Nina S Parikh

Clinical Associate Professor of Social and Behavioral Sciences

Professional overview

Dr. Nina S. Parikh has years of public health research experience, methodological expertise, and academic training in health services research and medical sociology.  A continuing theme of Dr. Parikh’s research involves the examination of social, psychosocial, and cultural factors related to the health needs of ethnic-racial populations and developing evidence-based strategies that address and mitigate health inequities for these and other underserved groups, in particular immigrants, the uninsured, those with inadequate health literacy, and the elderly. 

At NYU GPH, Dr. Parikh collaborates with scholars examining the social determinants of health, particularly social network mechanisms and how they relate to primary and secondary prevention of vascular diseases. This work builds on her previous research experience that has been community-based, grant-funded studies in partnership with local agencies and organizations that explore the well-being of older adults and their families, including social cohesion/social support, access to and utilization of health care services of immigrant populations, health disparities, community-based palliative care for chronically ill elders, and the promotion of healthy aging with a particular emphasis on developing and implementing behavioral strategies to combat some of the most prevalent chronic conditions for this group. In addition, Dr. Parikh developed and teaches the two-semester thesis course to MPH candidates.

Prior to coming to NYU, Dr. Parikh served as the Director of Research (Interim) at the Brookdale Center for Healthy Aging of Hunter College where she provided oversight and guidance on all research and evaluation studies conducted by the Center. Her work has received grant support from the Robert Wood Johnson Foundation, the Commonwealth Fund, Agency for Healthcare Research and Quality, and the NYC Department for the Aging.

Education

BS, Biology and minor in Sociology, John Carroll University, Cleveland, OH

MPH, Health Policy and Management, Emory University, Atlanta, GA

PhD, Sociomedical Sciences, Columbia University, New York, NY

Areas of research and study

Aging and the Life Course

Cultural Determinants of Health

Immigration

Racial/Ethnic Disparities

Social Determinants of Health

Publications

Publications

Sociodemographic variation in experiences with medication shortages among US adults

Fang, J., Goodman, M. S., Kaphingst, K. A., Parikh, N. S., Bae, J. Y., Silver, D., & Bather, J. R. (n.d.).

Publication year

2025

Journal title

Preventive Medicine Reports

Volume

51

10.1016/j.pmedr.2025.103004

Abstract

Abstract

Objective: To investigate sociodemographic factors associated with prescribed and over-the-counter medication shortage experiences. Methods: We analyzed repeated cross-sectional data from the 2023 US Census Household Pulse Survey, a nationwide survey of US adults. Outcomes were based on the following question: “In the past month, have you or a member of your household been directly affected by the following?” We created binary indicators based on the following response options: (1) “Shortage of prescription medications, which includes any medicine required or provided by a healthcare provider, pharmacist, or hospital” and (2) “Shortage of over-the-counter medications, encompassing any medication available without a prescription.” Sociodemographic factors included age, gender identity, race/ethnicity, marital status, educational attainment, household income, number of children, employment status, health insurance coverage, at risk for depression/anxiety, disability status, and region. Weighted multivariable models accounted for the complex survey design and estimated adjusted odds ratios with 95 % confidence intervals. Results: We found that more experiences with prescribed and over-the-counter medication shortages were associated with middle age, transgender/other gender identity, non-Hispanic Other race/ethnicity, higher educational attainment, having at least one child, at risk for depression or anxiety, and being disabled. In contrast, fewer experiences with prescribed and over-the-counter medication shortages were associated with higher household income. Conclusions: Sociodemographic variation exist in experiences with medication shortages among US adults. These findings underscore the need to bolster the pharmaceutical supply chain to mitigate inequities in medication access.

Lower social vulnerability is associated with a higher prevalence of social media-involved violent crimes in Prince George’s County, Maryland, 2018–2023

Bather, J. R., Silver, D., Gill, B. P., Harris, A., Bae, J. Y., Parikh, N. S., & Goodman, M. S. (n.d.).

Publication year

2024

Journal title

Injury Epidemiology

Volume

11

Issue

1

10.1186/s40621-024-00538-w

Abstract

Abstract

Background: Social vulnerability may play a role in social media-involved crime, but few studies have investigated this issue. We investigated associations between social vulnerability and social media-involved violent crimes. Methods: We analyzed 22,801 violent crimes occurring between 2018 and 2023 in Prince George’s County, Maryland. Social media involvement was obtained from crime reports at the Prince George’s County Police Department. Social media application types included social networking, advertising/selling, ridesharing, dating, image/video hosting, mobile payment, instant messaging/Voice over Internet Protocol, and other. We used the Centers for Disease Control and Prevention’s Social Vulnerability Index to assess socioeconomic status (SES), household characteristics, racial and ethnic minority status, housing type and transportation, and overall vulnerability. Modified Poisson models estimated adjusted prevalence ratios (aPRs) among the overall sample and stratified by crime type (assault and homicide, robbery, and sexual offense). Covariates included year and crime type. Results: Relative to high tertile areas, we observed a higher prevalence of social media-involved violent crimes in areas with low SES vulnerability (aPR: 1.82, 95% CI: 1.37-2.43), low housing type and transportation vulnerability (aPR: 1.53, 95% CI: 1.17-2.02), and low overall vulnerability (aPR: 1.63, 95% CI: 1.23-2.17). Low SES vulnerability areas were significantly associated with higher prevalences of social media-involved assaults and homicides (aPR: 1.64, 95% CI: 1.02-2.62), robberies (aPR: 2.00, 95% CI: 1.28-3.12), and sexual offenses (aPR: 2.07, 95% CI: 1.02-4.19) compared to high SES vulnerability areas. Low housing type and transportation vulnerability (vs. high) was significantly associated with a higher prevalence of social media-involved robberies (aPR: 1.54, 95% CI:1.01-2.37). Modified Poisson models also indicated that low overall vulnerability areas had higher prevalences of social media-involved robberies (aPR: 1.71, 95% CI: 1.10-2.67) and sexual offenses (aPR: 2.14, 95% CI: 1.05-4.39) than high overall vulnerability areas. Conclusions: We quantified the prevalence of social media-involved violent crimes across social vulnerability levels. These insights underscore the need for collecting incident-based social media involvement in crime reports among law enforcement agencies across the United States and internationally. Comprehensive data collection at the national and international levels provides the capacity to elucidate the relationships between neighborhoods, social media, and population health.

Mental health burdens among North American Asian adults living with chronic conditions: a systematic review

Islam, J. Y., Parikh, N. S., Lappen, H., Venkat, V., Nalkar, P., & Kapadia, F. (n.d.).

Publication year

2023

Journal title

Epidemiologic Reviews

Volume

45

Issue

1

Page(s)

82-92

10.1093/epirev/mxad003

Abstract

Abstract

Asians are likely to experience a high burden of chronic conditions, including, but not limited to, diabetes, cardiovascular disease, and cancer, due to differences in biologic, genetic, and environmental factors across Asian ethnic groups. A diagnosis of any chronic condition can contribute to increased mental health burdens, including depression, psychological distress, and posttraumatic stress disorder (PTSD). However, few studies have examined these comorbid conditions across distinct Asian ethnic groups—an important limitation given the differences in social, cultural, and behavioral drivers of mental health burdens within and across Asian ethnicities. To understand the disparities in mental health burdens among Asians living with a chronic health condition, we conducted a systematic literature review of relevant, peer-reviewed publication databases to identify studies reporting on mental health burdens (e.g., depression, anxiety, distress, PTSD) in distinct Asian ethnic groups in North America. Thirteen studies met the inclusion criteria for this review and collectively demonstrated a high burden of depression, psychological distress, and PTSD among Asians living with chronic conditions. Moreover, there were distinct disparities in mental health burdens across chronic conditions and across Asian ethnic groups. Despite the detrimental impact of poor mental health on chronic disease–specific outcomes, such as death and poor quality of life, few data exist that characterize mental health outcomes among Asian ethnicities living in North America with chronic conditions. Future work should prioritize estimating the national prevalence of mental health outcomes among adults with chronic conditions, by Asian ethnicities, to inform culturally tailored interventions to address this public health burden.

Acculturation and Depressive Symptoms Among Dominicans in New York City

Hagen, D., Goldmann, E., Parikh, N. S., Goodman, M., & Boden-Albala, B. (n.d.).

Publication year

2022

Journal title

Journal of Immigrant and Minority Health

Volume

24

Issue

5

Page(s)

1186-1195

10.1007/s10903-021-01316-2

Abstract

Abstract

Little 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.

Recruitment, Inclusion, and Diversity in Clinical Trials

Boden-Albala, B., Waddy, S. P., Appleton, N., Kuczynski, H., Nangle, E., & Parikh, N. S. (n.d.). In The Science of Health Disparities Research (1–).

Publication year

2021

Page(s)

413-428

10.1002/9781119374855.ch24

Abstract

Abstract

In this chapter, we discuss the importance of diversity and the inclusion of women and racial/ethnic minority groups in clinical research as a foundation for addressing health disparities. First, we provide a brief background on the scientific and ethical significance of diversity and inclusion in clinical research. Next, we discuss barriers to recruiting representative study populations, including: (i) optimizing the screening pool, (ii) converting eligible participants to enrolled research subjects, and (iii) retaining subjects in a study. We specifically examine patient/community-, investigator-, and structural/institutional-level barriers. Finally, we summarize various best practices for enhancing inclusion of under-represented groups in clinical research, as well as future directions and research needs.

Positive health beliefs and blood pressure reduction in the deserve study

Goldmann, E., Jacoby, R., Finfer, E., Appleton, N., Parikh, N. S., Roberts, E. T., & Boden-Albala, B. (n.d.).

Publication year

2020

Journal title

Journal of the American Heart Association

Volume

9

Issue

9

10.1161/JAHA.119.014782

Abstract

Abstract

BACKGROUND: There is growing recognition that positive health beliefs may promote blood pressure (BP) reduction, which is critical to stroke prevention but remains a persistent challenge. Yet, studies that examine the association between positive health beliefs and BP among stroke survivors are lacking. METHODS AND RESULTS: Data came from the DESERVE (Discharge Educational Strategies for Reduction of Vascular Events) study, a randomized controlled trial of a skills-based behavioral intervention to reduce vascular risk in a multiethnic cohort of 552 transient ischemic attack and mild/moderate stroke patients in New York City. The exposure was perception that people can protect themselves from having a stroke (ie, prevention self-efficacy) at baseline. The association between systolic BP (SBP) reduction at 12-month follow-up and self-efficacy was examined using linear regression adjusted for key confounders, overall and stratified by age, sex, race/ethnicity, and intervention trial arm. Approximately three quarters endorsed self-efficacy. These participants had, on average, 5.6 mm Hg greater SBP reduction compared with those who did not endorse it (95% CI, 0.5–10.7 mm Hg; P=0.032). Self-efficacy was significantly associated with greater SBP reduction, particularly among female versus male, younger versus older, and Hispanic versus non-Hispanic white patients. Sensitivity analysis adjusting for baseline SBP instead of elevated BP yielded no association between self-efficacy and SBP reduction, but showed sex differences in this association (women: β=5.3; 95% CI, −0.2 to 10.8; P=0.057; men: β=−3.3; 95% CI, −9.4 to 2.9; P=0.300; interaction P=0.064). CONCLUSIONS: Self-efficacy was linked with greater SBP reduction among female stroke survivors. Targeted strategies to improve health beliefs after stroke may be important for risk factor management.

Assessing the palliative care needs and service use of diverse older adults in an urban medically-underserved community

Gardner, D. S., Parikh, N. S., Villanueva, C. H., Ghesquiere, A., Kenien, C., Callahan, J., & Reid, M. C. (n.d.).

Publication year

2019

Journal title

Annals of Palliative Medicine

Volume

8

Issue

5

Page(s)

769-774

10.21037/apm.2019.11.22

Abstract

Abstract

Although palliative care (PC) has become increasingly familiar, considerable gaps persist in access to and use of services. Community-based programs remain rare, and low-income, minority communities significantly under-utilize hospice and palliative services. We used community-based participatory research (CBPR) methods to conduct a mixed-methods community needs assessment of seriously-ill older adults (n=100) and providers from community-based programs and churches (n=41) in an urban medically-underserved community in the U.S. to explore: (I) the prevalence and severity of illness-related symptoms and psychosocial-spiritual concerns; (II) the scope and quality of community supports helping older adults manage their symptoms; and (III) the perceptions and utilization of palliative and supportive care services among older adults and community-based service providers. Participants reported high rates of chronic illness-related symptoms (i.e., pain, fatigue, sleeping difficulties, depression, and anxiety), and many described unmet needs around symptom management. Few had ever utilized PC or pain management services, and most relied primarily on family, friends, and faith communities to help them manage burdensome symptoms. Barriers included lack of familiarity with PC, limited access and financial concerns. Older adults were largely unfamiliar with PC, and many described unmet needs and desire for help with symptom burden. Findings support the need to further explore community-level and cultural barriers to PC among diverse, underserved older adults. Development of innovative community partnerships may help raise awareness of PC and address the physical and psychosocial-spiritual challenges facing chronically-ill minority older adults and their families.

Efficacy of a Discharge Educational Strategy vs Standard Discharge Care on Reduction of Vascular Risk in Patients with Stroke and Transient Ischemic Attack: The DESERVE Randomized Clinical Trial

Boden-Albala, B., Goldmann, E., Parikh, N. S., Carman, H., Roberts, E. T., Lord, A. S., Torrico, V., Appleton, N., Birkemeier, J., Parides, M., & Quarles, L. (n.d.).

Publication year

2019

Journal title

JAMA Neurology

Volume

76

Issue

1

Page(s)

20-27

10.1001/jamaneurol.2018.2926

Abstract

Abstract

Importance: Despite secondary prevention strategies with proven efficacy, recurrent stroke rates remain high, particularly in racial/ethnic minority populations who are disproportionately affected by stroke. Objective: To determine the efficacy of a culturally tailored skills-based educational intervention with telephone follow-up compared with standard discharge care on systolic blood pressure reduction in a multiethnic cohort of patients with mild/moderate stroke/transient ischemic attack. Design, Setting, and Participants: Randomized clinical trial with 1-year follow-up. Participants were white, black, and Hispanic patients with mild/moderate stroke/transient ischemic attack prospectively enrolled from 4 New York City, New York, medical centers during hospitalization or emergency department visit between August 2012 and May 2016. Through screening of stroke admissions and emergency department notifications, 1083 eligible patients were identified, of whom 256 declined to participate and 275 were excluded for other reasons. Analyses were intention to treat. Interventions: The Discharge Educational Strategies for Reduction of Vascular Events (DESERVE) intervention is a skills-based, culturally tailored discharge program with follow-up calls delivered by a community health coordinator. This intervention was developed using a community engagement approach. Main Outcomes and Measures: The primary outcome was systolic blood pressure reduction at 12 months postdischarge. Results: A total of 552 participants were randomized to receive intervention or usual care (281 women [51%]; mean [SD] age, 64.61 [2.9] years; 180 Hispanic [33%], 151 non-Hispanic white [27%], and 183 non-Hispanic black [33%]). At 1-year follow-up, no significant difference in systolic blood pressure reduction was observed between intervention and usual care groups (β = 2.5 mm Hg; 95% CI, -1.9 to 6.9). Although not powered for subgroup analysis, we found that among Hispanic individuals, the intervention arm had a clinically and statically significant 9.9 mm Hg-greater mean systolic blood pressure reduction compared with usual care (95% CI, 1.8-18.0). There were no significant differences between arms among non-Hispanic white (β = 3.3; 95% CI, -4.1 to 10.7) and non-Hispanic black participants (β = -1.6; 95% CI, -10.1 to 6.8). Conclusions and Relevance: Few behavioral intervention studies in individuals who have had stroke have reported clinically meaningful reductions in blood pressure at 12 months, and fewer have focused on a skills-based approach. Results of secondary analyses suggest that culturally tailored, skills-based strategies may be an important alternative to knowledge-focused approaches in achieving sustained vascular risk reduction and addressing racial/ethnic stroke disparities; however, these findings should be tested in future studies. Trial Registration: ClinicalTrials.gov identifier: NCT01836354.

Immigration Status, Visa Types, and Body Weight Among New Immigrants in the United States

Yeh, M. C., Parikh, N. S., Megliola, A. E., & Kelvin, E. A. (n.d.).

Publication year

2018

Journal title

American Journal of Health Promotion

Volume

32

Issue

3

Page(s)

771-778

10.1177/0890117116677797

Abstract

Abstract

Purpose: To investigate the relationship between immigration-related factors and body mass index (BMI) among immigrants. Design: Secondary analyses of cross-sectional survey data. Setting: The New Immigrant Survey (NIS-2003) contains data from in-person or telephone interviews between May and November 2003, with a probability sample of immigrants granted legal permanent residency in the United States. Participants: A total of 8573 US immigrants. Measures: The NIS-2003 provided data on sociobehavioral domains, including migration history, education, employment, marital history, language, and health-related behaviors. The visa classifications are as follows: (1) family reunification, (2) employment, (3) diversity, (4) refugee, and (5) legalization. Analysis: Nested multivariable linear regression analysis was used to estimate the independent relationships between BMI and the variables of interest. Results: Overall, 32.6% of participants were overweight and 11.3% were obese (mean BMI = 25). Participants who were admitted to the United States with employment, refugee, or legalization visas compared with those who came with family reunion visas had a significantly higher BMI (P <.001, P <.001, P <.01, respectively). Duration in the United States predicted BMI, with those immigrants in the United States longer having a higher BMI (P <.001). Conclusion: Our findings suggest that immigrants who obtain particular visa categorizations and immigration status might have a higher risk of being overweight or obese. Immigrants need to be targeted along with the rest of the US population for weight management interventions.

The experiences of providing caregiving for patients with schizophrenia in the Ghanaian context

Gloria, O., Osafo, J., Goldmann, E., Parikh, N. S., Nonvignon, J., & Kretchy, I. M. (n.d.).

Publication year

2018

Journal title

Archives of Psychiatric Nursing

Volume

32

Issue

6

Page(s)

815-822

10.1016/j.apnu.2018.06.005

Age-related differences in antihypertensive medication adherence in hispanics: A cross-sectional community-based survey in New York City, 2011-2012

Bandi, P., Goldmann, E., Parikh, N. S., Farsi, P., & Boden-Albala, B. (n.d.).

Publication year

2017

Journal title

Preventing Chronic Disease

Volume

14

Issue

7

10.5888/pcd14.160512

Abstract

Abstract

Introduction US Hispanics, particularly younger adults in this population, have a higher prevalence of uncontrolled hypertension than do people of other racial/ethnic groups. Little is known about the prevalence and predictors of antihypertensive medication adherence, a major determinant of hypertension control and cardiovascular disease, and differences between age groups in this fast-growing population. Methods The cross-sectional study included 1,043 community-dwelling Hispanic adults with hypertension living in 3 northern Manhattan neighborhoods from 2011 through 2012. Age-stratified analyses assessed the prevalence and predictors of high medication adherence (score of 8 on the Morisky Medication Adherence Scale [MMAS-8]) among younger (< 60 y) and older (≥60 y) Hispanic adults. Results Prevalence of high adherence was significantly lower in younger versus older adults (24.5% vs 34.0%, P = .001). In younger adults, heavy alcohol consumption, a longer duration of hypertension, and recent poor physical health were negatively associated with high adherence, but poor self-rated general health was positively associated with high adherence. In older adults, advancing age, higher education level, high knowledge of hypertension control, and private insurance or Medicare versus Medicaid were positively associated with high adherence, whereas recent poor physical health and health-related activity limitations were negatively associated with high adherence. Conclusion Equitable achievement of national hypertension control goals will require attention to suboptimal antihypertensive medication adherence found in this study and other samples of US Hispanics, particularly in younger adults. Age differences in predictors of high adherence highlight the need to tailor efforts to the life stage of people with hypertension.

Barriers and Strategies for Recruitment of Racial and Ethnic Minorities: Perspectives from Neurological Clinical Research Coordinators

Haley, S. J., Southwick, L. E., Parikh, N. S., Rivera, J., Farrar-Edwards, D., & Boden-Albala, B. (n.d.).

Publication year

2017

Journal title

Journal of Racial and Ethnic Health Disparities

Volume

4

Issue

6

Page(s)

1225-1236

10.1007/s40615-016-0332-y

Abstract

Abstract

Introduction: Randomized controlled trials (RCTs) are the gold standard within evidence-based research. Low participant accrual rates, especially of underrepresented groups (e.g., racial-ethnic minorities), may jeopardize clinical studies’ viability and strength of findings. Research has begun to unweave clinical trial mechanics, including the roles of clinical research coordinators, to improve trial participation rates. Methods: Two semi-structured focus groups were conducted with a purposive sample of 29 clinical research coordinators (CRCs) at consecutive international stroke conferences in 2013 and 2014 to gain in-depth understanding of coordinator-level barriers to racial-ethnic minority recruitment and retention into neurological trials. Coded transcripts were used to create themes to define concepts, identify associations, summarize findings, and posit explanations. Results: Barriers related to translation, literacy, family composition, and severity of medical diagnosis were identified. Potential strategies included a focus on developing personal relationships with patients, community and patient education, centralized clinical trial administrative systems, and competency focused training and education for CRCs. Conclusion: Patient level barriers to clinical trial recruitment are well documented. Less is known about barriers facing CRCs. Further identification of how and when barriers manifest and the effectiveness of strategies to improve CRCs recruitment efforts is warranted.

Chronic Physical Illness Burden and Suicidal Ideation Among Dominicans in New York City

Goldmann, E., Roberts, E. T., Parikh, N. S., & Boden-Albala, B. (n.d.).

Publication year

2017

Journal title

Journal of Immigrant and Minority Health

Volume

19

Issue

3

Page(s)

616-622

10.1007/s10903-016-0477-0

Abstract

Abstract

Little is known about the association between chronic illness and suicidal ideation (SI) among Dominicans living in the United States. This study used data from a community survey of 2753 Dominican adults in New York City. SI included thoughts of self-harm or being better off dead in the past month. Chronic physical illness burden was categorized as having 0, 1, or 2+ diagnosed conditions. Adjusted logistic regressions evaluated the association between number of conditions and SI, overall and stratified by sex and age. Adjusted models yielded a strong association between chronic illness burden and SI among men [odds ratio (OR) 5.57, 95 % confidence interval (CI) 2.19–14.18] but not women (OR 0.80, 95 % CI 0.50–1.29; interaction p = 0.011). The association of interest did not differ significantly between younger and older adults. Screening for SI in health care practice, particularly among Dominican men with multiple chronic health conditions, may be warranted.

Gender, Social Networks, and Stroke Preparedness in the Stroke Warning Information and Faster Treatment Study

Madsen, T. E., Roberts, E. T., Kuczynski, H., Goldmann, E., Parikh, N. S., & Boden-Albala, B. (n.d.).

Publication year

2017

Journal title

Journal of Stroke and Cerebrovascular Diseases

Volume

26

Issue

12

Page(s)

2734-2741

10.1016/j.jstrokecerebrovasdis.2017.06.046

Abstract

Abstract

Background and Purpose The study aimed to investigate the effect of gender on the association between social networks and stroke preparedness as measured by emergency department (ED) arrival within 3 hours of symptom onset. Methods As part of the Stroke Warning Information and Faster Treatment study, baseline data on demographics, social networks, and time to ED arrival were collected from 1193 prospectively enrolled stroke/transient ischemic attack (TIA) patients at Columbia University Medical Center. Logistic regression was conducted with arrival to the ED ≤3 hours as the outcome, social network characteristics as explanatory variables, and gender as a potential effect modifier. Results Men who lived alone or were divorced were significantly less likely to arrive ≤3 hours than men who lived with a spouse (adjusted odds ratio [aOR]:.31, 95% confidence interval [CI]:.15-0.64) or were married (aOR:.45, 95% CI:.23-0.86). Among women, those who lived alone or were divorced had similar odds of arriving ≤3 hours compared with those who lived with a spouse (aOR: 1.25, 95% CI:.63-2.49) or were married (aOR:.73, 95% CI:.4-1.35). Conclusions In patients with stroke/TIA, living with someone or being married improved time to arrival in men only. Behavioral interventions to improve stroke preparedness should incorporate gender differences in how social networks affect arrival times.

Race/ethnic differences in post-stroke depr ession (PSD): Findings from the stroke warning information and faster treatment (SWIFT ) study

Goldmann, E., Roberts, E. T., Parikh, N. S., Lord, A. S., & Boden-Albala, B. (n.d.).

Publication year

2016

Journal title

Ethnicity and Disease

Volume

26

Issue

1

Page(s)

1-8

10.18865/ed.26.1.1

Abstract

Abstract

Objectives: Post-stroke depression (PSD) is common and associated with poor stroke outcomes, but few studies have examined race/ethnic disparities in PSD. Given the paucity of work and inconsistent findings in this important area of research, our study aimed to examine race/ethnic differences in depression in a multi-ethnic cohort of stroke patients. Design: Longitudinal. Setting: Prospective trial of a post-stroke educational intervention. Patients or Participants: 1,193 mild/moderate ischemic stroke/transient ischemic attack (TIA) patients. Main Outcome Measures: We used the Center for Epidemiologic Studies Depression (CES-D) Scale to assess subthreshold (CES-D score 8-15) and full (CES-D score ≥ 16) depression at one month ("early") and 12 months ("late") following stroke. Multinomial logistic regression analyses examined the association between race/ethnicity and early and late PSD separately. Results: The prevalence of subthreshold and full PSD was 22.5% and 32.6% in the early period and 22.0% and 27.4% in the late period, respectively. Hispanics had 60% lower odds of early full PSD compared with non-Hispanic Whites after adjusting for other covariates (OR=.4, 95% CI: .2, .8). Race/ ethnicity was not significantly associated with late PSD. Conclusions: Hispanic stroke patients had half the odds of PSD in early period compared with Whites, but no difference was found in the later period. Further studies comparing trajectories of PSD between race/ ethnic groups may further our understanding of race/ethnic disparities in PSD and help identify effective interventions.

Examining Barriers and Practices to Recruitment and Retention in Stroke Clinical Trials

Boden-Albala, B., Carman, H., Southwick, L., Parikh, N. S., Roberts, E., Waddy, S., & Edwards, D. (n.d.).

Publication year

2015

Journal title

Stroke; a journal of cerebral circulation

Volume

46

Issue

8

Page(s)

2232-2237

10.1161/STROKEAHA.114.008564

Abstract

Abstract

BACKGROUND AND PURPOSE: The National Institutes of Health policy calls for the inclusion of under-represented groups, such as women and minorities, in clinical research. Poor minority recruitment and retention in stroke clinical trials remain a significant challenge limiting safety and efficacy in a general population. Previous research examines participant barriers to clinical trial involvement, but little is known about the investigator perspective. This study addresses this gap and examines researcher-reported barriers and best practices of minority involvement in stroke clinical trials.METHODS: Quantitative and qualitative methods, including surveys, focus groups, and key informant interviews were used.RESULTS: In a survey of 93 prominent stroke researchers, 43 (51.2%; 70% response rate) respondents reported proactively setting recruitment goals for minority inclusion, 29 respondents (36.3%) reported requiring cultural competency staff training, and 44 respondents (51.2%) reported using community consultation about trial design. Focus groups and key informant interviews highlighted structural and institutional challenges to recruitment of minorities, including mistrust of the research/medical enterprise, poor communication, and lack of understanding of clinical trials. Researcher-identified best practices included using standardized project management procedures and protocols (eg, realistic budgeting to support challenges in recruitment, such as travel/parking reimbursement for participants), research staff cultural competency and communication training, and developing and fostering community partnerships that guide the research process.CONCLUSIONS: This study's formative evaluation contributes a new dimension to the literature as it highlights researcher-reported barriers and best practices for enhancing participation of minority populations into stroke clinical trials.

Restaurant management views on the views on the new national menu labeling laws

Yeh, M., Platkin, C., Fishman, J., L., F., & Parikh, N. (n.d.).

Publication year

2014

Journal title

International Journal of Nutrition Dietetics

Volume

2

Issue

1

Page(s)

1-18

Mind-body techniques, race-ethnicity, and depression among urban senior center participants

Morano, C., Giunta, N., Parikh, N. S., Panuska, S., Fahs, M. C., & Gallo, W. T. (n.d.).

Publication year

2013

Journal title

Health and Social Work

Volume

38

Issue

3

Page(s)

167-172

10.1093/hsw/hlt010

Abstract

Abstract

As the older adult population grows and becomes more diverse, more of its members are turning to complementary and alternative medicine (CAM). There are mixed findings regarding racial and ethnic differences in the use of CAM. This article explores racial and ethnic differences in use of a category of CAM known as mind-body techniques (MBT) among senior center participants with symptoms of depression. It also examines the relationship between use of MBT and depression severity. A cross-sectional survey was conducted with a representative sample of senior center participants in New York City, from which a subsample of those with depressive symptoms was drawn. Racial and ethnic differences in MBT use were identified, as was a significant negative relationship between MBT use and depression severity. African American elders were more likely to have used MBT than other racial or ethnic groups. When controlling for race or ethnicity, health status, and barriers to medical care, predictors of depression severity included health status, experiencing barriers to medical care, and Hispanic identity. Findings suggest that being female or younger is associated with a higher likelihood of using CAM. Contrary to some prior research, education level was not associated with use of MBT.

Linking neighborhood characteristics to food insecurity in older adults: The role of perceived safety, social cohesion, and walkability

Chung, W. T., Gallo, W. T., Giunta, N., Canavan, M. E., Parikh, N. S., & Fahs, M. C. (n.d.).

Publication year

2012

Journal title

Journal of Urban Health

Volume

89

Issue

3

Page(s)

407-418

10.1007/s11524-011-9633-y

Abstract

Abstract

Among the 14.6% of American households experiencing food insecurity, approximately 2 million are occupied by older adults. Food insecurity among older adults has been linked to poor health, lower cognitive function, and poor mental health outcomes. While evidence of the association between individual or household-level factors and food insecurity has been documented, the role of neighborhood-level factors is largely understudied. This study uses data from a representative sample of 1,870 New York City senior center participants in 2008 to investigate the relationship between three neighborhood-level factors (walkability, safety, and social cohesion) and food insecurity among the elderly. Issues relating to food security were measured by three separate outcome measures: whether the participant had a concern about having enough to eat this past month (concern about food security), whether the participant was unable to afford food during the past year (insufficient food intake related to financial resources), and whether the participant experienced hunger in the past year related to not being able to leave home (mobility-related food insufficiency). Unadjusted and adjusted logistic regression was performed for each measure of food insecurity. Results indicate that neighborhood walkability is an important correlate of mobilityrelated food insufficiency and concern about food insecurity, even after controlling the effects of other relevant factors.

Racial and Ethnic Diversity in Senior Centers: Comparing Participant Characteristics in More and Less Multicultural Settings

Giunta, N., Morano, C., Parikh, N. S., Friedman, D., Fahs, M. C., & Gallo, W. T. (n.d.).

Publication year

2012

Journal title

Journal of Gerontological Social Work

Volume

55

Issue

6

Page(s)

467-483

10.1080/01634372.2011.653519

Abstract

Abstract

The 2008 Health Indicators Project surveyed a probability sample (N = 1,870) of New York City senior center participants. Attendees of racially and ethnically diverse and nondiverse senior centers were compared across 5 domains: demographics; health and quality of life; social support networks; neighborhood perceptions and engagement; health service access/utilization. Although homogeneous and diverse center participants demonstrate similar health and quality-of-life outcomes, those from diverse centers demonstrate greater risk of social isolation, receive less family support, and more likely seek medical care from hospitals or community clinics. Implications and future directions for research, practice and policy are discussed.

The association between neighbourhood social cohesion and hypertension management strategies in older adults

Schmitz, M. F., Giunta, N., Parikh, N. S., Chen, K. K., Fahs, M. C., & Gallo, W. T. (n.d.). In Age and Ageing (1–).

Publication year

2012

Volume

41

Issue

3

Page(s)

388-392

10.1093/ageing/afr163

The influence of neighborhood factors on the quality of life of older adults attending New York City senior centers: Results from the Health Indicators Project

Friedman, D., Parikh, N. S., Giunta, N., Fahs, M. C., & Gallo, W. T. (n.d.).

Publication year

2012

Journal title

Quality of Life Research

Volume

21

Issue

1

Page(s)

123-131

10.1007/s11136-011-9923-6

Abstract

Abstract

Purpose To examine the association between selfassessed quality of life (QOL) and perceived neighborhood safety, social cohesion, and walkability among older adults in New York City (NYC). Methods We used data from the 2008 Health Indicators Project, a cross-sectional survey of 1,870 older adults attending 56 NYC senior centers. QOL, a binary measure, was created by dichotomizing a 5-point Likert-scaled global assessment. Neighborhood safety, social cohesion, and walkability were multi-component scale variables that were standardized due to varying response metrics. Multivariate binomial logistic regression analysis was performed on 1,660 participants with complete data. Results After adjusting for covariates, QOL was significantly associated with neighborhood safety and social cohesion. A one-standard deviation increase in neighborhood safety and social cohesion increased the log odds of having higher QOL by 30% (odds ratio (OR) = 1.30; 95% confidence interval (CI) = 1.14, 1.48; P ≤ 0.001) and 36% (OR = 1.36; 95% CI = 1.16, 1.59; P ≤ 0.001), respectively. Higher QOL was not significantly associated with neighborhood walkability. Conclusion The results of this study underscore the need for initiatives that focus on enhancing age-friendly neighborhood features in large urban centers such as NYC and beyond.

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

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

Publication year

2011

Journal title

Journal of Urban Health

Volume

88

Issue

4

Page(s)

651-662

10.1007/s11524-011-9555-8

Abstract

Abstract

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

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

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

Publication year

2009

Journal title

Journal of Immigrant and Minority Health

Volume

11

Issue

5

Page(s)

422-427

10.1007/s10903-007-9113-3

Abstract

Abstract

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

Health behaviors of older Chinese adults living in New York City

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

Publication year

2009

Journal title

Journal of Community Health

Volume

34

Issue

1

Page(s)

6-15

10.1007/s10900-008-9125-5

Abstract

Abstract

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