Melody Goodman
Melody Goodman
Scroll
Dean, School of Global Public Health
Professor of Biostatistics
-
Professional overview
-
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.
-
Education
-
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
-
Honors and awards
-
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)
-
Areas of research and study
-
BiostatisticsCommunity HealthCommunity-based Participatory ResearchDissemination and Implementation of Evidence-based ProgramsQuantitative Research
-
Publications
Publications
Copycat and lookalike edible cannabis product packaging in the United States
AbstractOmpad, D. C., Snyder, K. M., Sandh, S., Hagen, D., Collier, K. J., Goldmann, E., Goodman, M., & Tan, A. S. (n.d.).Publication year
2022Journal title
Drug and alcohol dependenceVolume
235AbstractBackground: Recent media reports have highlighted copycat/lookalike cannabis edibles as a public health concern. No empirical papers have described this phenomenon. Methods: From May 2020-August 2021, we collected photos of cannabis products via an online survey of cannabis users and through personal contacts. Copycat/lookalike products are defined as those that use the same or similar brand name, logo, and/or imagery as an existing commercial non-cannabis counterpart (CNCC). We assessed each package for similarities with its CNCC with respect to brand name, product name, font, color, flavors, and brand/promotional characters. We examined cannabis content indicators including: THC content per package and serving, cannabis leaf symbol, product warnings, cannabis terms, cannabis motifs, activation time, and guidance on edible use. Results: We collected photos of 731 cannabis products; 267 (36%) were edibles of which 22 (8%) represented 13 unique copycat/lookalike products. Eight used exact brand/product names as existing CNCCs, and five used similar names. Packages copied or imitated a mean of 3.9 of six features and indicated cannabis content with a mean of 4.1 of eight features. Thirteen packages indicated a mean THC content of 459 mg/package. Four reported THC dose per serving, with a mean dose of 47.5 mg. Conclusions: Our content analysis highlights three key concerns. First, copycat/lookalike edibles subtly indicate cannabis content while using high fidelity replication or imitation of their CNCC. Second, THC content is high and there were multiple 10 mg THC doses in the equivalent of 1 serving of a CNCC. Third, these products may be attractive to children.Cross-sectional and longitudinal effects of racism on mental health among residents of Black neighborhoods in New York City
AbstractKwate, N. O., & Goodman, M. (n.d.).Publication year
2015Journal title
American journal of public healthVolume
105Issue
4Page(s)
711-718AbstractObjectives. We investigated the impact of reported racism on the mental health of African Americans at cross-sectional time points and longitudinally, over the course of 1 year. Methods. The Black Linking Inequality, Feelings, and the Environment (LIFE) Study recruited Black residents (n = 144) from a probability sample of 2 predominantly Black New York City neighborhoods during December 2011 to June 2013. Respondents completed self-report surveys, including multiple measures of racism. We conducted assessments at baseline, 2-month follow-up, and 1-year follow-up. Weighted multivariate linear regression models assessed changes in racism and health over time. Results. Cross-sectional results varied by time point and by outcome, with only some measures associated with distress, and effects were stronger for poor mental health days than for depression. Individuals who denied thinking about their race fared worst. Longitudinally, increasing frequencies of racism predicted worse mental health across all 3 outcomes. Conclusions. These results support theories of racism as a health-defeating stressor and are among the few that show temporal associations with health.Decision role preferences for return of results from genome sequencing amongst young breast cancer patients
AbstractMatsen, C. B., Lyons, S., Goodman, M., Biesecker, B. B., & Kaphingst, K. A. (n.d.).Publication year
2019Journal title
Patient Education and CounselingVolume
102Issue
1Page(s)
155-161AbstractObjective: To better understand decision role preferences in women diagnosed with breast cancer at a young age for return of results of genome sequencing in research and clinical settings. Methods: Participants were surveyed about communication and decision-making preferences related to genome sequencing results and factors that may affect these preferences. The primary outcome was decision role preference (Control Preference Scale) for selecting what results to receive within medical care or within a research study. Results: For results returned as part of medical care, most patients preferred a collaborative (N = 481, 45%) or active (N = 488, 45%) role with only 107 (10%) choosing a passive role. When making the decision as part of a research study, most patients preferred an active role (N = 617, 57%), 350 (33%) choosing a collaborative role, and110 (10%) choosing a passive role. Conclusion: Most women in this study preferred to share in decision making. Participants had somewhat different role preferences for clinical and research contexts, with greater preference for active roles in the research context. Practice Implications: We advocate for practice guidelines that incorporate discussion of decision role as an integral part of patient centered care and shared decision-making and recognize that more work is needed to inform guidelines.Descriptive Analysis of the 2014 Race-Based Healthcare Disparities Measurement Literature
AbstractGoodman, M., Gilbert, K. L., Hudson, D., Milam, L., & Colditz, G. A. (n.d.).Publication year
2017Journal title
Journal of Racial and Ethnic Health DisparitiesVolume
4Issue
5Page(s)
796-802AbstractImportance: There are more than 500 articles in the 2014 race-based healthcare disparities literature across a broad array of diseases and outcomes. However, unlike many other forms of research (e.g., clinical trials and systematic reviews), there are no required reporting guidelines when submitting results of disparities studies to journals. Objective: This study describes the race-based healthcare disparities measurement literature in terms of study design, journal characteristics, generation of health disparities research, type of disparity measure used, and adherence to disparities measurement guidelines. Methods: We searched three databases of peer-reviewed literature, PubMed, Ovid Medline, and JSTOR, for English language articles published in 2014 on racial/ethnic healthcare disparities. Studies must have quantitatively measured the difference in health outcomes between two racial/ethnic groups in order to be included. Our final sample included 266 studies from 167 medical and public health journals. Findings: Only 7 % (n = 19) of articles reported both an absolute and relative measure of disparity; the majority of studies (64 %, n = 171) reported only a relative measure of effect. Most studies were published in clinical journals (74 %, n = 198), used secondary data (86 %, n = 229), and calculated black-white disparities (82 %, n = 218). The most common condition studied was cancer (25 %, n = 67), followed by a surgical procedure (18 %, n = 48). On average, articles in the sample only met 61 % of the applicable guidelines on reporting of disparities. Conclusions and Relevance: To be able to synthesize findings in the racial disparities literature (meta-analysis), there is a need for the use of consistent methods for quantifying disparities and reporting in the literature. A more consistent battery of measures and consistent reporting across studies may help speed our understanding of the origins and development of solutions to address healthcare disparities. Despite guidelines for best practices in reporting disparities, there is a lack of adherence in the current literature.Design and Analytic Methods to Evaluate Multilevel Interventions to Reduce Health Disparities : Rigorous Methods Are Available
AbstractMurray, D. M., & Goodman, M. (n.d.).Publication year
2024Journal title
Prevention ScienceVolume
25Issue
Suppl 3Page(s)
343-347AbstractIn June 2022, the NIH Office of Disease Prevention (ODP) issued a Call for Papers for a Supplemental Issue to Prevention Science on Design and Analytic Methods to Evaluate Multilevel Interventions to Reduce Health Disparities. ODP sought to bring together current thinking and new ideas about design and analytic methods for studies aimed at reducing health disparities, including strategies for balancing methodological rigor with design feasibility, acceptability, and ethical considerations. ODP was particularly interested in papers on design and analytic methods for parallel group- or cluster-randomized trials (GRTs), stepped-wedge GRTs, group-level regression discontinuity trials, and other methods appropriate for evaluating multilevel interventions. In this issue, we include 12 papers that report new methods, provide examples of strong applications of existing methods, or provide guidance on developing multilevel interventions to reduce health disparities. These papers provide examples showing that rigorous methods are available for the design and analysis of multilevel interventions to reduce health disparities.Designing for data sharing : Considerations for advancing health equity in data management and dissemination
AbstractRabin, B. A., Smith, J. D., Dressler, E. V., Cohen, D. J., Lee, R. M., Goodman, M., D'angelo, H., Norton, W. E., & Oh, A. Y. (n.d.).Publication year
2024Journal title
Translational Behavioral MedicineVolume
14Issue
11Page(s)
637-642AbstractData sharing, the act of making scientific research data available to others, can accelerate innovation and discoveries, and ultimately enhance public health. The National Cancer Institute Implementation Science Centers in Cancer Control convened a diverse group of research scientists, practitioners, and community partners in three interactive workshops (May-June 2022) to identify and discuss factors that must be considered when designing research for equitable data sharing with a specific emphasis on implementation science and social, behavioral, and population health research. This group identified and operationalized a set of seven key considerations for equitable data sharing - conceptualized as an inclusive process that fairly includes the perspectives and priorities of all partners involved in and impacted by data sharing, with consideration of ethics, history, and benefits - that were integrated into a framework. Key data-sharing components particularly important for health equity included: elevating data sharing into a core research activity, incorporating diverse perspectives, and meaningfully engaging partners in data-sharing decisions throughout the project lifecycle. As the process of data sharing grows in research, it is critical to continue considering the potential positive and adverse impact of data sharing on diverse beneficiaries of health data and research.Detecting multiple change points in piecewise constant hazard functions
AbstractGoodman, M., Li, Y., & Tiwari, R. C. (n.d.).Publication year
2011Journal title
Journal of Applied StatisticsVolume
38Issue
11Page(s)
2523-2532AbstractThe National Cancer Institute (NCI) suggests a sudden reduction in prostate cancer mortality rates, likely due to highly successful treatments and screening methods for early diagnosis. We are interested in understanding the impact of medical breakthroughs, treatments, or interventions, on the survival experience for a population. For this purpose, estimating the underlying hazard function, with possible time change points, would be of substantial interest, as it will provide a general picture of the survival trend and when this trend is disrupted. Increasing attention has been given to testing the assumption of a constant failure rate against a failure rate that changes at a single point in time. We expand the set of alternatives to allow for the consideration of multiple change-points, and propose a model selection algorithm using sequential testing for the piecewise constant hazard model. These methods are data driven and allow us to estimate not only the number of change points in the hazard function but where those changes occur. Such an analysis allows for better understanding of how changing medical practice affects the survival experience for a patient population. We test for change points in prostate cancer mortality rates using the NCI Surveillance, Epidemiology, and End Results dataset.Detecting univariate, bivariate, and overall effects of drug mixtures using Bayesian kernel machine regression
AbstractBather, J. R., Han, L., Bennett, A. S., Elliott, L. C., & Goodman, M. (n.d.).Publication year
2024Journal title
American Journal of Drug and Alcohol AbuseAbstractBackground: Innovative analytic approaches to drug studies are needed to understand better the co-use of opioids with non-opioids among people using illicit drugs. One approach is the Bayesian kernel machine regression (BKMR), widely applied in environmental epidemiology to study exposure mixtures but has received far less attention in substance use research. Objective: To describe the utility of the BKMR approach to study the effects of drug substance mixtures on health outcomes. Methods: We simulated data for 200 individuals. Using the Vale and Maurelli method, we simulated multivariate non-normal drug exposure data: xylazine (mean = 300 ng/mL, SD = 100 ng/mL), fentanyl (mean = 200 ng/mL, SD = 71 ng/mL), benzodiazepine (mean = 300 ng/mL, SD = 55 ng/mL), and nitazene (mean = 200 ng/mL, SD = 141 ng/mL) concentrations. We performed 10,000 MCMC sampling iterations with three Markov chains. Model diagnostics included trace plots, r-hat values, and effective sample sizes. We also provided visual relationships of the univariate and bivariate exposure-response and the overall mixture effect. Results: Higher levels of fentanyl and nitazene concentrations were associated with higher levels of the simulated health outcome, controlling for age. Trace plots, r-hat values, and effective sample size statistics demonstrated BKMR stability across multiple Markov chains. Conclusions: Our understanding of drug mixtures tends to be limited to studies of single-drug models. BKMR offers an innovative way to discern which substances pose a greater health risk than other substances and can be applied to assess univariate, bivariate, and cumulative drug effects on health outcomes.Determinants of Breast Cancer Screening Adherence During the COVID-19 Pandemic in a Cohort at Increased Inherited Cancer Risk in the United States
AbstractHarris, A., Bather, J. R., Kawamoto, K., Fiol, G. D., Bradshaw, R. L., Kaiser-Jackson, L., Monahan, R., Kohlmann, W., Liu, F., Ginsburg, O., Goodman, M., & Kaphingst, K. A. (n.d.).Publication year
2024Journal title
Cancer ControlVolume
31AbstractBackground: We examined neighborhood characteristics concerning breast cancer screening annual adherence during the COVID-19 pandemic. Methods: We analyzed 6673 female patients aged 40 or older at increased inherited cancer risk in 2 large health care systems (NYU Langone Health [NYULH] and the University of Utah Health [UHealth]). Multinomial models were used to identify predictors of mammogram screening groups (non-adherent, pre-pandemic adherent, pandemic period adherent) in comparison to adherent females. Potential determinants included sociodemographic characteristics and neighborhood factors. Results: Comparing each cancer group in reference to the adherent group, a reduced likelihood of being non-adherent was associated with older age (OR: 0.97, 95% CI: 0.95, 0.99), a greater number of relatives with cancer (OR: 0.80, 95% CI: 0.75, 0.86), and being seen at NYULH study site (OR: 0.42, 95% CI: 0.29, 0.60). More relatives with cancer were correlated with a lesser likelihood of being pandemic period adherent (OR: 0.89, 95% CI: 0.81, 0.97). A lower likelihood of being pre-pandemic adherent was seen in areas with less education (OR: 0.77, 95% CI: 0.62, 0.96) and NYULH study site (OR: 0.35, 95% CI: 0.22, 0.55). Finally, greater neighborhood deprivation (OR: 1.47, 95% CI: 1.08, 2.01) was associated with being non-adherent. Conclusion: Breast screening during the COVID-19 pandemic was associated with being older, having more relatives with cancer, residing in areas with less educational attainment, and being seen at NYULH; non-adherence was linked with greater neighborhood deprivation. These findings may mitigate risk of clinically important screening delays at times of disruptions in a population at greater risk for breast cancer.Determinants of Breast Cancer Screening Adherence During the COVID-19 Pandemic in a Cohort at Increased Inherited Cancer Risk in the United States
AbstractGoodman, M. (n.d.).Publication year
2024Journal title
Cancer ControlVolume
11Issue
54Abstract~Developing pathways to increase racial/ethnic diversity in biostatistics and data science
AbstractGoodman, M. (n.d.).Publication year
2023AbstractTo address racial/ethnic inequities in health outcomes, it is important to have a racially and ethnically diverse workforce capable of addressing complex public health issues with many biological, environmental, and social risk factors. Given its social justice focus, public health can be an attractive discipline for underrepresented racial/ethnic minority students. Thus, the potential exists for increased racial/ethnic diversity in the academic public health pipeline—from undergraduate study to faculty status—especially if students are exposed to the field early. Data is one of the world's most valuable resources, and the ability to work with data opens up many potential career paths. Given the recent Supreme Court decision on race-conscious admissions, we must develop innovative ways to increase racial diversity within the bounds of the law. I will discuss pathway programs as one way to increase the diversity of students using the Quantitative Public Health Data Literacy Training, The Emerging Leaders in Quantitative Reasoning program, and the Research and Racial Equity Summer Internship program as specific examples. These programs are designed to create windows, mirrors, and sliding glass doors that welcome underrepresented students into quantitative public health.Development and validation of a brief version of the research engagement survey tool
AbstractGoodman, M., Ackermann, N., Pierce, K. A., Bowen, D. J., & Thompson, V. S. (n.d.).Publication year
2021Journal title
International journal of environmental research and public healthVolume
18Issue
19AbstractThe Research Engagement Survey Tool (REST) examines the level of partner engagement in research studies. This study used mixed methods, including web‐based surveys (N = 336), a mod-ified Delphi process (N = 18), and cognitive response interviews (N = 16), with convenience sampling to develop and validate a short version of the REST. We conducted factor analysis and calculated internal consistency for the condensed REST. We validated the condensed REST against the comprehensive REST. All analyses were carried out on two scales (quality and quantity) based on Likert-type response options. We examined convergent validity with other measures theoretically associ-ated with the REST (e.g., the Community Engagement Research Index and the Partnership Self‐ Assessment Tool). This study produced a 9‐item condensed version of the REST. The condensed REST loads on 1 factor, has high internal consistency (Cronbach’s alpha = 0.92 for the quantity scale; 0.94 for the quality scale), is significantly correlated (ρ = 0.97; p < 0.001 for both scales) with the comprehensive (32‐item) REST, and has negligible, low, and moderate correlation with other measures (e.g., the Partnership Assessment In community‐based Research, trust in medical re-searchers, and the Coalition Self‐Assessment Survey). Use of the condensed REST will reduce par-ticipant burden and time to complete. This standardized and validated quantitative measure is useful to compare engagement across projects or within a project over time.Development of Plain Language Supplemental Materials for the Biobank Informed Consent Process
AbstractDrake, B. F., Brown, K. M., Gehlert, S., Wolf, L. E., Seo, J., Perkins, H., Goodman, M., & Kaphingst, K. A. (n.d.).Publication year
2017Journal title
Journal of Cancer EducationVolume
32Issue
4Page(s)
836-844AbstractThe US Department of Health and Human Services addresses clear communication in the informed consent process as part of the Notice of Proposed Rulemaking for revisions to the Common Rule. However, prior research has shown that participants may not fully comprehend research studies despite completion of an informed consent process. Our main goal was to provide plain language information about donation processes to a cancer biobank to supplement an informed consent form. We developed and conducted cognitive testing with supplemental brochures that clearly communicated information about three different models for consent (notice, broad and study-specific) to future use of biospecimens. During the brochure development process, we conducted qualitative, semi-structured, individual, in-person cognitive interviews among 14 women to examine participants’ perceptions of the brochures. Each participant provided feedback regarding the understandability, graphics and layout, and cultural appropriateness of the brochures. Our findings demonstrate that these methods may be used to tailor consent form brochures, such as the ones developed here, to other populations. This study therefore adds to our understanding of how best to present content to help women from two different racial groups make informed decisions about participation in a cancer biobank.Diagnostic accuracy of self-reported racial composition of residential neighborhood
AbstractHidalgo, B., Kaphingst, K. A., Stafford, J., Lachance, C., & Goodman, M. (n.d.).Publication year
2015Journal title
Annals of EpidemiologyVolume
25Issue
8Page(s)
597-604AbstractPurpose: To examine the diagnostic accuracy of self-reported measures of individuals' perceptions of the racial and ethnic composition of their communities with objective data (i.e., census) as the criterion standard and assess differences in concordance in subjective and objective measures of segregation by race and ethnicity. Methods: We examined data from 943 adult community health center visitors in Suffolk County, New York to assess differences between self-reported racial composition of current neighborhood and 2010 U.S. Census data. A cross-sectional convenience sample was obtained; questionnaires were used to compare participant responses about the racial composition of their current neighborhood and their town of residence. Results: Respondents who self-identified as white were more likely to self-report racial composition of their neighborhood consistent with 2010 Census estimates. Relative to census estimates, 93.1% of blacks overestimated the proportion of their current neighborhood that was black, and 69.8% of Hispanics overestimated the proportion that was Hispanic. Conclusions: There were statistically significant differences between the participants' self-reported neighborhood racial composition and census data across race and ethnicity groups. Future studies are needed to validate self-reported measures of individuals' perceptions of the racial and ethnic composition of their communities to examine the association between individual segregation experience and health.Differences in preferences for models of consent for biobanks between Black and White women
AbstractBrown, K. M., Drake, B. F., Gehlert, S., Wolf, L. E., DuBois, J., Seo, J., Woodward, K., Perkins, H., Goodman, M., & Kaphingst, K. A. (n.d.).Publication year
2016Journal title
Journal of Community GeneticsVolume
7Issue
1Page(s)
41-49AbstractBiobanks are essential resources, and participation by individuals from diverse groups is needed. Various models of consent have been proposed for secondary research use of biospecimens, differing in level of donor control and information received. Data are needed regarding participant preferences for models of consent, particularly among minorities. We conducted qualitative semi-structured interviews with 60 women to examine their attitudes about different models of consent. Recruitment was stratified by race (Black/White) and prior biobank participation (yes/no). Two coders independently coded interview transcripts. Qualitative thematic analysis was conducted using NVivo 10. The majority of Black and White participants preferred “broad” consent (i.e., blanket permission for secondary research use of biospecimens), and the second most preferred model for both groups was “study-specific” consent (i.e., consent for each future research study). The qualitative analysis showed that participants selected their most preferred model for 3 major reasons: having enough information, having control over their sample, and being asked for permission. Least preferred was notice model (i.e., participants notified that biospecimens may be used in future research). Attitudes toward models of consent differed somewhat by race and prior biobank participation. Participants preferred models of consent for secondary research use of biospecimens that provided them with both specific and general information, control over their biospecimens, and asked them to give permission for use. Our findings suggest that it will be important for researchers to provide information about future uses of biospecimens to the extent possible and have an explicit permission step for secondary research use.Distal Factors Associated With Proximal Overdose Risk Behaviors and Recent Non-Fatal Overdose Among a Sample of People Who Use Illicit Opioids in New York City
AbstractElliott, L. C., Chen, Y., Goodman, M., & Bennett, A. S. (n.d.).Publication year
2023Journal title
Journal of Drug IssuesAbstractThis analysis identifies factors associated with overdose risk behaviors and non-fatal overdose among a sample of 577 adult-age people who use illicit opioids and live in NYC. Survey data--which included outcome measures assessing (1) past 30-day non-fatal overdose and past 30-day overdose-related risk behaviors and (2) predictors representing potential risk and protective factors—were analyzed using bivariate and Poisson regression techniques. Results indicate being 41–56 years in age, being widowed, using cannabis, injecting, and having greater pain severity and mental health challenges were associated with greater risks. Current employment, homelessness, and prescription of medications for opioid use disorder were associated with fewer risks. Being 57+ was negatively associated with past-month overdose; higher pain severity and opioid related withdrawal were positively related, as were employment, cannabis use, and injection. Findings suggest the importance of expanding access to MOUD and tailoring OD prevention interventions for mental health and pain management services.Do subjective measures improve the ability to identify limited health literacy in a clinical setting?
AbstractGoodman, M., Griffey, R. T., Carpenter, C. R., Blanchard, M., & Kaphingst, K. A. (n.d.).Publication year
2015Journal title
Journal of the American Board of Family MedicineVolume
28Issue
5Page(s)
584-594AbstractBackground: Existing health literacy assessments developed for research purposes have constraints that limit their utility for clinical practice, including time requirements and administration protocols. The Brief Health Literacy Screen (BHLS) consists of 3 self-administered Single-Item Literacy Screener (SILS) questions and obviates these clinical barriers. We assessed whether the addition of SILS items or the BHLS to patient demographics readily available in ambulatory clinical settings reaching underserved patients improves the ability to identify limited health literacy. Methods: We analyzed data from 2 cross-sectional convenience samples of patients from an urban academic emergency department (n = 425) and a primary care clinic (n = 486) in St. Louis, Missouri. Across samples, health literacy was assessed using the Rapid Estimate of Adult Literacy in Medicine- Revised (REALM-R), Newest Vital Sign (NVS), and the BHLS. Our analytic sample consisted of 911 adult patients, who were primarily female (62%), black (66%), and had at least a high school education (82%); 456 were randomly assigned to the estimation sample and 455 to the validation sample. Results: The analysis showed that the best REALM-R estimation model contained age, sex, education, race, and 1 SILS item (difficulty understanding written information). In validation analysis this model had a sensitivity of 62%, specificity of 81%, a positive likelihood ratio (LR+) of 3.26, and a negative likelihood ratio (LR-) of 0.47; there was a 28% misclassification rate. The best NVS estimation model contained the BHLS, age, sex, education and race; this model had a sensitivity of 77%, specificity of 72%, LR+ of 2.75, LR- of 0.32, and a misclassification rate of 25%. Conclusions: Findings suggest that the BHLS and SILS items improve the ability to identify patients with limited health literacy compared with demographic predictors alone. However, despite being easier to administer in clinical settings, subjective estimates of health literacy have misclassification rates >20% and do not replace objective measures; universal precautions should be used with all patients.Does learning about race prevent substance abuse? Racial discrimination, racial socialization and substance use among African Americans
AbstractThompson, A. B., Goodman, M., & Kwate, N. O. (n.d.).Publication year
2016Journal title
Addictive BehaviorsVolume
61Page(s)
1-7Abstract~Does numeracy correlate with measures of health literacy in the emergency department?
AbstractGriffey, R. T., Melson, A. T., Lin, M. J., Carpenter, C. R., Goodman, M., & Kaphingst, K. A. (n.d.).Publication year
2014Journal title
Academic Emergency MedicineVolume
21Issue
2Page(s)
147-153AbstractObjectives The objective was to quantify the correlation between general numeracy and health literacy in an emergency department (ED) setting. Methods This was a prospective cross-sectional convenience sample study of adult patients in an urban, academic ED with 97,000 annual visits. General numeracy was evaluated using four validated questions and health literacy using three commonly used validated screening tools (Short Test of Functional Health Literacy in Adults [S-TOFHLA], Rapid Estimate of Adult Literacy in Medicine-Revised [REALM-R], and the Newest Vital Sign [NVS]). Scores were dichotomized for health literacy tests to limited (low or marginal) versus adequate health literacy, and the proportion of patients answering all numeracy questions correctly was calculated with the mean proportion of correct responses in these groups. The correlation between numeracy scores and scores on the health literacy screening tools was evaluated using Spearman's correlation. Results A total of 446 patients were enrolled. Performance on questions evaluating general numeracy was universally poor. Only 18 patients (4%) answered all numeracy questions correctly, 88 patients (20%) answered zero questions correctly, and overall the median number of correct answers was one (interquartile range [IQR] = 1 to 2). Among patients with limited health literacy (LHL) by any of the three screening tools used, the mean number of correct numeracy answers was approximately half that of patients with adequate health literacy. However, even among those with adequate health literacy, the average number of correct answers to numeracy questions ranged from 1.6 to 2.4 depending on the screening test used. When dichotomized into those who answered ≤50% versus >50% of numeracy questions correctly, there was a significant difference between those with LHL and those who scored ≤50% on numeracy. Health literacy screening results were correlated with general numeracy in the low to moderate range: S-TOFHLA rs = 0.428 (p < 0.0001); REALM, rs = 0.400 (p < 0.0001); and NVS, rs = 0.498 (p < 0.0001). Conclusions Correlations between measures of general numeracy and measures of health literacy are in the low to moderate range. Performance on numeracy testing was nearly universally poor, even among patients performing well on health literacy screens, with a substantial proportion of the latter patients unable to answer half of the numeracy items correctly. Insofar as numeracy is considered a subset of health literacy, these results suggest that commonly used health literacy screening tools in ED-based studies inadequately evaluate and overestimate numeracy. This suggests the potential need for separate numeracy screening when these skills are important for health outcomes of interest. Providers should be sensitive to potential numeracy deficits among those who may otherwise have normal health literacy.Does "off-hours" admission affect burn patient outcome?
AbstractTaira, B. R., Meng, H., Goodman, M., & Singer, A. J. (n.d.).Publication year
2009Journal title
BurnsVolume
35Issue
8Page(s)
1092-1096AbstractIntroduction: Previous critical care and cardiology studies find that critically ill patients have worse outcomes when admitted to the hospital during off-hours as compared to those admitted during weekdays. As severe burn is equally emergent we hypothesized that this disparity in outcomes would exist for burn patients as well. Study design: Secondary analysis of the National Trauma Data Bank (NTDB) version 7.1. The NTDB is a national registry of hospital admissions for traumatic injury administered by the American College of Surgeons. Setting: 700 trauma facilities nationwide contributing to the NTDB between 2002 and 2006. Subjects: All trauma patients included in the dataset with the injury mechanism of burn divided into "off-hours" admits (nights from 6 pm to 6 am and weekends) and weekday admits. Measures: Time and day of admission, demographics, ISS score, injury characteristics (±inhalational injury, TBSA, and full thickness injury), facility characteristics (number of burn beds, teaching status). Outcomes: Mortality as the primary outcome. Secondary outcomes include ICU length of stay (LOS), hospital length of stay. Data analysis: Descriptive statistics to summarize group characteristics, χ2 and Student's t tests for bivariate analysis, multivariable linear and logistic regressions. Results: Of the 25,572 burn patients, 17,625 (68.9%) arrived during off-hours. There was no difference in ICU length of stay (LOS) (p = 0.233), hospital LOS (p = 0.82), or mortality (p = 0.546) for those admitted during off-hours compared with weekday admits. In multivariate analysis when controlling for age, gender, burn characteristics (inhalation injury, full thickness injury, and TBSA >30%), and hospital type, off-hours admission was not predictive of mortality (OR = 1.06, 95% CI 0.91-1.23). Conclusions: Contrary to studies in other critically ill patient populations, off-hours admission is not predictive of worse outcomes in burn patients.Editorial : An insight into university medical and health science courses
AbstractKang, S., Goodman, M., Thakur, H. P., Grivna, M., & Zodpey, S. P. (n.d.).Publication year
2022Journal title
Frontiers in Public HealthVolume
10Abstract~Editorial : Women in science: Public health education and promotion 2021
AbstractCaron, R. M., Jamshed, S. Q., Goodman, M., & Kang, S. (n.d.).Publication year
2022Journal title
Frontiers in Public HealthVolume
10Abstract~Editorial : Women in science: Public Health Education and Promotion 2022
AbstractCaron, R. M., Jamshed, S. Q., Goodman, M., & Kang, S. (n.d.).Publication year
2023Journal title
Frontiers in Public HealthVolume
11Abstract~Effect of cognitive dysfunction on the relationship between age and health literacy
AbstractKaphingst, K. A., Goodman, M., MacMillan, W. D., Carpenter, C. R., & Griffey, R. T. (n.d.).Publication year
2014Journal title
Patient Education and CounselingVolume
95Issue
2Page(s)
218-225AbstractObjective: Age is generally an inverse predictor of health literacy. However, the role of cognitive dysfunction among older adults in this relationship is not understood. Methods: We conducted a cross-sectional survey of 446 adult patients in a large urban academic level one trauma center, assessing health literacy and cognitive dysfunction. Results: Removing older patients (60 years of age and older) who screened positive for cognitive dysfunction attenuated the relationship between age and health literacy (r= -0.16, p= 0.001 vs. r= -0.35, p< 0.0001). Older patients screening positive for cognitive dysfunction had significantly lower health literacy than older patients screening negative and patients less than 60 years; health literacy scores did not generally differ significantly between the latter groups. Conclusion: Much of the relationship between age and health literacy was driven by cognitive dysfunction among a subset of older adults. Practice implications: Our findings suggest that older patients with cognitive dysfunction have the greatest need for health literacy interventions.Effect of Health Literacy on Decision-Making Preferences among Medically Underserved Patients
AbstractSeo, J., Goodman, M., Politi, M., Blanchard, M., & Kaphingst, K. A. (n.d.).Publication year
2015Journal title
Medical Decision MakingVolume
36Issue
4Page(s)
550-556AbstractIntroduction. Participation in the decision-making process and health literacy may both affect health outcomes; data on how these factors are related among diverse groups are limited. This study examined the relationship between health literacy and decision-making preferences in a medically underserved population. Methods. We analyzed a sample of 576 primary care patients. Multivariable logistic regression was used to examine the independent association of health literacy (measured by the Rapid Estimate of Adult Literacy in Medicine-Revised) and patients' decision-making preferences (physician directed or patient involved), controlling for age, race/ethnicity, and gender. We tested whether having a regular doctor modified this association. Results. Adequate health literacy (odds ratio [OR] = 1.7; P = 0.009) was significantly associated with preferring patient-involved decision making, controlling for age, race/ethnicity, and gender. Having a regular doctor did not modify this relationship. Males were significantly less likely to prefer patient-involved decision making (OR = 0.65; P = 0.024). Discussion. Findings suggest health literacy affects decision-making preferences in medically underserved patients. More research is needed on how factors, such as patient knowledge or confidence, may influence decision-making preferences, particularly for those with limited health literacy.