Short online conferences at CUNY

Epidemiology and Biostatistics Forum: 10/21/20

Overview

  • Keynote: Professor Miguel Hernan
  • Speaker 1: Rebecca Zimba
  • Speaker 2: Elle Anastasiou
  • Speaker 3: Katharine J McCarthy
  • Networking

Conference Summary

The SPH Epi/Bios Conference is a forum for students, staff, alumni, faculty, and other interested attendees to learn about recent research in the CUNY community, talk to representatives of the department, school, and related institutes, and meet each other in random 1:1 networking using a full online conference platform. Make sure to register below, and contact us if you’re interested in organizing, contributing, or doing peer review for future events.

 

Agenda

 

 3:30 -4:00                             Sign-on and early bird networking: random 1:1 meetings with an open Welcome room.
 4:00 – 4:40 Keynote: If Not Us, Who? When researchers become activists, or vice versa, Professor Miguel Hernan, Harvard TH Chan School of Public Health, visiting professor CUNY SPH
 4:40 – 5:00 1:1 networking and breakout rooms
 5:00 – 5:10 Speaker #1: Testing, Testing: What SARS-CoV-2 testing services do adults in the United States actually want? Rebecca Zimba, CUNY SPH, CUNY ISPH research staff
 5:10 – 5:20 Speaker #2: The relationship between hormonal contraception and progression of HPV to cervical dysplasia and/or cervical cancer: a systematic review. Elle Anastasiou, CUNY SPH PhD student
 5:20 – 5:30 Speaker #3: The development of adolescent agency and implications for reproductive choice among girls in Zambia. Katharine J McCarthy, Mount Sinai, CUNY SPH alumna
 5:30 – 5:40 Questions
 5:40 – 6:00 1:1 networking and breakout rooms

 

 

Program Details

If Not Us, Who? When researchers become activists, or vice versa

Researchers face a conundrum when deciding how much to promote their own research findings. On the one hand, who else could do it better? On the other hand, who else is more conflicted? This talk explores the sources and consequences of (non-financial) conflicts of interest in research. To fix ideas, the session is organized around a case study of the effects of economic sanctions on child health. The lessons learned from this case study are readily applicable by any researcher interested in avoiding conflicts of interest.

Miguel Hernán  is the Kolokotrones Professor of Biostatistics and Epidemiology at the Harvard TH Chan School of Public Health and author of the popular textbook Causal Inference: What If. Boca Raton: Chapman & Hall/CRC. Dr. Hernán is currently a visiting professor at the CUNY SPH. 

Testing, Testing: What SARS-CoV-2 testing services do adults in the United States actually want?

Rebecca Zimba, Sarah Kulkarni, Amanda Berry, William You, Chloe Mirzayi, Drew A Westmoreland, Angela Parcesepe, Levi Waldron, Madhura Rane, Shivani Kochhar, McKaylee Robertson, Andrew Maroko, Christian Grov, Denis Nash

Importance: Ascertaining preferences for SARS-CoV-2 testing and incorporating findings into the design and implementation of strategies for delivering testing services may enhance testing uptake and engagement, a prerequisite to reducing onward transmission.

Objective: To determine important drivers of decisions to obtain a SARS-CoV-2 test in the context of increasing community transmission.

Design: A discrete choice experiment (DCE) was used to assess the relative importance of type of SARS-CoV-2 test, specimen type, testing venue, and results turnaround time. Uptake of an optimized testing scenario was simulated relative to the current typical testing scenario of polymerase chain reaction (PCR) via nasopharyngeal (NP) swab in a provider office or urgent care clinic with results in >5 days.

Setting:​ Online survey, embedded in an existing cohort study, conducted during July 30 – September 8, 2020. Participants: ​Participants (n=4,793) were enrolled in the CHASING COVID Cohort Study, a national longitudinal cohort of adults >18 years residing in the 50 US states, Washington, DC, Puerto Rico, or Guam.

Main Outcome(s) and Measure(s): Relative importance of SARS-CoV-2 testing method attributes, utilities of specific attribute levels, and probability of choosing a testing scenario based on preferences estimated from the DCE, the current typical testing option, or choosing not to test.

Results: ​Turnaround time for test results had the highest relative importance (30.4%), followed by test type (28.3%), specimen type (26.2%), and venue (15.0%). Participants preferred fast results on both past and current infection and using a noninvasive specimen, preferably collected at home. Simulations suggested that providing immediate or same day test results, providing both PCR and serology, or collecting oral specimens would substantially increase testing uptake over the current typical testing option. Simulated uptake of a hypothetical testing scenario of PCR and serology via a saliva sample at a pharmacy with same day results was 97.7%, compared to 0.6% for the current typical testing scenario, with 1.8% opting for no test.

Conclusions and Relevance: ​Testing strategies that offer both PCR and serology with non-invasive methods and rapid turnaround time would likely have the most uptake and engagement among residents in communities with increasing community transmission of SARS-CoV-2.

Rebecca Zimba is a Project Associate at CUNY ISPH. She has worked as an epidemiologist at the New York City Department of Health and Mental Hygiene, and as a data analyst in hospital settings for risk management, physician peer review, infection control, and compliance. Rebecca earned her MHS in Infectious Disease Epidemiology from the Johns Hopkins Bloomberg School of Public Health and is applying to PhD programs for Fall 2021

The relationship between hormonal contraception and progression of HPV to cervical dysplasia and/or cervical cancer: a systematic review

Elle Anastasiou, Katharine McCarthy, Erica Gollub, Lauren Ralph, Janneke van de Wijgert, Heidi Jones

Background: Studies on the effect of long-term use of oral contraceptives (OCs) on cervical dysplasia and/or cancer risk have been inconsistent, with some showing increased risk. Less is known about the effects of other forms of hormonal contraception (HC).

Objective: We conducted a systematic review of studies published between January 2000 and February 2020 to examine the relationship between HC use and progression of HPV to cervical intraepithelial neoplasia (CIN) 2/3 and/or cancer (Prospero #CRD42019130725).

Methods: We searched PubMed and EMBASE to identify prospective studies comparing rates of progression between women using HC versus non-hormonal methods or no contraceptive method.

Results: Only five of 14 eligible studies differentiated between types of HC and timing/duration of use. All five studies explored the relationship between OC use and progression to CIN 2/3+: two found an increased association with progression to CIN2/3+, one found a decreased association with progression to CIN3+, and two found no associations. One study that also included injectable progestin-only contraception (DMPA) found an increased risk of progression to CIN3 among current users. One study that also included Norplant found no association with progression to CIN 2/3+. Two studies included intrauterine device (IUD) use but did not differentiate between hormonal and copper IUDs.

Conclusion: The current evidence is limited due to inadequate exposure assessments in most studies. When exposure assessments were adequate, findings were inconsistent. Future studies should differentiate between different HC methods and assess HC use as a time-varying exposure.

Elle Anastasiou recently graduated from CUNY SPH this past May 2020, earning her MPH in Epidemiology and Biostatistics, with a specialization in Maternal, Child, Sexual and Reproductive Health. She will be continuing her studies at CUNY SPH in the doctoral program for Epidemiology beginning this Spring 2021. Concurrent to earning her MPH, Elle also works as a Data Analyst at NYU School of Medicine, Department of Population Health, focusing on research around housing and health, and substance use. For her Master’s thesis, Elle worked with Dr. Heidi Jones on a Systematic Review examining the Relationship between Hormonal Contraception and the progression of HPV to cervical dysplasia/cervical cancer.

 

The development of adolescent agency and implications for reproductive choice among girls in Zambia

Katharine J McCarthy*, Heidi E Jones

*Blavatnik Family Women’s Health Research Institute, Ichan School of Medicine at Mount Sinai

Background: The agency to decide one’s reproductive future is of paramount importance, yet an estimated 80 percent of unmarried adolescent girls in Zambia who have begun childbearing report experiencing mistimed or unwanted pregnancy. This study uses longitudinal data from the Adolescent Girls Empowerment Program (AGEP) in Zambia to characterize an empirical representation of agency and to investigate the relationship between agency and early and unwanted pregnancy and childbearing.

Methods: Using latent transition analysis, we characterized a multi-dimensional profile of adolescent agency annually over a four-year period across adolescence (N= 2701 ages 10-14, N=2534 ages 15-19 at baseline). We investigated the influence of early life access to resources as well as time-varying predictors (e.g., school retention, intimate partner violence, early marriage and early or unwanted pregnancy and childbearing) on agency profile membership as well as transitions in agency status over time. Finally, we examined the association between agency profile and the observed proportion of early and unwanted reproductive health events by time four (endline) to provide insight into the directionality of the relationship between agency status and adolescent fertility outcomes.

Results: A four-status agency profile was identified; however, the structure and prevalence of agency profiles differed by age cohort (10-14 years vs. 15-19 years). Three profiles had similar interpretation in both age cohorts but differed in baseline prevalence: Low-moderate agency (23% younger girls; 33% older girls), Self-assured gender conformers (15% younger girls; 19% older girls), and High agency (34% girls younger, 27% older girls). Unique to younger girls was the Gender conscious, low belief in abilities (29%) status, while among older girls was the Self-assured selective gender conscious (21%) status. While younger girls were most likely to transition to the highest agency status over time, high agency membership was substantially lower among older girls at the same time interval (48% vs. 23% at time 4). In general, early life resources were likely to augment agency while exposure to negative time-varying events such as early marriage, violence and early/unwanted pregnancy reduced the probability of high agency status. Findings support the protective influence of high agency status on early/unwanted reproductive events, while girls who expressed high self-efficacy but gender-conforming values were most at risk of early marriage and unwanted/mistimed pregnancy.

Conclusions: Results support the multidimensional and dynamic nature of agency but also show agency status is less mutable with increasing age. We describe the role of agency in early and unwanted reproductive health events during adolescence and inform strategies for intervention. Strategies to limit exposure to harmful life events early in adolescence may guard against losses to agency which contribute to unwanted fertility outcomes.

Kate McCarthy completed her PhD in Epidemiology at CUNY in May of this year. Her dissertation research focused on adolescent agency and reproductive choice, some of which she will be speaking about today. Most recently, Kate was a Staff Associate at the Population Council in New York where she worked on research regarding measuring quality of maternal and newborn care in developing country settings. She is now a post doctoral fellow at the Blatnavik Women’s Health Research Institute at Mount Sinai School of Medicine where she is focused on studying biomarkers of type II diabetes in pregnant women as well as the influence of the Covid-pandemic on birth experiences and postpartum outcomes.

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