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
Race, law, and health : Examination of 'Stand Your Ground' and defendant convictions in Florida
AbstractAckermann, N., Goodman, M., Gilbert, K., Arroyo-Johnson, C., & Pagano, M. (n.d.).Publication year
2015Journal title
Social Science and MedicineVolume
142Page(s)
194-201AbstractPrevious analyses of Stand Your Ground (SYG) cases have been primarily descriptive. We examine the relationship between race of the victim and conviction of the defendant in SYG cases in Florida from 2005 to 2013. Using a regression analytic approach, we allow for simultaneous examination of multiple factors to better understand existing interrelationships. Data was obtained from the Tampa Bay Times SYG database (237 cases) which was supplemented with available online court documents and/or news reports. After excluding cases which were, still pending as of January 2015; had multiple outcomes (because of multiple suspects); and missing information on race of victim and weapon of victim, our final analytic sample has 204 cases. We chose whether the case resulted in a conviction as the outcome. We develop logistic regression models using significant bivariate predictors as candidates. These include race of the victim (White, non-White), whether the defendant could have retreated from the situation, whether the defendant pursued the victim, if the victim was unarmed, and who was the initiator of the confrontation. We find race of the victim to be a significant predictor of case outcome in this data set. After controlling for other variables, the defendant is two times (OR = 2.1, 95% CI [1.07, 4.10]) more likely to be convicted in a case that involves White victims compared to those involving non-White victims. Our results depict a disturbing message: SYG legislation in Florida has a quantifiable racial bias that reveals a leniency in convictions if the victim is non-White, which provides evidence towards unequal treatment under the law. Rather than attempting to hide the outcomes of these laws, as was done in Florida, other states with SYG laws should carry out similar analyses to see if their manifestations are the same as those in Florida, and all should remediate any injustices found.Racial composition over the life course : Examining separate and unequal environments and the risk for heart disease for African American men
AbstractGilbert, K. L., Elder, K., Lyons, S., Kaphingst, K., Blanchard, M., & Goodman, M. (n.d.).Publication year
2015Journal title
Ethnicity and DiseaseVolume
25Issue
3Page(s)
295-304AbstractPurpose: Studies have demonstrated the effects of segregated social and physical environments on the development of chronic diseases for African Americans. Studies have not delineated the effects of segregated environments specifically on the health of African American men over their lifetime. This study examines the relationship between life course measures of racial composition of social environments and diagnosis of hypertension among African American men. Design: We analyzed cross-sectional data from a convenience sample of African American men seeking health care services in an outpatient primary care clinic serving a medically underserved patient population (N=118). Multivariable logistic regression analyses were used to examine associations between racial composition of multiple environments across the life course (eg, junior high school, high school, neighborhood growing up, current neighborhood, place of employment, place of worship) and hypertension diagnosis. Results: The majority (86%) of participants were not currently in the workforce (retired, unemployed, or disabled) and more than half (54%) reported an annual household income ofRacism at the Intersections : Gender and Socioeconomic Differences in the Experience of Racism Among African Americans
AbstractKwate, N. O., & Goodman, M. (n.d.).Publication year
2015Journal title
American Journal of OrthopsychiatryVolume
85Issue
5Page(s)
397-408AbstractSeveral studies investigating the health effects of racism have reported gender and socioeconomic differences in exposures to racism, with women typically reporting lower frequencies, and individuals with greater resources reporting higher frequencies. This study used diverse measures of socioeconomic position and multiple measures and methods to assess experienced racism. Socioeconomic position included education and financial and employment status. Quantitative racism measures assessed individual experiences with day-to-day and with major lifetime incidents and perceptions of the extent to which African Americans as a group experience racism. A brief qualitative question asked respondents to describe a racist incident that stood out in recent memory. Participants comprised a probability sample of N ± 144 African American adults aged 19 to 87 residing in New York City. Results suggested that women reported fewer lifetime incidents but did not differ from men on everyday racism. These differences appear to be partly because of scale content. Socioeconomic position as measured by years of education was positively associated with reported racism in the total sample but differently patterned across gender; subjective social status showed a negative association. Qualitative responses describing memorable incidents fell into 5 key categories: resources/opportunity structures, criminal profiling, racial aggression/assault, interpersonal incivilities, and stereotyping. In these narratives, men were more likely to offer accounts involving criminal profiling, and women encountered incivilities more often. The findings highlight the need for closer attention to the intersection of gender and socioeconomic factors in investigations of the health effects of racism.The impact of teach-back on comprehension of discharge instructions and satisfaction among emergency patients with limited health literacy : A randomized, controlled study
AbstractGriffey, R. T., Shin, N., Jones, S., Aginam, N., Gross, M., Kinsella, Y., Williams, J. A., Carpenter, C. R., Goodman, M., & Kaphingst, K. A. (n.d.).Publication year
2015Journal title
Journal of Communication in HealthcareVolume
8Issue
1Page(s)
10-21AbstractObjective: Recommended as a ‘universal precaution’ for improving provider–patient communication, teach-back has a limited evidence base. Discharge from the emergency department (ED) to home is an important high-risk transition of care with potential for miscommunication of critical information. We examined whether teach-back improves: comprehension and perceived comprehension of discharge instructions and satisfaction among patients with limited health literacy (LHL) in the ED. Methods: We performed a randomized, controlled study among adult patients with LHL, randomized to teach-back or standard discharge instructions. Patients completed an audio-recorded structured interview evaluating comprehension and perceived comprehension of (1) diagnosis, (2) ED course, (3) post-ED care, and (4) reasons to return and satisfaction using four Consumer Assessment of Healthcare Providers and Systems questions. Concordance with the medical record was rated using a five-level scale. We analyzed differences between groups using multivariable ordinal logistic regression. Results: Patients randomized to receive teach-back had higher comprehension of post-ED care areas: post-ED medication (P < 0.02), self-care (P < 0.03), and follow-up instructions (P < 0.0001), but no change in patient satisfaction or perceived comprehension. Conclusion: Teach-back appears to improve comprehension of post-ED care instructions but not satisfaction or perceived comprehension. Our data from a randomized, controlled study support the effectiveness of teach-back in a busy clinical setting. Further research is needed to test the utility and feasibility of teach-back for routine use including its impacts on distal outcomes.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.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.Brentwood community health care assessment
AbstractGoodman, M., Gonzalez, M., Gil, S., Si, X., Pashoukos, J. L., Stafford, J. D., Ford, E., & Pashoukos, D. A. (n.d.).Publication year
2014Journal title
Progress in Community Health Partnerships: Research, Education, and ActionVolume
8Issue
1Page(s)
5-6Abstract~Brentwood community health care assessment
AbstractGoodman, M., Gonzalez, M., Gil, S., Si, X., Pashoukos, J. L., Stafford, J. D., Ford, E., & Pashoukos, D. A. (n.d.).Publication year
2014Journal title
Progress in Community Health Partnerships: Research, Education, and ActionVolume
8Issue
1Page(s)
29-39AbstractBackground: The Community Alliance for Research Empowering Social Change (CARES) is an academic-community research partnership designed to train community members on research methods and develop the infrastructure for community-based participatory research (CBPR) to examine and address racial/ethnic health disparities. The Brentwood Community Health Assessment (BCHA) was developed through a CBPR pilot project grant from CARES. Objectives: The purpose of the BCHA is to assess health care utilization and identify existing barriers to health care access among a multi-ethnic community in the Hamlet of Brentwood, New York. Methods: Using CBPR approaches, the community-academic research partnership develop the study design and survey instrument. Trained Bilingual (English/Spanish) data collectors verbally administered surveys door-to-door to residents of Brentwood from October 2010 to May 2011. Inclusion criteria required participants to be at least 18 years of age and speak either English or Spanish. Results: Overall, 232 residents completed the BCHA; 49% were male, 66% Hispanic, 13% non-Hispanic White, 13% non-Hispanic Black, 29% had less than a high school education, and 33% were born in United States. The assessment results revealed that most residents are able to access health care when needed and the most significant barriers to health care access are insurance and cost. Conclusions: We describe the community-academic partnered process used to develop and implement the BCHA and report assessment findings; the community-partnered approach improved data collection and allowed access into one of Suffolk County's most vulnerable communities.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.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.Feasibility and diagnostic accuracy of brief health literacy and numeracy screening instruments in an urban emergency department
AbstractCarpenter, C. R., Kaphingst, K. A., Goodman, M., Lin, M. J., Melson, A. T., & Griffey, R. T. (n.d.).Publication year
2014Journal title
Academic Emergency MedicineVolume
21Issue
2Page(s)
137-146AbstractObjectives The objective was to evaluate the diagnostic accuracy of five health literacy screening instruments in emergency department (ED) patients: the Rapid Evaluation of Adult Literacy in Medicine-Revised (REALM-R), the Newest Vital Sign (NVS), Single Item Literacy Screens (SILS), health numeracy, and physician gestalt. A secondary objective was to evaluate the feasibility of these instruments as measured by administration time, time on task, and interruptions during test administration. Methods This was a prospective observational cross-sectional study of a convenience sampling of adult patients presenting during March 2011 and February 2012 to one urban university- affiliated ED. Subjects were consenting non-critically ill, English-speaking patients over the age of 18 years without aphasia, dementia, mental retardation, or inability to communicate. The diagnostic test characteristics of the REALM-R, NVS, SILS, health numeracy, and physician gestalt were quantitatively assessed by using the short Test of Functional Health Literacy in Adults (S-TOFHLA). A score of 22 or less was the criterion standard for limited health literacy (LHL). Results A total of 435 participants were enrolled, with a mean (±SD) age of 45 (±15.7) years, and 18% had less than a high school education. As defined by an S-TOFHLA score of 22 or less, the prevalence of LHL was 23.9%. In contrast, the NVS, REALM-R, and physician gestalt identified 64.8, 48.5, and 35% of participants as LHL, respectively. A normal NVS screen was the most useful test to exclude LHL, with a negative likelihood ratio of 0.04 (95% confidence interval [CI] = 0.01 to 0.17). When abnormal, none of the screening instruments, including physician gestalt, significantly increased the posttest probability of LHL. The NVS and REALM-R require 3 and 5 minutes less time to administer than the S-TOFHLA. Administration of the REALM-R is associated with fewer test interruptions. Conclusions One-quarter of these ED patients had marginal or inadequate health literacy. Among the brief screening instruments evaluated, a normal NVS result accurately reduced the probability of LHL, although it will identify two-thirds of ED patients as high risk for LHL. None of the brief screening instruments significantly increases the probability of LHL when abnormal.Is low health literacy associated with increased emergency department utilization and recidivism?
AbstractGriffey, R. T., Kennedy, S. K., McGownan, L., Goodman, M., & Kaphingst, K. A. (n.d.).Publication year
2014Journal title
Academic Emergency MedicineVolume
21Issue
10Page(s)
1109-1115AbstractObjectives: The objective was to determine whether patients with low health literacy have higher emergency department (ED) utilization and higher ED recidivism than patients with adequate health literacy. Methods: The study was conducted at an urban academic ED with more than 95,000 annual visits that is part of a 13-hospital health system, using electronic records that are captured in a central data repository. As part of a larger, cross-sectional, convenience sample study, health literacy testing was performed using the short test of functional health literacy in adults (S-TOFHLA) and standard test thresholds identifying those with inadequate, marginal, and adequate health literacy. The authors collected patients' demographic and clinical data, including items known to affect recidivism. This was a structured electronic record review directed at determining 1) the median number of total ED visits in this health system within a 2-year period and 2) the proportion of patients with each level of health literacy who had return visits within 3, 7, and 14 days of index visits. Descriptive data for demographics and ED returns are reported, stratified by health literacy level. The Mantel-Haenszel chi-square was used to test whether there is an association between health literacy and ED recidivism. A negative binomial multivariable model was performed to examine whether health literacy affects ED use, including variables significant at the 0.1 alpha level on bivariate analysis and retaining those significant at an alpha of 0.05 in the final model. Results: Among 431 patients evaluated, 13.2% had inadequate, 10% had marginal, and 76.3% had adequate health literacy as identified by S-TOFHLA. Patients with inadequate health literacy had higher ED utilization compared to those with adequate health literacy (p = 0.03). Variables retained in the final model included S-TOFHLA score, number of medications, having a personal doctor, being a property owner, race, insurance, age, and simple comorbidity score. During the study period, 118 unique patients each made at least one return ED visit within a 14-day period. The proportion of patients with inadequate health literacy making at least one return visit was higher than that of patients with adequate health literacy at 14 days, but was not significantly higher within 3 or 7 days. Conclusions: In this single-center study, higher utilization of the ED by patients with inadequate health literacy when compared to those with adequate health literacy was observed. Patients with inadequate health literacy made a higher number of return visits at 14 days but not at 3 or 7 days.Perceived barriers to mammography among underserved women in a Breast Health Center Outreach Program
AbstractFayanju, O. M., Kraenzle, S., Drake, B. F., Oka, M., & Goodman, M. (n.d.).Publication year
2014Journal title
American Journal of SurgeryVolume
208Issue
3Page(s)
425-434AbstractBackground To investigate perceived barriers to mammography among underserved women, we asked participants in the Siteman Cancer Center Mammography Outreach Registry-developed in 2006 to evaluate mobile mammography's effectiveness among the underserved-why they believed women did not get mammograms. Methods The responses of approximately 9,000 registrants were analyzed using multivariable logistic regression. We report adjusted odds ratios (OR) and 95% confidence intervals (CI) significant at 2-tailed P values less than.05. Results Fears of cost (40%), mammogram-related pain (13%), and bad news (13%) were the most commonly reported barriers. Having insurance was associated with not perceiving cost as a barrier (OR.44, 95% CI.40 to.49), but with perceiving fear of both mammogram-related pain (OR 1.39, 95% CI 1.21 to 1.60) and receiving bad news (OR 1.38, 95% CI 1.19 to 1.60) as barriers. Conclusion Despite free services, underserved women continue to report experiential and psychological obstacles to mammography, suggesting the need for more targeted education and outreach in this population.Racial disparities in risk of second breast tumors after ductal carcinoma in situ
AbstractLiu, Y., Colditz, G. A., Gehlert, S., & Goodman, M. (n.d.).Publication year
2014Journal title
Breast Cancer Research and TreatmentVolume
148Issue
1Page(s)
163-173AbstractThe purpose of the study was to examine the impact of race/ethnicity on second breast tumors among women with ductal carcinoma in situ (DCIS). We identified 102,489 women diagnosed with primary DCIS between 1988 and 2009 from the 18 NCI-SEER Registries. Cox proportional hazard regression was used to estimate race/ethnicity-associated relative risks (RRs) and their 95 % confidence intervals (CI) of ipsilateral breast tumors (IBT; defined as DCIS or invasive carcinoma in the ipsilateral breast) and contralateral breast tumors (CBT; defined as DCIS or invasive carcinoma in the contralateral breast). Overall, 2,925 women had IBT and 3,723 had CBT. Compared with white women, black (RR 1.46; 95 % CI 1.29–1.65), and Hispanic (RR 1.18; 95 % CI 1.03–1.36) women had higher IBT risk, which was similar for invasive IBT and ipsilateral DCIS. A significant increase in IBT risk among black women persisted, regardless of age at diagnosis, treatment, tumor grade, tumor size, and histology. The CBT risk was significantly increased among black (RR 1.21; 95 % CI 1.08–1.36) and Asian/PI (RR 1.16; 95 % CI 1.02–1.31) women compared with white women. The association was stronger for invasive CBT among black women and for contralateral DCIS among Asian/PI women (Pheterogeneity < 0.0001). The black race-associated CBT risk was more pronounced among women ≥50 years at diagnosis and those with comedo DCIS; in contrast, a significant increase in risk among Asian/PI women was restricted to thoseResponses to genomic information by race/ethnicity in a medically underserved population
AbstractKaphingst, K. A., Stafford, J. D., D'Agostino-McGowan, L., Seo, J., Lachance, C., & Goodman, M. (n.d.).Publication year
2014Journal title
Health PsychologyVolume
95Issue
2Page(s)
218Abstract~Screening for colorectal cancer : Using data to set prevention priorities
AbstractColditz, G. A., McGowan, L. D., James, A. S., Bohlke, K., & Goodman, M. (n.d.).Publication year
2014Journal title
Cancer Causes and ControlVolume
25Issue
1Page(s)
93-98AbstractIntroduction: Adherence to colorectal cancer screening recommendations is known to vary by state, but less information is available about within-state variability. In the current study, we assess county-level screening rates for Missouri, with the goal of better targeting public health efforts to increase screening. Methods: Prevalence of colorectal cancer screening among Missouri adults between the ages of 50 and 74 was obtained from 2008 and 2010 Behavioral Risk Factor Surveillance System data. We used multilevel logistic regression to generate county-specific estimates. After excluding 77 counties with fewer than 30 respondents, information was available about 3,739 individuals in 37 counties, representing 78.5 % of the state population. Results: Across counties, the prevalence of being up-to-date with recommended colorectal cancer screening ranged from 25 to 70 %. Conclusion: State-level information about colorectal cancer screening masks substantial within-state variability. Assessing and monitoring county-level disparities in screening can guide public health efforts to increase screening and reduce colorectal cancer mortality. More complete population survey data will make such analysis possible.Urological chronic pelvic pain syndrome symptom flares : Characterisation of the full range of flares at two sites in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network
AbstractSutcliffe, S., Colditz, G. A., Goodman, M., Pakpahan, R., Vetter, J., Ness, T. J., Andriole, G. L., & Lai, H. H. (n.d.).Publication year
2014Journal title
BJU InternationalVolume
114Issue
6Page(s)
916-925AbstractObjectives To describe the full range of symptom exacerbations defined by people with interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome as 'flares', and to investigate their associated healthcare utilization and bother at two sites of the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Epidemiology and Phenotyping study. Subjects and Methods Participants completed a flare survey that asked them: 1) whether they had ever had flares ('symptoms that are much worse than usual') that lasted 1 h and 1 day; and 2) for each duration of flare, to report: their average length and frequency; their typical levels of urological and pelvic pain symptoms; and their levels of healthcare utilization and bother. We compared participants' responses to their non-flare MAPP values and by duration of flare using generalized linear mixed models. Results Of 85 participants, 76 (89.4%) completed the flare survey, 72 (94.7%) of whom reported experiencing flares. Flares varied widely in terms of their duration (seconds to months), frequency (several times per day to once per year or less), and intensity and type of symptoms (e.g. pelvic pain vs urological symptoms). Flares of all durations were associated with greater pelvic pain, urological symptoms, disruption to participants' activities and bother, with increasing severity of each of these factors as the duration of flares increased. Days-long flares were also associated with greater healthcare utilization. In addition to duration, symptoms (pelvic pain, in particular) were also significant determinants of flare-related bother. Conclusions Our findings suggest that flares are common and associated with greater symptoms, healthcare utilization, disruption and bother. Our findings also show the characteristics of flares most bothersome to patients (i.e. increased pelvic pain and duration), and thus of greatest importance to consider in future research on flare prevention and treatment.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.Availability of and Ease of Access to Calorie Information on Restaurant Websites
AbstractBennett, G. G., Steinberg, D. M., Lanpher, M. G., Askew, S., Lane, I. B., Levine, E. L., Goodman, M., & Foley, P. B. (n.d.).Publication year
2013Journal title
PloS oneVolume
8Issue
8AbstractObjective:Offering calories on restaurant websites might be particularly important for consumer meal planning, but the availability of and ease of accessing this information are unknown.Methods:We assessed websites for the top 100 U.S. chain restaurants to determine the availability of and ease of access to calorie information as well as website design characteristics. We also examined potential predictors of calorie availability and ease of access.Results:Eighty-two percent of restaurants provided calorie information on their websites; 25% presented calories on a mobile-formatted website. On average, calories could be accessed in 2.35±0.99 clicks. About half of sites (51.2%) linked to calorie information via the homepage. Fewer than half had a separate section identifying healthful options (46.3%), or utilized interactive meal planning tools (35.4%). Quick service/fast casual, larger restaurants, and those with less expensive entrées and lower revenue were more likely to make calorie information available. There were no predictors of ease of access.Conclusion:Calorie information is both available and largely accessible on the websites of America's leading restaurants. It is unclear whether consumer behavior is affected by the variability in the presentation of calorie information.Examining infant and neonatal mortality by community health center concentration
AbstractBarnes, P. A., Goodman, M., Mathis, A., Shah, G. H., & Oka, M. (n.d.).Publication year
2013Journal title
European Journal of Scientific ResearchPage(s)
547Abstract~Family Health History Communication Networks of Older Adults : Importance of Social Relationships and Disease Perceptions
AbstractAshida, S., Kaphingst, K. A., Goodman, M., & Schafer, E. J. (n.d.).Publication year
2013Journal title
Health Education and BehaviorVolume
40Issue
5Page(s)
612-619AbstractOlder individuals play a critical role in disseminating family health history (FHH) information that can facilitate disease prevention among younger family members. This study evaluated the characteristics of older adults and their familial networks associated with two types of communication (have shared and intend to share new FHH information with family members) to inform public health efforts to facilitate FHH dissemination. Information on 970 social network members enumerated by 99 seniors (aged 57 years and older) at 3 senior centers in Memphis, Tennessee, through face-to-face interviews was analyzed. Participants shared FHH information with 27.5% of the network members; 54.7% of children and 24.4% of siblings. Two-level logistic regression models showed that participants had shared FHH with those to whom they provided emotional support (odds ratio [OR] = 1.836) and felt close to (OR = 1.757). Network-members were more likely to have received FHH from participants with a cancer diagnosis (OR = 2.617) and higher familiarity with (OR = 1.380) and importance of sharing FHH with family (OR = 1.474). Participants intended to share new FHH with those who provide tangible support to (OR = 1.804) and were very close to them (OR = 2.112). Members with whom participants intend to share new FHH were more likely to belong to the network of participants with higher perceived severity if family members encountered heart disease (OR = 1.329). Many first-degree relatives were not informed of FHH. Perceptions about FHH and disease risk as well as quality of social relationships may play roles in whether seniors communicate FHH with their families. Future studies may consider influencing these perceptions and relationships.Hidalgo and goodman respond
AbstractHidalgo, B., & Goodman, M. (n.d.).Publication year
2013Journal title
American journal of public healthVolume
103Issue
6Page(s)
e1-e2Abstract~Multivariate or multivariable regression?
AbstractHidalgo, B., & Goodman, M. (n.d.).Publication year
2013Journal title
American journal of public healthVolume
103Issue
1Page(s)
39-40Abstract~Spatial and Racial Patterning of Real Estate Broker Listings in New York City
AbstractKwate, N. O., Goodman, M., Jackson, J., & Harris, J. (n.d.).Publication year
2013Journal title
Review of Black Political EconomyVolume
40Issue
4Page(s)
401-424AbstractIt has been well documented that Black homeseekers face discrimination in the housing market in the form of racial steering and other institutional policies and practices that are critical in limiting housing access. Less is known about the mechanisms that operate on the other side of real estate transactions to perpetuate racially segregated neighborhoods. We investigated whether White and Black brokers face segregation in the housing market. That is, to what extent do White and Black brokers differentially market property listings in neighborhoods of varying racial composition? Using real estate listings extracted from the websites of two of the largest New York City real estate brokerages, we examined whether Black and White brokers market properties primarily in Black and White neighborhoods, respectively; and whether, controlling for gender and experience level, Black brokers had a lower average price per square foot than White brokers. Results showed that Black brokers overwhelmingly marketed properties in Black neighborhoods, with fewer listings in White areas. Black brokers also marketed properties with an average price per square foot that was $197 lower than White brokers. Black brokers who worked in offices in Black neighborhoods had the lowest asking price of all brokers. Taken together, Black and White real estate brokers control a bifurcated market in NYC, perpetuating residential segregation and Black-White income and wealth disparities.Using small-area analysis to estimate county-level racial disparities in obesity demonstrating the necessity of targeted interventions
AbstractD'Agostino-McGowan, L., Gennarelli, R. L., Lyons, S. A., & Goodman, M. (n.d.).Publication year
2013Journal title
International journal of environmental research and public healthVolume
11Issue
1Page(s)
418-428AbstractData on the national and state levels is often used to inform policy decisions and strategies designed to reduce racial disparities in obesity. Obesity-related health outcomes are realized on the individual level, and policies based on state and national-level data may be inappropriate due to the variations in health outcomes within and between states. To examine county-level variation of obesity within states, we use a small-area analysis technique to fill the void for county-level obesity data by race. Five years of Behavioral Risk Factor Surveillance System data are used to estimate the prevalence of obesity by county, both overall and race-stratified. A modified weighting system is used based on demographics at the county level using 2010 census data. We fit a multilevel reweighted regression model to obtain county-level prevalence estimates by race. We compare the distribution of prevalence estimates of non-Hispanic Blacks to non-Hispanic Whites. For 25 of the 26 states included in our analysis there is a statistically significant difference between within-state county-level average obesity prevalence rates for non-Hispanic Whites and non-Hispanic Blacks. This study provides information needed to target disparities interventions and resources to the local areas with greatest need; it also identifies the necessity of doing so.