH Programs After the Onset of COVID-19 : An Interrupted Time-Series Analysis
AbstractBather, J. R., Burke, E. M., Plepys, C. M., Rajbhandari-Thapa, J., Furr-Holden, D., & Goodman, M. (n.d.).Publication year
2024Journal title
Public Health ReportsAbstractObjectives: The relationship between the onset of the COVID-19 pandemic and interest in master of public health (MPH) programs is unknown. We examined trends in MPH application rates for 31 MPH concentrations and specifically for the MPH concentration in epidemiology and differences by race and ethnicity before and after the onset of the COVID-19 pandemic. Methods: We constructed a quasi-experimental design to examine trends in MPH application rates from academic years 2015-2016 through 2022-2023 by using Centralized Application Service for Schools and Programs of Public Health data. We used an interrupted time-series analysis to test whether application rates surged after the pandemic’s onset (academic years 2019-2020 through 2020-2021) and whether this increase persisted during the pandemic (academic years 2020-2021 through 2022-2023). We fit models for the overall sample, a combined racially and ethnically minoritized sample, each racial and ethnic group separately, and a non–US citizen sample. Results: The pandemic’s onset correlated with an immediate increase in application rates across most samples: overall (38%) and among American Indian/Alaska Native/Native Hawaiian/Pacific Islander (91%), Asian (35%), Black (42%), Hispanic (60%), multiracial (30%), racially and ethnically minoritized (44%), and White (53%) samples. However, this trend was not sustained; application rate trends during the pandemic were significantly lower than prepandemic trends. Application rate trends for all MPH concentrations and the MPH in epidemiology concentration among non–US citizens were significantly higher during the pandemic than prepandemic. Conclusions: Our results highlight the need for innovative strategies to sustain MPH degree interest and a diverse applicant pool.An institutional strategy to increase minority recruitment to therapeutic trials
AbstractAnwuri, V. V., Hall, L. E., Mathews, K., Springer, B. C., Tappenden, J. R., Farria, D. M., Jackson, S., Goodman, M., Eberlein, T. J., & Colditz, G. A. (n.d.).Publication year
2013Journal title
Cancer Causes and ControlVolume
24Issue
10Page(s)
1797-1809AbstractPurpose: Participation in therapeutic clinical trials rarely reflects the race and ethnic composition of the patient population. To meet National Institutes of Health-mandated goals, strategies to increase participation are required. We present a framework for institutional enhancement of minority clinical trial accrual. Methods: We implemented structural changes on four levels to induce and sustain minority accrual to clinical trials: (1) leadership support; (2) center-wide policy change; (3) infrastructural process control, data analysis, and reporting; and (4) follow-up with clinical investigators. A Protocol Review and Monitoring Committee reviews studies and monitors accrual, and the Program for the Elimination Cancer Disparities leads efforts for proportional accrual, supporting the system through data tracking, Web tools, and feedback to investigators. Results: Following implementation in 2005, minority accrual to therapeutic trials increased from 12.0 % in 2005 to 14.0 % in 2010. The "rolling average" minority cancer incidence at the institution during this timeframe was 17.5 %. In addition to therapeutic trial accrual rates, we note significant increase in the number of minorities participating in all trials (therapeutic and nontherapeutic) from 2005 to 2010 (346-552, 60 % increase, p < 0.05) compared to a 52 % increase for Caucasians. Conclusions: Implementing a system to aid investigators in planning and establishing targets for accrual, while requiring this component as a part of annual protocol review and monitoring of accrual, offers a successful strategy that can be replicated in other cancer centers, an approach that may extend to other clinical and translational research centers.Analysis of ordinal outcomes with longitudinal covariates subject to missingness
AbstractGoodman, M., Li, Y., Stoddard, A. M., & Sorensen, G. (n.d.).Publication year
2014Journal title
Journal of Applied StatisticsVolume
41Issue
5Page(s)
1040-1052AbstractWe propose a mixture model for data with an ordinal outcome and a longitudinal covariate that is subject to missingness. Data from a tailored telephone delivered, smoking cessation intervention for construction laborers are used to illustrate the method, which considers as an outcome a categorical measure of smoking cessation, and evaluates the effectiveness of the motivational telephone interviews on this outcome. We propose two model structures for the longitudinal covariate, for the case when the missing data are missing at random, and when the missing data mechanism is non-ignorable. A generalized EM algorithm is used to obtain maximum likelihood estimates.Application of a Heuristic Framework for Multilevel Interventions to Eliminate the Impact of Unjust Social Processes and Other Harmful Social Determinants of Health
AbstractGuilamo-Ramos, V., Thimm-Kaiser, M., Benzekri, A., Johnson, C., Williams, D. T., Wilhelm-Hilkey, N., Goodman, M., & Hagan, H. (n.d.).Publication year
2024Journal title
Prevention ScienceAbstractThere is consensus about the importance of developing a strong cadre of effective multilevel interventions to eliminate the impacts of unjust social processes, such as structural racism and other harmful social determinants of health (SDOH), on health inequities in the USA. However, the available cadre of rigorously evaluated evidence-based interventions for SDOH mitigation remains underdeveloped relative to the magnitude of historic and current health inequities. The proposed manuscript addresses this gap in two ways: first, by introducing a heuristic framework to inform decisions in multilevel intervention development, study design, and selection of analytic methods and, second, by providing a roadmap for future applications of the framework in multilevel intervention research through an exemplar application using the ongoing NIH-funded evaluation study of the Nurse-Community-Family Partnership (NCFP) intervention. NCFP leverages individual, family, institutional, and system factors to shape COVID-19 mitigation outcomes at the individual and household levels. NCFP takes an approach informed by the heuristic framework to addressing and mitigating unjust social processes and other harmful SDOH. We discuss the application of a two-arm parallel explanatory group randomized trial to evaluate the efficacy of NCFP in improving the primary (COVID-19 testing uptake) and secondary (adoption of COVID-19 control measures, COVID-19 vaccine uptake, mutual aid capacity, etc.) outcomes at the individual and household levels. The analysis approach relies on random-intercept models, and we calculate the variance partitioning coefficient to estimate the extent to which household- and individual-level variables contribute to the outcome, allowing examination of NCFP effects at multiple levels.Are You Making an Impact? Evaluating the Population Health Impact of Community Benefit Programs
AbstractRains, C. M., Todd, G., Kozma, N., & Goodman, M. (n.d.).Publication year
2018Journal title
Journal of Public Health Management and PracticeVolume
24Issue
4Page(s)
335-339AbstractContext: The Patient Protection and Affordable Care Act includes a change to the IRS 990 Schedule H, requiring nonprofit hospitals to submit a community health needs assessment every 3 years. Such health care entities are challenged to evaluate the effectiveness of community benefit programs addressing the health needs identified. Objective: In an effort to determine the population health impact of community benefit programs in 1 hospital outreach department, researchers and staff conducted an impact evaluation to develop priority areas and overarching goals along with program- and department-level objectives. Design: The longitudinal impact evaluation study design consists of retrospective and prospective secondary data analyses. Setting: As an urban pediatric hospital, St Louis Children's Hospital provides an array of community benefit programs to the surrounding community. Participants: Hospital staff and researchers came together to form an evaluation team. Data from program evaluation and administrative data for analysis were provided by hospital staff. Main Outcome Measure: Impact scores were calculated by scoring objectives as met or unmet and averaged across goals to create impact scores that measure how closely programs meet the overarching departmental mission and goals. Results: Over the 4-year period, there is an increasing trend in program-specific impact scores across all programs except one, Healthy Kids Express Asthma, which had a slight decrease in year 4 only. Implications: Current work in measuring and assessing the population health impact of community benefit programs is mostly focused on quantifying dollars invested into community benefit work rather than measuring the quality and impact of services. This article provides a methodology for measuring population health impact of community benefit programs that can be used to evaluate the effort of hospitals in providing community benefit. This is particularly relevant in our changing health care climate, as hospitals are being asked to justify community benefit and make meaningful contributions to population health. The Patient Protection and Affordable Care Act includes a change to the IRS 990 Schedule H, requiring nonprofit hospitals to submit a community health needs assessment every 3 years, and requires evaluation of program effectiveness; yet, it does not require any quantification of the impact of community benefit programs. The IRS Schedule H 990 policies could be strengthened by requiring an impact evaluation such as outlined in this article. Conclusion: As hospitals are being asked to justify community benefit and make meaningful contributions to population health, impact evaluations can be utilized to demonstrate the cumulative community benefit of programs and assess population health impact of community benefit programs.Association of Disparities in Family History and Family Cancer History in the Electronic Health Record with Sex, Race, Hispanic or Latino Ethnicity, and Language Preference in 2 Large US Health Care Systems
AbstractChavez-Yenter, D., Goodman, M., Chen, Y., Chu, X., Bradshaw, R. L., Lorenz Chambers, R., Chan, P. A., Daly, B. M., Flynn, M., Gammon, A., Hess, R., Kessler, C., Kohlmann, W. K., Mann, D. M., Monahan, R., Peel, S., Kawamoto, K., Del Fiol, G., Sigireddi, M., … Kaphingst, K. A. (n.d.).Publication year
2022Journal title
JAMA network openPage(s)
E2234574AbstractImportance: Clinical decision support (CDS) algorithms are increasingly being implemented in health care systems to identify patients for specialty care. However, systematic differences in missingness of electronic health record (EHR) data may lead to disparities in identification by CDS algorithms. Objective: To examine the availability and comprehensiveness of cancer family history information (FHI) in patients' EHRs by sex, race, Hispanic or Latino ethnicity, and language preference in 2 large health care systems in 2021. Design, Setting, and Participants: This retrospective EHR quality improvement study used EHR data from 2 health care systems: University of Utah Health (UHealth) and NYU Langone Health (NYULH). Participants included patients aged 25 to 60 years who had a primary care appointment in the previous 3 years. Data were collected or abstracted from the EHR from December 10, 2020, to October 31, 2021, and analyzed from June 15 to October 31, 2021. Exposures: Prior collection of cancer FHI in primary care settings. Main Outcomes and Measures: Availability was defined as having any FHI and any cancer FHI in the EHR and was examined at the patient level. Comprehensiveness was defined as whether a cancer family history observation in the EHR specified the type of cancer diagnosed in a family member, the relationship of the family member to the patient, and the age at onset for the family member and was examined at the observation level. Results: Among 144484 patients in the UHealth system, 53.6% were women; 74.4% were non-Hispanic or non-Latino and 67.6% were White; and 83.0% had an English language preference. Among 377621 patients in the NYULH system, 55.3% were women; 63.2% were non-Hispanic or non-Latino, and 55.3% were White; and 89.9% had an English language preference. Patients from historically medically undeserved groups - specifically, Black vs White patients (UHealth: 17.3% [95% CI, 16.1%-18.6%] vs 42.8% [95% CI, 42.5%-43.1%]; NYULH: 24.4% [95% CI, 24.0%-24.8%] vs 33.8% [95% CI, 33.6%-34.0%]), Hispanic or Latino vs non-Hispanic or non-Latino patients (UHealth: 27.2% [95% CI, 26.5%-27.8%] vs 40.2% [95% CI, 39.9%-40.5%]; NYULH: 24.4% [95% CI, 24.1%-24.7%] vs 31.6% [95% CI, 31.4%-31.8%]), Spanish-speaking vs English-speaking patients (UHealth: 18.4% [95% CI, 17.2%-19.1%] vs 40.0% [95% CI, 39.7%-40.3%]; NYULH: 15.1% [95% CI, 14.6%-15.6%] vs 31.1% [95% CI, 30.9%-31.2%), and men vs women (UHealth: 30.8% [95% CI, 30.4%-31.2%] vs 43.0% [95% CI, 42.6%-43.3%]; NYULH: 23.1% [95% CI, 22.9%-23.3%] vs 34.9% [95% CI, 34.7%-35.1%]) - had significantly lower availability and comprehensiveness of cancer FHI (PAssociations between perceived discrimination over the life course, subjective social status, and health literacy : A racial/ethnic stratification analysis
AbstractBather, J. R., Cuevas, A. G., Harris, A., Kaphingst, K. A., & Goodman, M. (n.d.).Publication year
2024Journal title
PEC InnovationVolume
5AbstractObjective: To analyze the relationship between perceived discrimination over the life course, social status, and limited health literacy (HL). Methods: 5040 adults who participated in the 2023 Survey of Racism and Public Health. We applied stratified multilevel models adjusted for sociodemographic characteristics. Results: The average age was 47 years, 48% identified as White, 20% as Latinx, and 17% as Black. In the overall sample, we observed associations of perceived discrimination (b = 0.05, 95% CI: 0.01, 0.09), subjective social status (b = −0.16, 95% CI: −0.23, −0.10), and their interaction (b = 0.02, 95% CI: 0.01, 0.03). More perceived discrimination was associated with lower HL in the White and Multiracial participants. Higher subjective social status was associated with higher HL in the White and Latinx participants. There was a statistically significant interaction between perceived discrimination and subjective social status on HL among the White, Latinx, and Multiracial participants. Conclusion: This analysis has implications for public health practice, indicating that multi-level interventions are needed to address limited HL. Innovation: Our findings provide novel insights for identifying key SDOH indicators to assess in clinical settings to provide health literate care.Associations Between Perceived Discrimination Over the Life Course, Subjective Social Status, and Health Literacy: A Racial Stratification Analysis
AbstractGoodman, M. (n.d.).Publication year
2024Journal title
PEC InnovationAbstract~Associations between subjective social status and predictors of interest in genetic testing among women diagnosed with breast cancer at a young age
AbstractOdumegwu, J. N., Chavez-Yenter, D., Goodman, M., & Kaphingst, K. A. (n.d.).Publication year
2024Journal title
Cancer Causes and ControlAbstractPurpose: Genetic testing for gene mutations which elevate risk for breast cancer is particularly important for women diagnosed at a young age. Differences remain in access and utilization to testing across social groups, and research on the predictors of interest in genetic testing for women diagnosed at a young age is limited. Methods: We examined the relationships between subjective social status (SSS) and variables previously identified as possible predictors of genetic testing, including genome sequencing knowledge, genetic worry, cancer worry, health consciousness, decision-making preferences, genetic self-efficacy, genetic-related beliefs, and subjective numeracy, among a cohort of women who were diagnosed with breast cancer at a young age. Results: In this sample (n = 1,076), those who had higher SSS had significantly higher knowledge about the limitations of genome sequencing (Odds Ratio (OR) = 1.11; 95% CI = 1.01−1.21) and significantly higher informational norms (OR = 1.93; 95% CI = 1.19−3.14) than those with lower SSS. Similarly, education (OR = 2.75; 95% CI = 1.79−4.22), health status (OR = 2.18; 95% CI = 1.44−3.31) were significant predictors among higher SSS women compared to lower SSS women in our multivariate analysis. Lower SSS women with low self-reported income (OR = 0.13; 95% CI = 0.08−0.20) had lower odds of genetic testing interest. Our results are consistent with some prior research utilizing proxy indicators for socioeconomic status, but our research adds the importance of using a multidimensional indicator such as SSS to examine cancer and genetic testing predictor outcomes. Conclusion: To develop interventions to improve genetic knowledge, researchers should consider the social status and contexts of women diagnosed with breast cancer at a young age (or before 40 years old) to ensure equity in the distribution of genetic testing benefits.