Publications by authors named "Schnall R"

Background: In the United States, young men who have sex with men (YMSM) and young transgender women (YTGW) are disproportionately affected by HIV infection. Adequate HIV knowledge is critical for protecting adolescents and young adults at risk for HIV. This study aimed to evaluate the effectiveness of the mLab App intervention in enhancing HIV knowledge among YMSM and YTGW.

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Objective: To identify demographic, social, and clinical factors associated with HIV self-management and evaluate whether the CHAMPS intervention is associated with changes in an individual's HIV self-management.

Method: This study was a secondary data analysis from a randomized controlled trial evaluating the effects of the CHAMPS, a mHealth intervention with community health worker sessions, on HIV self-management in New York City (NYC) and Birmingham. Group comparisons and linear regression analyses identified demographic, social, and clinical factors associated with HIV self-management.

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Our study was designed to update the HIV Knowledge Questionnaire by incorporating pre-exposure prophylaxis (PrEP) knowledge questions, as previous HIV knowledge tools lack this focus. Four rounds of Delphi surveys were conducted with 47 expert participants, each with extensive HIV-related expertise (mean experience: 18.94 years).

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Article Synopsis
  • The HIV incidence rate is rising among youth, particularly young men who have sex with men (YMSM) and young transgender women (YTW), necessitating a deeper understanding of their HIV prevention intentions.
  • Behavioral intentions impact key practices such as condom use and PrEP usage, and different sociodemographic factors influence these intentions, highlighting the need to identify barriers and facilitators in HIV prevention.
  • A study identified four distinct classes of HIV prevention intentions among vulnerable youth, revealing significant variations based on age, sexual orientation, education, income, and living arrangements, indicating that those with no recent HIV testing or PrEP use are at higher risk for HIV infection.
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Background: Using a theoretically-grounded approach to the epidemiological study of HIV incidence among a national, diverse sample of sexual and gender minority (SGM) men (age 17 -29 years), as well as examining HIV incidence through an innovative geospatial lens, is of considerable public health significance. Our overarching objectives are to assemble a U.S.

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Article Synopsis
  • Progress has been made in reducing HIV rates among cisgender women, but the goal of eliminating new cases has not yet been achieved.
  • The study aims to recruit 1,800 diverse women at higher risk for HIV using social media and community-driven ads to explore factors influencing HIV-related sexual risk.
  • The research will collect demographic and health data, along with biological specimens, and aims to develop effective strategies for improving access to HIV prevention and treatment services for this group.
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Objective: To determine the efficacy of the mLab App, a mobile-delivered HIV prevention intervention to increase HIV self-testing in MSM and TGW.

Materials And Methods: This was a randomized (2:2:1) clinical trial of the efficacy the mLab App as compared to standard of care vs mailed home HIV test arm among 525 MSM and TGW aged 18-29 years to increase HIV testing.

Results: The mLab App arm participants demonstrated an increase from 35.

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People with HIV (PWH) are at risk of developing HIV-associated neurocognitive disorder (HAND) despite receiving combination antiretroviral therapy. Brain-derived neurotrophic factor (BDNF) has been implicated in cognitive function and neuroplasticity, but its role in HIV-related neuroinflammation remains understudied. This study analyzed data from the CHAMPS study, assessing BDNF serum levels and cognitive function in 140 adults with HIV at baseline.

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Article Synopsis
  • The study evaluated a digital health intervention called Dr. Eric, aimed at improving sexual health among adolescent and young adult males in emergency departments.
  • A pilot randomized controlled trial was conducted with 119 male participants aged 14-21, comparing those using the app and text messaging (intervention group) to those receiving usual care.
  • Results showed that the intervention was feasible and well-received, with participants increasing condom use in the short term, though the effect did not last by the 13-week follow-up.
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Background: Adolescents and young adults frequently present to the emergency department (ED) for medical care and continue to have many unmet sexual health needs. Digital interventions show promise to improve adolescent and young adult sexual health; yet, few interventions focus on male ED patients, despite their infrequent use of contraceptives and rising rates of sexually transmitted infections.

Objective: This paper describes the design and development of Dr.

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Depression and low medication taking self-efficacy are among the most important mechanisms contributing to poor adherence to treatment and care for persons with HIV (PWH). While the overall negative relationship between depression and medication taking self-efficacy has been well established, little is known on the precise pathways linking depression and medication taking self-efficacy. Thus, it is critical to identify a specific item of depression and medication taking self-efficacy that derives the overall negative relationship.

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There is evidence to support the use of mHealth tools for improving medication adherence. Building on this evidence, our study team culturally adapted and translated the WiseApp for improving antiretroviral medication adherence in Spanish-speaking persons with HIV. We are currently conducting a multi-site randomized controlled trial (RCT) to test the effectiveness and sustainability of the WiseApp for Spanish speakers in New York City and the Dominican Republic.

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Introduction: Globalization has increased the importance of multicultural research to address health disparities and improve healthcare outcomes for underrepresented communities. The International Nursing Network for HIV Research (The Network) serves as a platform for researchers to collaborate on cross-cultural and cross-national HIV studies. This article discusses the Network's approach to overcoming barriers in multicultural and multinational research in a qualitative context.

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Article Synopsis
  • The study developed the Mobile-Centered Digital Health Readiness: Health Literacy and Equity Scale (mDiHERS) to assess digital health readiness among patients, particularly those with chronic conditions like inflammatory bowel disease.
  • Conducted from October 2021 to October 2022, the research included literature reviews, focus groups, and validation with 403 participants, confirming the scale's reliability and construct validity through various statistical analyses.
  • mDiHERS consists of 36 items across 6 domains, effectively measuring patients' abilities and readiness to engage with digital health services, highlighting both technical skills and confidence in using mobile health technology.
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Background: Chronic stress causes harmful physiological responses that yield increased inflammation and subsequent health conditions. Stress is an important measure among minoritized populations who face social situations that predispose risk to developing mental health problems. Hair and fingernail cortisol have been studied as retrospective measures of chronic stress and to demonstrate biological response to social situations.

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In the United States, young men who have sex with men (YMSM) and young transgender women (YTGW) are disproportionality affected by HIV. To overcome this public health problem, we created and tested the mLab application (app), a novel mobile health (mHealth) that offers HIV prevention information and an imaging algorithm for interpreting the at-home HIV test. This study assessed the mLab app usability for HIV testing and its relation to users' education and health literacy.

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Hair and nail cortisol is increasingly studied as a physiologic proxy for chronic stress response. Glucocorticoid use is an expected confounder for cortisol measurement, yet there remains little evidence of whether external cortisol use should be subject to exclusion in study subjects. In a group of 209 youth (15-22 year-olds), we analyzed hair and fingernail cortisol concentrations.

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Objectives: Hemoglobin (Hgb) is associated with cognitive function, with low and high levels of Hgb leading to impaired cerebral oxygenation and perfusion. Yet, current studies focused on understanding the association between Hgb and cognitive function without consideration for each cognitive domain. Thus, this study aims to identify and visualize potentially interactive associations between Hgb and specific cognitive domains among older adults.

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Background: Transgender men and transmasculine youth are at high risk for acquiring HIV. Growing research on transgender men demonstrates increased HIV risk and burden compared with the general US population. Despite biomedical advancements in HIV prevention, there remains a dearth of evidence-based, sexual health HIV prevention interventions for young transgender men.

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Article Synopsis
  • Effective recruitment strategies are crucial for the success of informatics-based intervention trials aimed at people living with HIV, as engaging this population can be difficult.
  • Using a social marketing framework, researchers conducted interviews with 90 participants from four trials to explore their experiences, revealing six subthemes related to motivation, perceptions, and trust.
  • The study highlights that while trust in the research process is vital, recruitment methods and communication preferences vary between age groups, suggesting the need for tailored strategies to enhance participant engagement.
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Objective: Oral pre-exposure prophylaxis (PrEP) is effective in preventing HIV transmission. However, oral PrEP uptake is low, particularly among sexual and gender minority youth who are vulnerable to HIV infection. Alternative methods of PrEP delivery, such as long-acting injectable (LAI) PrEP may overcome barriers and be preferred.

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Poor adherence to tuberculosis (TB) treatment leads to further disease transmission, worsened outcomes, and the development of drug resistance. Digital adherence technologies may facilitate a more patient-centered approach for improving TB treatment outcomes than current strategies. The objective of this study was to evaluate and explore improving usability of the TB Treatment Support Tools (TB-TST) mobile application.

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Article Synopsis
  • Alzheimer's disease and related dementias impact over 55 million people worldwide, and low recruitment rates in clinical trials pose a significant challenge that could potentially be improved through natural language processing (NLP) technologies for identifying eligible participants.
  • A study assessed the usability of three NLP-driven prescreening tools among 60 clinical research staff, finding that usability varied, with Leaf scoring highest, and cognitive complexity influenced by factors like age and computer literacy but not usability.
  • The findings underscore the need for careful task management, effective training, and clear eligibility criteria when implementing NLP tools in ADRD research to enhance usability and support increased participant recruitment.
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