Graduate School Of Public Health And Health Policy

NIH Research Projects · FY 2026 · 2026-06

SUMMARY RFA-AI-24-009 (LITE-LA) is designed to address critical needs in HIV prevention research by using innovative technology to enroll and follow large-scale epidemiological cohorts of those at highest risk of infection in Latin America. In response to the LITE-LA RFA, our proposed study (Proyecto VIDA) will replicate established Internet- based strategies—employed successfully by the research team in LITE1 and LITE2—to enroll a new cohort of 5,000 HIV-negative men who have sex with men (MSM) ages 18 to 49 in Colombia and follow them annually for three years. The design features of our proposal were chosen specifically to identify (a) individual-, network-, and contextual-level determinants of HIV seroconversion and PrEP uptake/discontinuation, (b) participation/retention in the HIV continuum of care including individual-/network-/contextual-level determinants, and (c) missed HIV prevention opportunities among those seroconverting or stopping PrEP care. Our goal is to inform interventions to further reduce HIV acquisition and transmission. We chose to focus on MSM in Colombia because they are disproportionately impacted by HIV—HIV prevalence estimates among MSM in Colombia ranged from 11.4-26.4%. With ~52 million residents, Colombia is the 3rd largest country in Latin America, the 2nd largest in South America, and the largest Spanish-speaking country in South America. PROPOSED STUDY: Participants will complete annual at-home self-administered rapid HIV testing (results submitted via a digital photo of the test paddle),57 as well as at-home online surveys (~30 min)—a strategy we have used successfully in prior LITE research. In addition to being referred for care, study participants who HIV seroconvert or quit PrEP will complete a semi-structured telephone/zoom interview to identify missed HIV prevention opportunities, as well as contextual factors/circumstances surrounding seroconversion. We will also monitor newly seroconverting participants' movement through the HIV care continuum or PrEP care. Aim 1 (UG3 Phase, FY1-2): Establish a cohort of 5,000 HIV-vulnerable (HIV-negative) MSM in Colombia, all of whom complete baseline online surveys and at-home self-administered HIV testing, as well as consent for longitudinal follow-up. In so doing, determine PrEP uptake and HIV incidence and engagement in HIV treatment 12 months after study enrollment (in FY2). Aim 2 (UH3 Phase, FY3-5): Follow the cohort for 3 years to identify (a) individual-, network-, and contextual-level determinants of HIV seroconversion and PrEP uptake/discontinuation, (b) participation/retention in the HIV continuum of care including individual/network/contextual-level determinants, and (c) missed HIV prevention opportunities among those seroconverting or stopping PrEP care. Our goal here is to inform interventions to further reduce HIV acquisition and transmission.

NIH Research Projects · FY 2025 · 2025-09

STREAMS Abstract Interventions that use a combination approach—as recommended by UNAIDS—to address mental health in low- and middle-income countries (LMICs), are crucial to achieving the UNAIDS 95-95-95 targets, yet few such evidence-based combination interventions currently exist for the 1.7 million adolescents living with HIV (ALWHIV) in Africa. We propose Streamlined Treatment and Evidence-based Adolescent counseling and Medication Support (STREAMS) to evaluate a combination intervention comprising of streamlined interpersonal psychotherapy groups (IPT-G) tailored to adolescents (15-19 years) and streamlined family strengthening and treatment adherence counseling in rural Uganda. In our pilot work, PI Kreniske (K01MH122319) collaborated with StrongMinds and Brown School’s International Center for Child Health and Development (ICHAD) to demonstrate feasibility and acceptability of a streamlined text message based PHQ-9 screener to assess depression. Adolescents were successfully linked to StrongMinds 6-week IPT-G counseling and experienced a reduction in depressive symptoms. StrongMinds IPT-G counseling is tailored to the Ugandan context and has been reduced from a program based on 16 IPT-G sessions to the streamlined 6 sessions. To date, this approach has not been evaluated among ALWHIV. To address HIV counseling and adherence, we propose streamlining Suubi+Adherence (R01HD074949; PI Ssewamala), a family-based combination intervention combining economic empowerment intervention with medication adherence counseling for ALWHIV in Uganda that improves antiretroviral (ART) treatment adherence but has not been examined specifically among youth experiencing symptoms of depression. STREAMS will be implemented across 24 ICHAD-affiliated HIV health clinics within the greater Masaka region of Uganda—a region heavily impacted by HIV compared to national averages. We will use a Type I Hybrid design 3-arm cluster-randomized trial to evaluate effectiveness at both reducing depressive symptoms and improving ART adherence, with the secondary aim of characterizing the combined interventions’ feasibility and acceptability comparing (1) streamlined IPT-G and streamlined Suubi+Adherence in combination, (2) streamlined IPT-G and SOC ART counseling (3) SOC mental health and SOC ART counseling. Randomized at the clinic level, adolescents will be consecutively sampled, and those who screen positive for depressive symptoms on the mobile phone administered PHQ-9 will be enrolled. Using Consolidated Framework for Implementation Research (CFIR) informed in-depth interviews and analysis, we will systematically assess barriers and facilitators to accessing mental health care and adhering to ART across CFIR domains (e.g., individual characteristics, inner – healthcare settings) to inform scalable changes to care to support HIV treatment among ALWHIV in rural Uganda. STREAMS examines if our mobile phone screening tool along with a combination of streamlined StrongMinds IPT-G and streamlined Suubi+Adherence ART counseling, provides a low-cost, efficacious, and scalable approach for improving mental health and ART adherence.

NIH Research Projects · FY 2025 · 2025-08

Project Summary/Abstract The health challenges arising from extreme weather events (EWEs), such as droughts, floods, and major storms (e.g., hurricanes, typhoons) are increasingly common and severe, threatening to undermine public health progress made over the past century. There is limited evidence on how EWEs affect care outcomes among the 37 million people living with HIV/AIDS (PLWH), particularly in geographic regions most vulnerable to EWEs. Cross-sectional studies have shown both drought and excess rainfall to be associated with higher HIV prevalence. However, very little is known about how EWEs impact short- and long-term HIV care outcomes. Our preliminary analysis of data from 11 sub-Saharan African countries found that extreme rainfall may delay the timely initiation of antiretroviral therapy (ART) and increase loss to follow-up among those newly enrolling in HIV care. Our preliminary qualitative work in Kenya suggests that exposure to drought and flooding adversely affects HIV outcomes through decreased food availability and ART adherence and increased infectious disease incidence. The absence of rigorous longitudinal assessments of the relationships and causal pathways between EWE exposures and HIV care outcomes remains a crucial gap in knowledge and obstacle to intervention development. The global IeDEA cohort collaboration, with >2 million PLWH enrolled in HIV care in 44 countries over a long time horizon (2004-present) provides an unparalleled opportunity to characterize the influence of EWEs on HIV care outcomes across several geographic contexts and sub-populations of PLWH (e.g., those with advanced disease, adolescents, those who are pregnant, etc). The proposed 5-year, mixed methods study will combine high resolution daily data on temperature and rainfall from five publicly available climate datasets with the global IeDEA cohort data from 2004-present to longitudinally assess the impacts of EWEs on HIV care outcomes (timely ART initiation HIV viral load monitoring, and HIV viral suppression) (Aim 1). In Aim 2, we will use a mixed methods approach to explore subgroups of vulnerability and resilience to EWEs among PLWH, mechanisms of impact, and adaptation and mitigation strategies employed in specific communities to inform interventions. In Aim 3, we will create and disseminate a country-level public use climate dataset with geocoded temperature and rainfall data going back to 1984 for ready use by other investigators, program implementers, and policymakers. We expect this novel study to inform climate mitigation and adaptation strategies, and lay the groundwork for the development of other targeted (population and region-specific) interventions to address deleterious health effects of EWEs. Moreover, we expect our study to have significant implications for global health programs, policies, mathematical modelers and funders, creating new health-related applications for climate datasets.

NIH Research Projects · FY 2024 · 2024-09

SUMMARY This exploratory R21 proposal addresses a critical gap in HIV prevention by identifying preferences and care components to optimize the delivery of long-acting injectable (LAI) PrEP for sexual minority men (SMM) who use methamphetamine (meth). In the U.S., SMM are disproportionately affected by HIV, exacerbated by the resurging meth epidemic. SMM who use meth have a quadrupled risk of HIV seroconversion, and those who use stimulants face a 3-fold risk of disengagement from PrEP care and 5-fold risk of sub-optimal oral PrEP adherence. Bimonthly LAI PrEP has proven more effective than daily oral PrEP, and is generally preferred by people who inject drugs. LAI PrEP could be well-received and a game-changer to improve adherence and reduce HIV risk. However, there is a lack of data that has systematically assessed acceptable and preferred strategies to maximize LAI PrEP implementation for SMM who use meth. Our study leverages the participant pool from the ongoing AMETHST U.S. national cohort of SMM who use meth (UH3AI169652, Grov/Carrico) to first qualitatively identify modifiable care options for LAI PrEP use, followed by a large Discrete Choice Experiment (DCE) to quantitatively assess care preferences. Aim 1: Conduct rapid qualitative interviews to develop the DCE. We will interview 30-36 SMM who use meth (10-12 Black, 10-12 Latinx, and 10-12 others) and 20-30 healthcare providers with diverse experiences (e.g., LAI PrEP implementation experience, primary care or specialized clinic providers, and PrEP educators/navigators). Open-ended questions will gather insights on familiarity and preferences for LAI PrEP delivery, barriers and facilitators, healthcare settings and providers, and social, behavioral, and practical considerations. These insights will help develop DCE attributes and levels and inform choice architecture for testing. Aim 2: Elicit the preferred choice architecture for LAI PrEP care delivery using a rigorous DCE among a sample of 600 SMM who use meth, stratified by race/ethnicity: 200 Black, 200 Latinx, and 200 others. Plus, we will collect additional data on demographics, risk behaviors (e.g., sexual practices, current meth/substance use), and LAI PrEP experiences. After pilot testing the DCE, we will recruit participants for this new study from the ongoing AMETHST cohort (an available participant pool of 2,820 HIV-negative SMM who use meth, 56.5% persons of color), n = 600 of whom will complete an online DCE (via Sawtooth Software) and survey (via Qualtrics). Hierarchical Bayesian regression models will evaluate utilities for each attribute level and determine the relative importance of attributes among diverse SMM who use meth subgroups (e.g., race/ethnicity, rural/urban). Impact: This timely R21 developmental study will generate critical insights on care preferences among diverse subgroups of SMM who use meth to inform LAI PrEP implementation in the U.S., providing actionable data to guide targeted, scalable strategies for novel prevention products and delivery systems, ultimately reducing HIV incidence in this highly affected population.

NIH Research Projects · FY 2025 · 2024-08

MODIFIED ABSTRACT As a co-occurring condition, SARS-CoV-2 may have negatively impacted efforts aimed at Ending the HIV epidemic (EHE) and worsened HIV outcomes in the long-term. For EHE to be successful, it is important to understand factors that adversely complicate HIV control and impact care of people with HIV (PWH) and to address issues at the root of worsening outcomes. The impact of post COVID conditions (PCC) on HIV outcomes has not been studied, and data on the epidemiology of PCC are lacking for PWH. It is critical to understand epidemiological risk and any long-term increases in comorbidities and complications among PWH due to a co-occurring condition in order to inform care and support. The goal of the proposed study is to understand the factors that impact PCC among PWH and to characterize how PCC may influence HIV care outcomes. This research will leverage established cohorts: 1) clinical cohorts of PWH and PWoH from the Johns Hopkins Healthcare System and Kaiser Permanente Mid-Atlantic States and 2) the CHASING COVID Cohort, an online community-based cohort of US adults. The proposed research poses unique methodological challenges due to the varying definitions of PCC, the quantity of exposure data and the longitudinal design, all of which may increase measurement error. This K01 will provide experience, knowledge and training in methods (advanced biostatistics methods related to improving inferences in settings with complex exposure pathways and measurement error) and content (comorbidity development among PWH, including PCC, and causal inference). The study aims to: (1) compare clinical risk factors for PCC-related comorbidities by HIV status using target trial approaches with marginal structural models for time-varying confounding and outcome censoring; (2) characterize determinants of PCC-related comorbidities among HIV status using multi-level models; and (3) assess the role of PCC on differences in HIV outcomes, using a novel mediation approach in combination with modern approaches for minimizing bias (e.g., potential-mediator weighted models). Focusing the research, in part, on PCC will provide an opportunity to address a complicated and multi-faceted problem lacking robust epidemiological data for PWH. Findings from the proposed study are critical to understanding the longer-term impact of a co-occurring condition on HIV outcomes and the epidemiology and natural history of PCC within an immunocompromised population. Other innovations include: 1) triangulating electronic health record data with reported data from one of the few national-community-based cohorts and 2) improving inference by incorporating advanced design and methods with clinical insight. Furthermore, the focus on determinants and pathways is critical for implementation science and for identifying the next generation of HIV interventions for EHE.

NIH Research Projects · FY 2025 · 2024-07

Abstract Bioconductor is a crucial resource for statistical analysis and data management in cancer genomics research, providing more than 2,200 open-source software and data packages. This software ecosystem is supported by core data classes and methods that provide convenient representations and efficient operations for many kinds of high-throughput omics data. Recent technical advances enable increasingly resolved study of the molecular biology of cancer at the single-cell level, through combined assaying of DNA sequence, epigenetics, gene expression, protein, and other aspects, even with spatial information. These developments present new challenges in the complexity, size, and interpretability of data analysis. The overarching goal of this project is to maintain and expand the core Bioconductor software infrastructure to meet these challenges, through the following aims. First, we will maintain and expand infrastructure for multimodal experiments and spatial transcriptomics, and connect the R/Bioconductor ecosystem with non-R image analysis tools to facilitate statistical analysis of histopathology images in the context of spatial transcriptomics and other molecular data. Second, we will transition Bioconductor’s data and annotation-sharing tools to a federated, language-agnostic system that facilitates contribution and extension by the community, improves findability, enables automated improvement in metadata, and enhances utility for non-R users. Third, we will create curated and integrated data repositories that make key datasets more findable and usable, and drive the development of the planned new data-sharing systems. Finally, we will develop a program of user training and new outreach approaches to support the training of users and developers, including the creation of a large language model-based chatbot and a cloud-based platform with persistent disks for courses and workshops. By fostering knowledge dissemination and practical training, we aim to empower researchers with the necessary skills and resources to leverage the enhanced capabilities of Bioconductor for advanced cancer genomics research.

NIH Research Projects · FY 2026 · 2024-04

Abstract For research on sensitive topics like HIV, it is critical to understand the capacity of adolescents to provide informed consent, as parental consent has been identified as the greatest barrier to adolescent participation in biomedical research. In many countries including low-and middle-income countries, where 90% of adolescents live, adolescents can consent to sexual and reproductive healthcare but require parent/guardian permission to participate in research before age 18 – leading to adolescent underrepresentation and systematic exclusion from biomedical and behavioral studies. Among adults, research has identified effective biomedical HIV prevention tools such as pre-exposure prophylaxis (PrEP) that have successfully decreased HIV transmission. Youth in East and Southern Africa have the highest HIV incidence in the world, yet less than 1% of biomedical HIV prevention trials include minor adolescents. Thus, developmentally tailored HIV prevention and care research for adolescents and young adults is urgently needed. Improving understanding of Capacity to consent to sensitive biomedical Research among adolescents in Rakai Uganda (ICARE) will leverage The Rakai Community Cohort Study (RCCS) to test adolescent capacity to consent to biomedical research, identify differences in developmental decision-making, characterize eligibility for, beliefs about and interest in oral and injectable pre-exposure prophylaxis (PrEP), and construct a digital toolkit for including adolescents in biomedical research. The RCCS presents a unique opportunity to compare cognitive capacity to consent for biomedical research among adolescents with and without prior research experience at three developmental stages – early (10-14 years), middle (15-17 years), and late (18-19 years) – with the cognitive capacity of their parents/guardians. Limited data are available on adolescents’ actual capacity to consent, particularly in low- and middle-income countries and low resource, high HIV prevalence settings. Findings will contribute to addressing a major barrier to research participation through an examination of the capacity of adolescents to comprehend risks, benefits, and the other elements of informed consent and, therefore, to provide informed consent to biomedical research. ICARE has the potential to offer guidance for ethical boards seeking to harmonize adolescent treatment and prevention with research procedures, thus addressing disparities in research by age and facilitating studies that prioritize adolescents to end the HIV epidemic.

NIH Research Projects · FY 2026 · 2023-02

Project Summary/Abstract We propose updating, piloting and testing a socialization and sex education curriculum (STEPS-2) designed for adolescents and young adults with intellectual and developmental disabilities (I/DD). We will test this updated curriculum in a randomized controlled trial (RCT) among 856 adolescents and young adults (aged 18- 27 years) with mild to moderate I/DD who receive services from disability providers in four of the five Developmental Disabilities Regions of the New York State Office for People with Developmental Disabilities. Randomization will be stratified by region, sex (male/female) and age (18-22, 23-27). Half of the participants will be randomized to receive the updated STEPS-2 socialization and sex education curriculum in individualized sessions during home visits, and the other half will receive a group-based intervention on physical exercise and nutrition in a local community center; only one roommate will be eligible to be enrolled from any group living arrangement to minimize spillover effects. Regional Coordinat ors will provide the 6-week long interventions, with interview data collected at baseline (prior to intervention), month 2 (completion of intervention), month 6 and month 12. We project completing recruitment into the RCT during the second quarter of year 3, and completion of month 12 assessments in the third quarter of year 4. The primary outcome will be proportion of participants reporting having had a conversation about sex/reproductive health with a medical provider by month 12, with secondary outcomes including HPV vaccination status, receipt of sex and age-specific preventive health screening, social sexual behaviors, agency over decisions, and, among those sexually active, use of contraception (if not desiring a pregnancy), and use of sexually transmitted infection/HIV protection. Interim measures will be used to assess knowledge and to reduce the likelihood of recall bias for the primary endpoint. Specifically, we aim to: (1) Update and pilot an existing socialization and sex education curriculum (STEPS-2) for 18-27 year olds with I/DD in New York State through a participatory process centering the voices of diverse lived experiences; (2) Test the efficacy of this socialization and sex education curriculum in a randomized intervention trial using intention-to-treat and instrumental variable analyses to adjust for compliance. We hypothesize that at least an additional 10% of the individuals in the experimental group will have had a reproductive health discussion with a medical provider by month 12 compared with the control group; and (3) Test whether the efficacy of the intervention differs by sex and age in stratified analyses. We have powered the study for sex-specific efficacy estimates and will explore whether efficacy differs by age. The findings from this translational study will inform practitioners, advocates, and self-advocates about best practices for reproductive and sexual health education for adolescents and young adults with I/DD as they transition to adulthood.

NIH Research Projects · FY 2026 · 2022-09

Project Summary Parks are a key feature of the built environment that foster community engagement, make communities vibrant, and support resident wellbeing. This study will test the impact on community-level health-related quality of life and mental health of a community-engaged, community-level intervention that aims to improve park-based health and social programming. The study will leverage neighborhood parks that have recently been redesigned and renovated as part of the Community Parks Initiative, a capital investment and park equity program in New York City. We aim to work with eight lower income and predominantly Latino and Black neighborhoods through an asset-based and human-centered design process to co-create and implement one health and one social strategy in each neighborhood park. The health strategy will focus on physical activity and the social strategy will seek to enhance social relationships and networks in each neighborhood. Achieving broad reach, inclusivity, and sustainability are key factors that will be taken into account in the design process. The eight neighborhoods will be cluster-randomized to one of two steps in a stepped wedge intervention trial. The intervention is 24 months in each community, with follow-up to 48 months. We will study outcomes, including HR-QoL, depression, anxiety, stress and loneliness, at the community level (not among individuals participating in park activities) via random, representative samples of adult residents in participating communities at intervention baseline and months 24 and 48 post-baseline.In addition, we will examine whether the intervention effects might be mediated through social cohesion, neighborhood ties, sense of community, park use and perception and/or health behaviors such as physical activity and sleep. Finally, we will conduct qualitative research to examine the implementation of the community-level intervention based on constructs from the Consolidated Framework for Implementation Research. Study findings will help inform future best practices in urban community development and park programs and policies to promote population health and reduce health disparities.

NIH Research Projects · FY 2026 · 2022-04

Modified Project Summary/Abstract Section This LITE-2 (RFA-AI-21-018) initiative responds to a resurgent epidemic of methamphetamine (meth) use in men who have sex with men (MSM), which is a primary driver of HIV incidence. The overarching goals are two-fold: 1) identify multi-level and bio-behavioral determinants of amplified HIV seroconversion risk in meth- using MSM; and 2) test the effectiveness of telehealth motivational enhancement interventions for optimizing entry or re-entry of MSM who use meth into the PrEP care continuum. Findings from our LITE-1 cohort (UG3/UH3 AI-133675, RFA-AI-16-031) and others provide compelling evidence that meth use is increasing and accounts for one-in-three new HIV infections in MSM. In response to LITE-2 (RFA-AI-21-018) we propose a multi-component initiative zeroing in on the “Where,” “How,” and “Why” of meth use and HIV risk. Where: What are the geospatial determinants of the association of meth use with HIV incidence? How: How can we support (re-)entry into the PrEP care continuum with this high priority population of MSM who use meth? Why: Does meth amplify biological risk of HIV by potentiating rectal immune dysregulation? Aim 1: Examine multi-level structural, psychological, and social determinants of amplified HIV seroconversion risk in MSM who use meth. The centerpiece of our LITE-2 initiative is a new prospective, bio-behavioral cohort with N=5,000 MSM (n=3,000 MSM who use meth, n=2,000 who do not). Participants will complete assessments over 36 months and provide biological samples for HIV testing, drug toxicology testing, rectal STIs, and rectal cytokines/chemokines. Our primary goal will be to investigate the role of geospatial determinants (e.g., background meth and HIV prevalence, urbanicity) and other structural determinants (e.g., stigma as evidenced by policies/laws) in relation to the association of meth use with amplified HIV seroconversion risk. Aim 2: Test the comparative and combined effectiveness of telehealth motivational enhancement interventions for optimizing PrEP use. PrEP Readiness Interventions for Supporting Motivation (PRISM) is a hybrid type I, modified factorial randomized controlled trial (RCT) of telehealth contingency management (CM) that provides incentives for filling a PrEP prescription, and a 2-session telehealth MI intervention that we adapted with meth-using MSM (R34-DA046367, Carrico/Grov). PRISM will enroll 840 meth-using MSM who are not currently taking PrEP from the LITE-2 cohort (Aim 1) to examine the effectiveness of CM (n = 280), MI (n = 280), and MI+CM (n = 280) on the primary outcome – filling a PrEP prescription. Aim 3: Determine whether greater rectal immune dysregulation partially explains amplified risk of HIV seroconversion in MSM who use meth. Using a case-cohort design, we will compare HIV seroconverters (n=450) with matched seronegative controls (n=450) to examine the clinical relevance of meth-induced alterations in rectal cytokines with respect to HIV seroconversion. This LITE-2 initiative could have an exceptional impact by transforming HIV prevention in the United States.

NIH Research Projects · FY 2025 · 2022-01

Abstract – Overall AIMINGS Center The vision of this proposed Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center is to implement computational and data science approaches and tools to advance nutrition for precision health in a way that accounts for the complex systems involved. Many existing data sets include extraneous data, making them difficult to analyze at best, and at worst, prone to generating misleading or biased insights. Thus, there is a need to for new approaches, methods, and tools to collapse and distill data to make them more Artificial Intelligence (AI)-ready and ready for a range of different analyses. This coincides with the goal of Project 1: to develop and utilize The Data Distiller for Precision Nutrition, a set of approached and tools that can collapse and distill nutrition-relevant data to create datasets that are AI- ready and ready for a range of other analyses. The first objective of the Nutrition for Precision Health (NPH) program is to “examine individual differences observed in response to different diets by studying the interactions between diet, genes, proteins, microbiome, metabolism and other individual contextual factors.” Given the type of missing data we face in nutrition, and the importance of establishing causal relationships rather than correlations, there is a need for new imputation methods. To address this, Project 2, the Causal Relationship Disentangler, will introduce new approaches for handling missing data while preserving causal structure. Learning how to transfer causal knowledge and doing so with missing data is critical for realizing the potential of nutrition for precision health. The NPH program’s other objectives are “to use AI to develop algorithms to predict individual responses to foods and dietary patterns,” and “to validate algorithms for clinical application.” This requires bringing different causal pathways together to understand how they interact. Agent-based models (ABMs) can help and serve as "virtual laboratories" to predict how different people may respond to a particular diet under different circumstances. Therefore, the goal of Project 3 (The Virtual Human for Precision Nutrition) is to develop an ABM tool that can help better understand and predict an individual's response to food and dietary patterns, while bringing together and accounting for the interactions between genetic, physiological, and behavioral factors. However, focusing on the individual alone will not be enough to address all aspects of NPH. Therefore, the Virtual Public Health Precision Nutrition Laboratory (Project 4) will develop ABMs that represent and account for the systems outside individuals such as their social, economic, and built environments. An Administrative and Coordination Core will oversee all operations and a pilot program. A Data Systems Core (DSC) will leverage the substantial computing resources of CUNY, West Point, and the Department of Defense to create a flexible cloud-based architecture for data flow and a collaborative workspace. A Computational Systems Core will provide resources and personnel to support the DSC and tool development/deployment.

NIH Research Projects · FY 2025 · 2021-09

ABSTRACT Improving access to mental health services requires an integrated, multisector, community-based approach. First, community-partnered networks are necessary to engage residents, strengthen safety-net systems, expand linkages to essential services, and promote mental health awareness. Second, task-sharing mental health support skills to non-mental health providers in gateway settings has shown promise globally but remains understudied in U.S. low-income housing developments. Third, a syndemic approach may enhance engagement in mental and physical health services, particularly for individuals facing multiple barriers to care. Guided by a community-based participatory research (CBPR) framework, the Harlem Strong Collaborative—led by the CUNY Graduate School of Public Health, Harlem Health Initiative, Center for Innovation in Mental Health, and Harlem Congregation for Community Improvement, and Healthfirst (a managed care organization) will implement an enhanced model of community collaborative care to integrate mental health task-sharing through two strategic gateways: low-income housing developments and primary care practices. The study will evaluate the impact of the Harlem Strong Community Mental Health Collaborative—a community-wide, multisector model in which a health insurer collaborates with housing providers, community-based organizations, and medical and behavioral health providers to: (1) address financing, access, and quality barriers; (2) build capacity for mental health task-sharing by community health workers; (3) support coordination across health, housing, and social services; and (4) establish common metrics and strategies for continuous quality improvement. Using a Hybrid Implementation-Effectiveness design, we will assess the model’s impact on system and consumer outcomes. Implementation outcomes and key informant interviews will explore the influence of community engagement, organizational context, and provider characteristics on the process of integrating mental health task-sharing in a coordinated network of services.

NIH Research Projects · FY 2025 · 2021-09

The development of new technologies for detection of environmental contaminants have increased considerably in the last 15 years. The technology in the form of new sensors, smartphone applications, and wearables devices are widely available for researchers as well as consumers interested in obtaining environmental data. For industrial hygienists, the availability of new sensors allows for the collection of greater spatial and temporally resolved data which improves anticipation, recognition, measurement, and control of workplace exposures. This proposal builds on a long-standing collaboration between the City University of New York School of Public Health (CUNY SPH) and the Icahn School of Medicine at Mount Sinai in the NIOSH New York/New Jersey Educational Research Center while adding new collaborations with CUNY’s Queens College and the CUNY Advanced Science Research Center. The overall goal of this proposed training program is to add significant new training and research opportunities for industrial hygiene students at the CUNY SPH in the hands-on use of sensor technology and laboratory. Students will be trained to recognize and utilize state of the art new technologies that can be used to quantify contaminants in the workplace such as total volatile organic compounds, particulate matter, heat exposure, noise and ultraviolet radiation. This proposal will expand upon the existing NIOSH funded industrial hygiene program to: 1) revise existing industrial hygiene curriculum to include training in laboratory practices and sensor technologies, 2) fund student research projects in the evaluation and applicability low-cost sensors to quantify workers’ exposure, 3) develop an outreach and training program in industrial hygiene for Spanish speaking occupational health and safety trainers who train construction and other low wage Latinx immigrant workers. We will provide five graduate assistantships per year for students to work with faculty mentors in the research areas of sensor technologies or worker outreach programs. In addition, approximately 35 students in the Department of Environmental, Occupational, and Geospatial Health Sciences at the CUNY SPH will enroll in updated laboratory and didactic courses. The program will also provide training to enhance the skills of a group of 40 trainers associated with Latinx community-based organization in the New York/New Jersey region who provide training in occupational safety and health in Spanish to low wage workers. By integrating graduate training programs for industrial hygiene students with community-based training for occupational safety and health trainers serving for low wage Latinx workers, this program will promote a commitment to community engagement and service among our industrial hygiene trainees assisted by the enhanced use of low-cost sensor technologies to identify, measure and control workplace exposures.

NIH Research Projects · FY 2025 · 2021-07

Abstract The Ryan White HIV/AIDS Program (RWHAP) for low-income people with HIV (PWH) is a key resource for reducing HIV health disparities and scaling up evidence-based interventions. As RWHAP serves >50% of US PWH, RWHAP outcomes are vital to achieving “getting to zero”/ Ending the HIV Epidemic (EHE) Plan targets. As a grantee for RWHAP Part A (RWPA) funding distributed to the counties/cities severely affected by HIV, New York City (NYC) conducts regular HIV care continuum monitoring citywide and in its RWPA programs, which offer support services to reduce social and behavioral barriers to care/treatment. Local data consistently show lower viral suppression (VS) among RWPA clients in HIV care than among non-RWPA PWH in HIV care. Relative to NYC HIV cases overall, NYC RWPA clients (~14,000 per year) over-represent Black and Latinx PWH and high-poverty neighborhoods. To address local outcome disparities and to fill gaps left by data-to-care (D2C) strategies and research focused on medical care (re-)linkage, we propose to implement and rigorously evaluate the effectiveness of a novel ‘data-to-suppression’ (D2S) intervention among ~1,300 RWPA clients in HIV care but unsuppressed. Surveillance-based reports on unsuppressed clients plus D2S capacity-building assistance will guide RWPA providers in targeting and delivering evidence-informed strategies to improve VS. Our proposed aims are to: 1) Measure D2S intervention effects on timely VS and time to VS, in a stepped- wedge hybrid Type 1 trial; 2) Identify modifiable determinants of D2S response, by comparing characteristics of D2S-exposed clients who do and do not achieve VS, to recognize opportunities to tailor and strengthen the intervention; 3) Assess D2S acceptability and participant preferences and priorities for its implementation, in eight (client and provider) focus groups and in a discrete choice experiment (DCE) with RWPA staff (n=200). This proposal answers the call in PAR-20-036 for research to deepen understanding of the broader context of VS, by leveraging extensive/multiple datasets and resources and applying implementation science methods to test an intervention to improve service delivery and ultimately achieve VS. The study is also aligned with the National HIV/AIDS Strategy goal to reduce health disparities – in this case, a VS gap between RWPA clients in care and other PWH in care in the same jurisdiction. The proposed study’s hybrid, Type 1 trial design supports rapid dissemination and uptake beyond NYC, should the intervention prove effective. Through the D2S trial, analysis of factors driving D2S response, and primary data collection in NYC RWPA support- service settings, the project seeks to clarify future intervention directions for low-income, Black and Latinx PWH, whose care continuum advances are vital for meeting 90-90-90, “getting to zero” and EHE Plan goals. The project’s potential impact is heightened in the time of COVID-19, given disproportionate burden of COVID- 19 and related restrictions in the communities RWPA serves, and new obstacles to continuity of care/treatment and to maintaining close communication between medical and support-service providers about clients’ needs.

NIH Research Projects · FY 2025 · 2019-07

Abstract Dysbiosis of the host microbiome is now recognized as a hallmark of cancer and a factor in the systemic response to immunotherapy. While a large volume of literature and data resources on microbiome research are available, systemic comparison and analysis are limited due to the heterogeneity in data and reporting schema. To enable rapid and cost-effective elucidation of the roles of microorganisms in the etiology and progression of cancer, we have developed high-quality harmonized databases of public microbiome data and microbial signatures. This proposal expands and creates new features of these microbiome databases through four aims. First, it will enhance the analytic scope of BugSigDB, a Semantic Mediawiki for manual curation and review of microbial signatures by incorporating microbial physiologies and morphologies, predicted metabolic functions, automatic identification of similar signatures, and creation of user-friendly Bug Set Enrichment Analysis workflows. Second, it will establish the next generation of curatedMetagenomicData, a microbiome database of large-scale manual curation and uniformly processed shotgun sequencing data, supporting FAIR principles. We will create a federated, ontology-based curation system and distributed computing metagenomic profiling workflow, both applicable to all Sequence Read Archive (SRA) records. Third, it will expand curatedMetagenomicData and BugSigDB with data from thousands of published studies and perform meta-analyses using these resources. Lastly, we will mobilize hundreds of data curators from diverse backgrounds by participating in established internship programs and mobilize the microbiome research community to adopt reporting standards for publication. This contribution is significant because it increases the likelihood of developing effective public health interventions to prevent and detect microbiota-linked cancers by providing methods for improved mechanistic interpretation of microbiome studies, extracting new information from published raw metagenomic shotgun sequencing data and metadata, and enabling re-use of existing data by a much broader range of researchers and methodologies. The proposed research is innovative because it identifies and corrects important deficiencies in how microbiome data are published, increasing the utility of public data and published results on a large scale by other research teams.