Ann-Margaret Navarra


Ann-Margaret Navarra headshot

Ann-Margaret Navarra


Associate Professor

1 212 998 9009

NEW YORK, NY 10010
United States

Ann-Margaret Navarra's additional information

Ann-Margaret Navarra is an associate professor at NYU Rory Meyers College of Nursing. Her current research interests include the design and implementation of technology-supported behavioral interventions for improved disease self-management among HIV-infected youth. As an NIH-funded researcher and board-certified pediatric nurse practitioner, her research training includes NIH-funded pre- and post-doctoral fellowships (T-90 & T-32) supported by Columbia University School of Nursing. Navarra has presented at regional and national meetings and published in the Journal of Pediatric Health Care and the Journal of the Association of Nurses in AIDS Care.

Navarra completed a PhD, MPhil, and MS at Columbia University and BS at the College of New Rochelle.

PhD - Columbia University
MPhil - Columbia University
MS - Columbia University
BS - College of New Rochelle

Chronic disease
Underserved populations

American Association of Nurses (ANA)
Eastern Nursing Research Society (ENRS)
Fellow, National Association of Pediatric Nurse Practitioners (NAPNAP)
National Certification Board of Pediatric Nurse Practitioners and Nurses
Sigma Theta Tau International Nursing Honor Society, Alpha Zeta Chapter
Sigma Theta Tau International Nursing Honor Society, Zeta Omega Chapter

Faculty Honors Awards

Alpha Zeta Chapter Award, Sigma Theta Tau (2012)
Student Research Award, Sigma Theta Tau-Alpha Zeta Chapter (2010)
Sigma Theta Tau International Honor Society of Nursing, Alpha Zeta Chapter (2008)
Alumni Scholar, Columbia University (2008)
Scholarship Recipient, Vancouver (1996)
Sigma Theta Tau International Honor Society of Nursing, Zeta Omega Chapter (1988)


Developing and testing a web-based platform for antiretroviral therapy (ART) adherence support among adolescents and young adults (AYA) living with HIV

Dunn Navarra, A. M., Gormley, M., Liang, E., Loughran, C., Vorderstrasse, A., Garcia, D. R., Rosenberg, M. G., Fletcher, J., & Goldsamt, L. A. (2024). PEC Innovation, 4. 10.1016/j.pecinn.2024.100263
Objective: Describe the development and testing of a web-based platform for antiretroviral treatment (ART) adherence support among HIV+ adolescents and young adults (AYA) in a randomized controlled trial (RCT). Methods: A seven-member multi-disciplinary team operationalized the flat, password protected, web-based platform. Manualized protocols guided the objectives and content for each of the eight web-based sessions. Team members evaluated usability and content validity. Client satisfaction and perceived ease of use was evaluated with the first ten HIV+ AYA participants. Results: The web-based platform was developed, evaluated, refined, implemented and pilot tested between September 2020 to April 2022. Usability was rated as high; the evaluation of content validity showed an excellent fit between session content and objectives. HIV+ AYA participants (mean age = 24.2 years) were satisfied with the quality, type, and amount of support/education received, and found the platform easy to use, operate, and navigate. Average time spent per session was 6.5 min. Conclusion: Findings support the usability, validity, acceptability, and feasibility of this web-based platform for ART adherence support among HIV+ AYA. Innovation: Our research and findings are responsive to research gaps and the need for transparency in the methodological development and testing of web-based control arms for ART adherence support among HIV+ AYA.

The development of social capital in a peer-led mHealth cognitive behavioral antiretroviral therapy adherence intervention for HIV + adolescents and young adults

Goldsamt, L. A., Liang, E., Handschuh, C., & Navarra, A. M. (2024). AIDS Care - Psychological and Socio-Medical Aspects of AIDS HIV, 36(4), 425-431. 10.1080/09540121.2023.2262981
Adherence Connection for Counseling, Education, and Support (ACCESS)-I is a peer-led mHealth antiretroviral therapy adherence intervention for adolescents and young adults living with HIV who are in treatment but have detectable viral loads. Participants received five online sessions with peer health coaches who followed a structured intervention manual. Peers maintained intervention fidelity but also engaged in casual discussion that was not directly related to ART adherence or HIV. We conducted a qualitative analysis of the casual interactions that occurred during the ACCESS I intervention. Sessions were transcribed and coded, and these casual interactions were then coded into 10 subcodes to document their content, and also coded for three types of social capital–emotional, informational, and instrumental. Emotional and Informational social capital codes were the most common, while instrumental codes were rare. Activities was the most common topic overall, while encouragement was more common in emotional social capital narratives and personal experience was more common in informational social capital narratives. These casual interactions may strengthen peer-participant relationships, building social capital that could then be used to encourage positive behavior change. Although social capital was not directly measured, these analyses illustrate the value of attending to seemingly casual interactions in peer-led interventions.

HIV Syndemic Factor Associations Among Adolescent Gay and Bisexual Men in the Youth Risk Behavior Survey 2015-2019: A Secondary Data Analysis

Garcia, D. R., Fletcher, J., Goldsamt, L., Bell, D. L., Zheng, Y., & Dunn Navarra, A.-M. (2023). The Journal of the Association of Nurses in AIDS Care : JANAC, 34(5), 440-458. 10.1097/JNC.0000000000000423
This analysis of the Youth Risk Behavior Survey examined HIV syndemic factor associations (substance use, violence, mental health, and HIV risk behaviors) among adolescent gay, bisexual, and other men who have sex with men-a population with the highest prevalence of undiagnosed HIV infections. The representative sample ( n = 644) exhibited low condom use (52%) and HIV testing (21%). Adjusted multivariate logistic regression models showed that Blacks were less likely to report HIV testing (adjusted odds ratio [aOR] = 0.06, 95% confidence interval [CI] [0.01-0.44], p < .01), whereas Hispanics were more likely to report four or more lifetime sexual partners (aOR = 3.75, 95% CI [1.49-9.44], p < .01), compared with Whites. A syndemic of substance use and intimate partner violence (sexual, sexual dating, and/or physical dating violence) was associated with early intercourse, multiple sexual partners, and drugs/alcohol before intercourse. Multiple syndemic factor exposures were associated with additive risk, suggesting multilevel approaches for HIV prevention.

Integrative Review of Methods From Youth Risk Behavior Survey Secondary Data Analyses Examining HIV Syndemic Factors Among Adolescent Gay and Bisexual Men

Garcia, D. R., Fletcher, J., Goldsamt, L., & Dunn Navarra, A. M. (2023). Nursing Research, 72(2), 141-149. 10.1097/NNR.0000000000000632
Background Adolescent gay/bisexual men exhibit the highest prevalence of undiagnosed HIV infections. Ascertaining antecedents of behaviorally acquired HIV infections among adolescent gay/bisexual men can be challenging; however, these challenges can be overcome through the utilization of secondary data, such as the Youth Risk Behavior Survey. Objective Syndemics theory suggests that HIV infections are not a singular phenomenon; instead, many infections occur at the intersection of syndemic factors, such as substance use, violence, and mental health. Our objective is to describe and synthesize research methods of secondary data analyses that examine syndemic factors in relation to HIV risk behavior outcomes among subsamples of adolescent gay/bisexual men. Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsycInfo were systematically searched. Inclusion criteria were (a) peer-reviewed Youth Risk Behavior Survey secondary data analyses conducted in the United States after 1991, (b) subsamples with adolescent gay/bisexual men, (c) one or more syndemic factor(s), and (d) one or more HIV risk behavior outcome(s). We used the National Institutes of Health Quality Assessment Tools for quality appraisal. Results Of 1,036 citations retrieved, nine studies met inclusion criteria. Results included using logistic regression analysis and data from 2015 to 2017 in six studies and underpinnings with minority stress theory in four studies. Eight studies omitted race/ethnicity in subsamples and six grouped lesbians with adolescent gay/bisexual men. Seven studies examined substance use, six examined violence, and five examined mental health. Condom use and number of partners were the most studied HIV risk behavior outcomes in four studies, whereas intercourse in the last 3 months was an outcome in only one study. Protective factors were not present. Conclusion Limitations found the need to highlight better inclusion of race/ethnicity and sexual orientation. Adding contemporary survey items is also necessary, such as nonbinary sex and gender identity, access to HIV prevention (condoms, HIV testing, and preexposure prophylaxis), and experiences with stigma, to elucidate risk behaviors among populations disproportionately affected by HIV infections, including Blacks/African Americans and Hispanics/Latinos.

Lived experiences of maintaining self-identity among persons living with young-onset dementia: A qualitative meta-synthesis

Tang, X., Wang, J., Wu, B., Navarra, A. M., Cui, X., & Wang, J. (2023). Dementia, 22(8), 1776-1798. 10.1177/14713012231193547
Background: The self-identity of persons with young-onset dementia (YOD) is affected by the disease progression. However, the lived experience of maintaining self-identity along the disease trajectory is understudied. This meta-synthesis integrated qualitative data on the challenges, coping strategies, and needs of persons living with YOD and how their experiences affected their self-identity over time. Methods: Four English (PubMed, Scopus, CINAHL, PsycINFO) and two Chinese (CNKI and Wanfang) electronic databases were searched for published literature peer-reviewed from the time of database inception to 2022. We used thematic analysis to extract and synthesize data from the literature concerning the long-term lived experiences of persons living with YOD. Results: A total of five peer-reviewed publications were eligible for inclusion in this meta-synthesis study. We identified four themes: (1) declining cognitive function and a prolonged diagnostic process threaten the self-identity of persons living with YOD, (2) struggling to accept the diagnosis of YOD and maintain self-identity, (3) maintaining self-identity and the normalcy of life through social support and person-centered care, and (4) living with YOD through self-development and self-identity reshaping at a later stage of the disease. Conclusions: Persons living with YOD experience challenges maintaining their self-identity throughout the disease trajectory. These challenges are affected by their cognitive function, experiences of personal and social stigma associated with the disease, perceived social support, and person-centered care. Study findings have implications for developing tailored supportive programs for persons living with YOD at various stages of the disease trajectory.

An Integrative Review of Experiences Parenting Transgender and Gender Diverse Children

Warner, A., Dorsen, C., Navarra, A. M. D., & Cohen, S. (2021). Journal of Family Nursing, 27(4), 304-326. 10.1177/10748407211001559
Transgender and gender diverse (TGD) children face increased behavioral health risks including suicidal behaviors and substance abuse. Parental affirmation is associated with behavioral health outcomes similar to non-TGD peers. This integrative review synthesizes and appraises evidence regarding experiences of parenting a TGD child in the United States or Canada from 2008 to 2018. Most parents across these 15 studies described affirming their child’s gender at time of interview. Parents reported initial interpersonal processes (emotions, concerns, beliefs), sought education (frequently online), and described interactions with family members and professionals that were not always affirming. Parents accessed support groups but described their own well-being as a low priority relative to the child’s needs. Parents’ own needs for well-being may affect the process of parenting a TGD child and should be explored. Future research should address the experiences of non-parent family members and participants from more diverse backgrounds. Nursing education must consistently address gender affirming care.

Recruitment of US Adolescents and Young Adults (AYA) into Human Immunodeficiency Virus (HIV)–Related Behavioral Research Studies: A Scoping Review

Navarra, A. M. D., Handschuh, C., Hroncich, T., Jacobs, S. K., & Goldsamt, L. (2020). Current HIV AIDS Reports, 17(6), 615-631. 10.1007/s11904-020-00530-1
Purpose of Review: The objective of this scoping review was to examine the range of published evidence on recruitment approaches and outcomes of US adolescents and young adults (AYA) ages (18–29 years) into human immunodeficiency virus (HIV)–related behavioral research studies during the past 10 years. Recent Findings: Implementation of effective behavioral research strategies among HIV at-risk and infected AYA is key to ending the HIV epidemic and necessitates successful recruitment strategies. Summary: A comprehensive search was executed across four electronic databases. Of the 1697 identified studies, seven met inclusion criteria with six of these seven directed to HIV prevention. Most studies used online recruitment as part of a hybrid strategy, and combined field-based/in-person and online methods. Recruitment strategies and outcomes, resources and compensation, procedures for consent, and timelines varied among all seven studies. Our results highlight the need for development of recruitment models in alignment with behavioral strategies aimed to treat and prevent HIV among US AYA.

Engaging and Supporting Youth to Promote Adherence Success (EASYPAS): A Cognitive Behavioral Intervention for Youth Living with HIV

Navarra, A. M. D., Ford, H., Cleland, C. M., Liang, E., Rodriguez, K., & Neu, N. (2019). Journal of the Association of Nurses in AIDS Care, 30(3), 372-378. 10.1097/JNC.0000000000000034

Beliefs and perceptions of mentorship among nursing faculty and traditional and accelerated undergraduate nursing students

Navarra, A. M., Stimpfel, A. W., Rodriguez, K., Lim, F., Nelson, N., & Slater, L. Z. (2018). Nurse Education Today, 61, 20-24. 10.1016/j.nedt.2017.10.009
Background In order to meet the demands of a dynamic and complex health care landscape, nursing education must develop and implement programming to produce a highly educated nursing workforce. Interprofessional honors education in nursing with targeted mentorship is one such model. Purpose To describe undergraduate nursing student and faculty perceptions and beliefs of mentorship in the context of interprofessional honors education, and compare and contrast the perceptions and beliefs about mentorship in interprofessional honors education between undergraduate nursing students and faculty. Methods The study used a cross-sectional, descriptive design. Data were collected at an urban university in the northeast US, using a researcher-developed electronic survey. The sample included 24 full-time nursing faculty, and 142 undergraduate nursing students. Results Perceptions and beliefs regarding mentorship in the context of interprofessional honors education were similar for faculty and students, with both ranking mentorship among the most important components of a successful honors program. Conclusions Honors education with a dedicated mentorship component may be implemented to improve the undergraduate education experience, facilitate advanced degree attainment, and develop future nursing leaders.

Faculty and Student Perspectives on Mentorship in a Nursing Honors Program

Nelson, N., Lim, F., Navarra, A. M., Rodriguez, K., Witkoski, A., & Slater, L. Z. (2018). Nursing Education Perspectives, 39(1), 29-31. 10.1097/01.NEP.0000000000000197
Honors programs in nursing can facilitate the professional development of high-achieving students, supporting their lifelong engagement in nursing practice, education, research, and health care policy issues. Strong mentoring relationships are commonly identified as essential to the success of nursing honors programs, but literature on mentoring relationships in an honors context is limited. The purpose of this study was to gain insight into faculty and student expectations for mentorship. Faculty and students shared similar expectations for both the mentor and mentee, highlighting key themes of engagement, facilitation, accountability, and collaboration as necessary for the success of an undergraduate nursing honors program.