Melody S. Goodman

Bio: Melody S. Goodman is an academic researcher from New York University. The author has contributed to research in topics: Medicine & Health equity. The author has an hindex of 27, co-authored 129 publications receiving 2365 citations. Previous affiliations of Melody S. Goodman include Harvard University & Stony Brook University.

Multivariate or Multivariable Regression

Abstract: The terms multivariate and multivariable are often used interchangeably in the public health literature. However, these terms actually represent 2 very distinct types of analyses. We define the 2 types of analysis and assess the prevalence of use of the statistical term multivariate in a 1-year span of articles published in the American Journal of Public Health. Our goal is to make a clear distinction and to identify the nuances that make these types of analyses so distinct from one another.

The science of stakeholder engagement in research: classification, implementation, and evaluation.

Abstract: In this commentary, we discuss the science of stakeholder engagement in research. We propose a classification system with definitions to determine where projects lie on the stakeholder engagement continuum. We discuss the key elements of implementation and evaluation of stakeholder engagement in research posing key questions to consider when doing this work. We commend and critique the work of Hamilton et al. in their multilevel stakeholder engagement in a VA implementation trial of evidence-based quality improvement in women's health primary care. We also discuss the need for more work in this area to enhance the science of stakeholder engagement in research.

The impact of teach-back on comprehension of discharge instructions and satisfaction among emergency patients with limited health literacy: A randomized, controlled study

Abstract: ObjectiveRecommended as a ‘universal precaution’ for improving provider–patient communication, teach-back has a limited evidence base. Discharge from the emergency department (ED) to home is an important high-risk transition of care with potential for miscommunication of critical information. We examined whether teach-back improves: comprehension and perceived comprehension of discharge instructions and satisfaction among patients with limited health literacy (LHL) in the ED.MethodsWe performed a randomized, controlled study among adult patients with LHL, randomized to teach-back or standard discharge instructions. Patients completed an audio-recorded structured interview evaluating comprehension and perceived comprehension of (1) diagnosis, (2) ED course, (3) post-ED care, and (4) reasons to return and satisfaction using four Consumer Assessment of Healthcare Providers and Systems questions. Concordance with the medical record was rated using a five-level scale. We analyzed differences between gr...

Is low health literacy associated with increased emergency department utilization and recidivism

Abstract: Objectives The objective was to determine whether patients with low health literacy have higher emergency department (ED) utilization and higher ED recidivism than patients with adequate health literacy. Methods The study was conducted at an urban academic ED with more than 95,000 annual visits that is part of a 13-hospital health system, using electronic records that are captured in a central data repository. As part of a larger, cross-sectional, convenience sample study, health literacy testing was performed using the short test of functional health literacy in adults (S-TOFHLA) and standard test thresholds identifying those with inadequate, marginal, and adequate health literacy. The authors collected patients' demographic and clinical data, including items known to affect recidivism. This was a structured electronic record review directed at determining 1) the median number of total ED visits in this health system within a 2-year period and 2) the proportion of patients with each level of health literacy who had return visits within 3, 7, and 14 days of index visits. Descriptive data for demographics and ED returns are reported, stratified by health literacy level. The Mantel-Haenszel chi-square was used to test whether there is an association between health literacy and ED recidivism. A negative binomial multivariable model was performed to examine whether health literacy affects ED use, including variables significant at the 0.1 alpha level on bivariate analysis and retaining those significant at an alpha of 0.05 in the final model. Results Among 431 patients evaluated, 13.2% had inadequate, 10% had marginal, and 76.3% had adequate health literacy as identified by S-TOFHLA. Patients with inadequate health literacy had higher ED utilization compared to those with adequate health literacy (p = 0.03). Variables retained in the final model included S-TOFHLA score, number of medications, having a personal doctor, being a property owner, race, insurance, age, and simple comorbidity score. During the study period, 118 unique patients each made at least one return ED visit within a 14-day period. The proportion of patients with inadequate health literacy making at least one return visit was higher than that of patients with adequate health literacy at 14 days, but was not significantly higher within 3 or 7 days. Conclusions In this single-center study, higher utilization of the ED by patients with inadequate health literacy when compared to those with adequate health literacy was observed. Patients with inadequate health literacy made a higher number of return visits at 14 days but not at 3 or 7 days. Resumen Objetivos Determinar si los pacientes con una educacion sanitaria baja tienen un mayor uso y frecuentacion al servicio de urgencias (SU) que los pacientes con una educacion sanitaria adecuada. Metodologia Este estudio se llevo a cabo en un SU urbano y universitario con mas de 95.000 visitas al ano que forma parte de un sistema sanitario de 13 hospitales, mediante la revision de historias clinicas electronicas que son capturadas en un repositorio de datos central. Como parte de un gran estudio transversal de muestra de conveniencia, se realizaron pruebas de educacion sanitaria mediante el Short Test of Functional Health Literacy in Adults (S-TOFHLA) y los umbrales de la prueba estandar identificaron aquellos con educacion sanitaria inadecuada, marginal y adecuada. Los autores recogieron datos demograficos y clinicos de los pacientes, que incluian variables conocidas para el impacto de la refrecuentacion. Se realizo una revision de historia clinica electronica estructurada dirigida para determinar: 1) la mediana de numero de visitas totales al SU en este sistema sanitario en un periodo de 2 anos, y 2) la proporcion de pacientes en cada nivel de educacion sanitaria que revisitan a los 3, 7 y 14 dias de la visita indice. Se documentaron los datos descriptivos para la demografia y las revisitas al SU estratificados por el nivel de educacion sanitaria. Se uso el test de la ji cuadrado de Mantel-Haenszel para analizar si habia una asociacion entre la educacion sanitaria y la refrecuentacion al SU. Un modelo multivariable binomial negativo se utilizo para examinar si la educacion sanitaria impacta en el uso del SU, el cual incluia las variables significativas con nivel de alfa de 0,1 en el analisis univariable, y permanecieron aquellas con nivel de alfa de 0,05 en el modelo final. Resultados De los 431 pacientes evaluados, 13,2% tuvieron una educacion sanitaria inadecuada, 10% marginal y 76,3% adecuada segun el S-TOFHLA. Los pacientes con educacion sanitaria inadecuada tuvieron mayor uso del SU en comparacion con aquellos con educacion sanitaria adecuada (p = 0,03). Las variables que permanecieron en el modelo final incluyeron la puntuacion del S-TOFHLA, el numero de medicaciones, el tener un medico personal, el ser propietario, la raza, el seguro, la edad y la puntuacion de la comorbilidad simple. Durante el periodo del estudio, unicamente 118 pacientes hicieron al menos una revisita al SU en el periodo de 14 dias. La frecuencia de pacientes con educacion sanitaria inadecuada que hizo al menos una revisita fue mayor que en aquellos pacientes con educacion sanitaria adecuada a los 14 dias, pero no fue significativamente mayor entre los primeros 3 o 7 dias. Conclusiones En este estudio de un unico centro, se observo una mayor utilizacion del SU por los pacientes con educacion sanitaria inadecuada cuando se comparo con aquellos con educacion sanitaria adecuada. Los pacientes con educacion sanitaria inadecuada hicieron un mayor numero de revisitas a los 14 dias, pero no a los 3 ni a los 7 dias.

Age Differences in Genetic Knowledge, Health Literacy and Causal Beliefs for Health Conditions

Abstract: Objectives: This study examined the levels of genetic knowledge, health literacy and beliefs about causation of health conditions among individuals in different age groups.

Narrative Methods for the Human Sciences

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Impact of Informing Overweight Individuals about the Role of Genetics in Obesity: An Online Experimental Study

Abstract: Background/Aims: Increasing public awareness of obesity genetics could have beneficial or harmful effects on overweight individuals. This study examined the impact of genetic information on weight-related cognitions as well as interest in personalized genetic information about obesity among overweight individuals. Methods: Online survey respondents (n = 655) were randomly assigned to read either genetic, gene-environment, or nongenetic obesity causal information. Fifty-two percent of the participants were female, 82.4% were White, 45% had an annual income of USD Results: Participants in the genetic and gene-environment conditions were more likely to believe genetics increase obesity risk than participants in the nongenetic condition (both p Conclusion: Dissemination of information about obesity genetics may have neither a beneficial nor a harmful impact on how overweight individuals perceive themselves. Some overweight individuals may be interested in receiving personalized genetic information. The actual effects of obesity genetic information being incorporated into public health messages and of personalized genetic information on obesity prevention and treatment interventions remain to be seen.

Neighborhoods, Obesity, and Diabetes — A Randomized Social Experiment

Abstract: ference of 4.61 percentage points (95% confidence interval (CI), −8.54 to −0.69), 3.38 percentage points (95% CI, −6.39 to −0.36), and 4.31 percentage points (95% CI, −7.82 to −0.80), respectively. The differences between the group receiving traditional vouchers and the control group were not significant. CONCLUSIONS The opportunity to move from a neighborhood with a high level of poverty to one with a lower level of poverty was associated with modest but potentially important reductions in the prevalence of extreme obesity and diabetes. The mechanisms under - lying these associations remain unclear but warrant further investigation, given their potential to guide the design of community-level interventions intended to improve health. (Funded by HUD and others.)

A practical guide to the American Community Survey (3-year estimates)

Abstract: Historically, most demographic data for states and substate areas were collected from the long version of the decennial census questionnaire. A “snapshot” of the characteristics of the population on the April 1 census date was available once every 10 years. The long form of the decennial census has been replaced by the American Community Survey (ACS) that has been conducted on an ongoing basis for the entire country since 2005. Instead of a snapshot in which all of the data are gathered at one time, the ACS aggregates data collected over time, making the results more difficult to interpret. However, the ACS data are updated annually.

Cardiovascular Health in African Americans: A Scientific Statement From the American Heart Association

Abstract: Background and Purpose:Population-wide reductions in cardiovascular disease incidence and mortality have not been shared equally by African Americans. The burden of cardiovascular disease in the Af...