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

Effect of an STD/HIV behavioral intervention on women's use of the female condom

Van Devanter, N., Gonzales, V., Merzel, C., Parikh, N. S., Celantano, D., & Greenberg, J. (n.d.).

Publication year

2002

Journal title

American journal of public health

Volume

92

Issue

1

Page(s)

109-115

10.2105/AJPH.92.1.109

Abstract

Abstract

Objectives. This study assessed the effectiveness of a sexually transmitted disease (STD)/HIV behavior change intervention in increasing women's use of the female condom. Methods. A total of 604 women at high risk for STDs and HIV in New York City, Baltimore, Md, and Seattle, Wash, enrolled in a randomized controlled trial of a small-group, skills-training intervention that included information and skills training in the use of the female condom. Results. In a logistic regression, the strongest predictors of use were exposure to the intervention (odds ratio [OR] = 5.5; 95% confidence interval [CI] = 2.8, 10.7), intention to use the female condom in the future (OR= 4.5; 95% CI = 2.4, 8.5), having asked a partner to use a condom in the past 30 days (OR= 2.3; 95% CI = 1.3, 3.9), and confidence in asking a partner to use a condom (OR = 1.9; 95% CI= 1.1, 3.5). Conclusions. Clinicians counseling women in the use of the female condom need to provide information, demonstrate its correct use with their clients, and provide an opportunity for their clients to practice skills themselves.

Emergency department use in New York City: a substitute for primary care?

Billings, J., Parikh, N., & Mijanovich, T. (n.d.).

Publication year

2000

Journal title

Issue brief (Commonwealth Fund)

Issue

433

Page(s)

1-5

Abstract

Abstract

For the uninsured and many low-income people, hospital emergency departments (EDs) are a crucial entryway to the health care system. New York City's uninsured-27 percent of the nonelderly population in 1998, up from 20 percent in 1990-rely heavily on the ED for their medical care. Residents who regularly get their health care at an ED do not have regular doctors or continuity in their care, use costlier services, and often receive treatment that could have been avoided. Low-income New Yorkers may be depending on emergency department care even more as Medicaid enrollment declines and physician reimbursement rates are cut. This Issue Brief describes patterns of ED use through-out New York City and discusses some of the ways to improve the availability of primary care services and reduce ED dependency.

Emergency department use in New York City: a survey of Bronx patients.

Billings, J., Parikh, N., & Mijanovich, T. (n.d.).

Publication year

2000

Journal title

Issue brief (Commonwealth Fund)

Issue

435

Page(s)

1-5

Emergency department use: the New York Story.

Billings, J., Parikh, N., & Mijanovich, T. (n.d.).

Publication year

2000

Journal title

Issue brief (Commonwealth Fund)

Issue

434

Page(s)

1-12

Factors influencing participation in weekly support groups among women completing an HIV/STD intervention program

Vandevanter, N., Parikh, N. S., Cohall, R. M., Merzel, C., Faber, N., Litwak, E., Gonzales, V., Kahn-Krieger, S., Messeri, P., Weinberg, G., & Greenberg, J. (n.d.).

Publication year

1999

Journal title

Women and Health

Volume

30

Issue

1

Page(s)

15-34

10.1300/J013v30n01_02

Abstract

Abstract

Over the past three decades, the influence and importance of social support has been well documented and the findings have suggested a beneficial effect on stress-related situations, mental and physical health, and social functioning. More recently, small group/skills training behavioral interventions have demonstrated success in changing behaviors which affect the transmission of sexually transmitted diseases, including HIV among populations at risk for these diseases. Studies of support groups to date have been conducted exclusively in research settings where women are offered financial incentives for participation. Little is known about the willingness of women to participate in ongoing support groups after successfully completing a skills training intervention. The present study examines the factors that may influence participation among women in a weekly support group after completing a structured, six session HIV/STD intervention. Both quantitative and qualitative data are collected from 265 women in the intervention arm of a multi-site randomized controlled behavioral intervention trial. Results reveal that less than a quarter (22%) of women participated in at least one support group. Participation varied significantly by site, ranging from 34% to 15% (p =.008). Participation was also strongly linked to recent use of domestic violence services. Qualitative data indicated that although monetary incentives play some role in the woman's decision to participate, other factors are also important. These include program outreach, support group size, salience of the group content, consistency of group leadership from the intervention to the support group, and use of peer leaders along with professional facilitators. Implications for design of post-intervention support groups programs are discussed.

Shame and health literacy: The unspoken connection

Parikh, N. S., Parker, R. M., Nurss, J. R., Baker, D. W., & Williams, M. V. (n.d.).

Publication year

1996

Journal title

Patient Education and Counseling

Volume

27

Issue

1

Page(s)

33-39

10.1016/0738-3991(95)00787-3

Abstract

Abstract

Illiteracy is a well known national crisis, yet relatively little research has focused on how low literacy affects patients' health care experiences. The purpose of this study was to determine the relationship between shame and low functional literacy in the health care setting. It hypothesized that many patients with low literacy may not admit they have difficulty reading because of shame. Patients who presented for acute care at a large, public hospital in Atlanta, Georgia were interviewed. A total of 202 predominately indigent African-American patients completed a demographic survey, the Test of Functional Health Literacy in Adults (TOFHLA) and answered questions about difficulty reading and shame. Of the 202 patients interviewed, 42.6% had inadequate or marginal functional health literacy. Patients with low literacy were more likely to be male (P < 0.05), have less than a high school education (P < 0.01) and be over the age of 60 (P < 0.01). Of those patients with low literacy, 67.4% admitted having trouble reading and understanding what they read. Almost 40% (n = 23) of patients with low functional literacy who acknowledged they have trouble reading admitted shame. Of the, 58 patients who had low functional health literacy and admitted having trouble reading, 67.2% had never told their spouses, and 53.4% had never told their children of their difficulties reading. Nineteen percent of patients had never disclosed their difficulty reading to anyone. Many patients with reading problems are ashamed and hide their inability to read. Shame is a deeply harbored emotion that plays an important role in understanding how low literate patients interact with health care providers. Further research is needed to understand how providers should deal with the shame associated with low literacy.

The Health Care Experience of Patients with Low Literacy

Baker, D. W., Parker, R. M., Williams, M. V., Pitkin, K., Parikh, N. S., Coates, W., & Imara, M. (n.d.).

Publication year

1996

Journal title

Archives of Family Medicine

Volume

5

Issue

6

Page(s)

329-334

10.1001/archfami.5.6.329

Abstract

Abstract

Objectives: To understand the difficulties that patients with poor reading ability have interacting with the health care system and to identify the coping mechanisms they use to deal with these problems. Design: Focus groups and individual interviews with patients who are illiterate and patients with low literacy. Setting: Two large, urban public hospitals. Participants: Sixty patients with marginal to poor reading abilities as measured by the Rapid Estimate of Adult Literacy in Medicine were interviewed in focus groups or individual interviews. Measurements and Main Results: Patients with low literacy harbor a deep sense of shame, which is reinforced by hospital staff who become frustrated or angry when someone cannot complete a form or read instructions. Seeking medical care is intimidating for patients with low literacy because they cannot understand signs and registration forms. Many patients recounted serious medication errors resulting from their inability to read labels. To cope with these problems, the patients with low literacy rely heavily on oral explanations, visual clues, and demonstrations of tasks to learn new material. Most also use a friend or family member as a surrogate reader. Conclusions: Patients with poor reading ability have important problems accessing the health care system, understanding recommended treatments, and following the instructions of providers. Because of their shame, patients with low literacy may be unwilling to disclose their problem to health care providers, and screening tests of reading ability may be necessary to identify those who need special assistance. Patients' coping mechanisms give insight into possible interventions that may improve their interactions with the health care system.

Inadequate Functional Health Literacy Among Patients at Two Public Hospitals

Williams, M. V., Parker, R. M., Baker, D. W., Parikh, N. S., Pitkin, K., Coates, W. C., & Nurss, J. R. (n.d.).

Publication year

1995

Journal title

JAMA: The Journal of the American Medical Association

Volume

274

Issue

21

Page(s)

1677-1682

10.1001/jama.1995.03530210031026

Abstract

Abstract

To determine the ability of patients to complete successfully basic reading and numeracy tasks required to function adequately in the health care setting. -Cross-sectional survey. -Two urban, public hospitals. -A total of 2659 predominantly indigent and minority patients, 1892 English-speaking and 767 Spanish-speaking, presenting for acute care. -Functional health literacy as measured by the Test of Functional Health Literacy in Adults (TOFHLA), an instrument that measures ability to read and understand medical instructions and health care information presented in prose passages and passages containing numerical information (eg, prescription bottle labels and appointment slips). -A high proportion of patients were unable to read and understand written basic medical instructions. Of 2659 patients, 1106 (41.6%) were unable to comprehend directions for taking medication on an empty stomach, 691 (26%) were unable to understand information regarding when a next appointment is scheduled, and 1582 (59.5%) could not understand a standard informed consent document. A total of 665 (35.1%) of 1892 English-speaking patients and 473 (61.7%) of 767 Spanish-speaking patients had inadequate or marginal functional health literacy. The prevalence of inadequate or marginal functional health literacy among the elderly (age ≥60 years) was 81.3% (187/230) for English-speaking patients and 82.6% (57/69) for Spanish-speaking patients, and was significantly higher (P<.001) than in younger patients. -Many patients at our institutions cannot perform the basic reading tasks required to function in the health care environment. Inadequate health literacy may be an important barrier to patients’ understanding of their diagnoses and treatments, and to receiving high-quality care. (JAMA. 1995;274:1677-1682).