Faculty

Michele Crespo Fierro headshot

Michele Crespo Fierro

Clinical Assistant Professor

1 212 992 7114

433 First Avenue
Room 451
New York, NY 10010
United States

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Professional overview

Professor Crespo-Fierro has authored articles and publications on the care of people living with HIV/AIDS and the importance of nursing specialization in HIV/AIDS, in addition to developing graduate curricula in HIV care. She is the founding faculty advisor for the student group, Latinos Aspiring To Imagine Nursing Opportunities (LATINOS). She is a doctoral candidate at the Graduate Center, CUNY. Her dissertation study explored the “Cultural Care Needs of Puerto Rican Women Receiving HIV Care from Nurse Practitioners in New York City using the ethnonursing method in collaboration with multidisciplinary HIV/AIDS researchers at the College.

Education

PhD (2018), Graduate Center, City University of New York
MS/MPH (1996), Hunter College, City University of New York
BS (1990), NYU College of Nursing

Honors and awards

STTI Upsilon Research Grant (2014)
Summer Doctoral Dissertation Fellowship, The Center for Puerto Rican Studies at Hunter College, City University of New York (2012)
Doctoral Students Research Grant Program Competition #7, City University of New York, Graduate Center (2012)
National Hispanic Health Student Scholarship, National Hispanic Health Foundation (2011)
Second Place Education Poster Presentation, 35th Annual National Association of Hispanic Nurses Conference (2010)
Dean's Award, NYU College of Nursing (2009)
JANAC Outstanding Clinical Article of the Year, JANAC and Sage Publications, Inc. (1998)
The Dorothy White Leadership Award, Hunter-Bellvue School of Nursing (1996)
Nurse Excellence Award, Visiting Nurse Service of New York (1995)
Founders Day Award, NYU (1990)
University Scholar, NYU (1986)
National Hispanic Merit Scholar (1986)

Specialties

HIV/AIDS
Community/population health
Transcultural care

Professional membership

ACHNE
AHNA
ANA-NY
ANAC
APHA
NAHN
STTI - Upsilon
TCNS

Publications

Publications

Linguistic and cultural adaptation of a computer-based counseling program (CARE+ Spanish) to support HIV treatment adherence and risk reduction for people living with HIV/AIDS: A randomized controlled trial

Kurth, A. E., Chhun, N., Cleland, C. M., -Crespo-Fierro, M., Parés-Avila, J. A., Lizcano, J. A., GNorman, R., Shedlin, M., Johnston, B. E., & Sharp, V. L. (2016). Journal of Medical Internet Research, 18(7). 10.2196/jmir.5830
Abstract
Background: Human immunodeficiency virus (HIV) disease in the United States disproportionately affects minorities, including Latinos. Barriers including language are associated with lower antiretroviral therapy (ART) adherence seen among Latinos, yet ART and interventions for clinic visit adherence are rarely developed or delivered in Spanish. Objective: The aim was to adapt a computer-based counseling tool, demonstrated to reduce HIV-1 viral load and sexual risk transmission in a population of English-speaking adults, for use during routine clinical visits for an HIV-positive Spanish-speaking population (CARE+ Spanish); the Technology Acceptance Model (TAM) was the theoretical framework guiding program development. Methods: A longitudinal randomized controlled trial was conducted from June 4, 2010 to March 29, 2012. Participants were recruited from a comprehensive HIV treatment center comprising three clinics in New York City. Eligibility criteria were (1) adults (age ≥18 years), (2) Latino birth or ancestry, (3) speaks Spanish (mono- or multilingual), and (4) on antiretrovirals. Linear and generalized mixed linear effects models were used to analyze primary outcomes, which included ART adherence, sexual transmission risk behaviors, and HIV-1 viral loads. Exit interviews were offered to purposively selected intervention participants to explore cultural acceptability of the tool among participants, and focus groups explored the acceptability and system efficiency issues among clinic providers, using the TAM framework. Results: A total of 494 Spanish-speaking HIV clinic attendees were enrolled and randomly assigned to the intervention (arm A: n=253) or risk assessment-only control (arm B, n=241) group and followed up at 3-month intervals for one year. Gender distribution was 296 (68.4%) male, 110 (25.4%) female, and 10 (2.3%) transgender. By study end, 433 of 494 (87.7%) participants were retained. Although intervention participants had reduced viral loads, increased ART adherence and decreased sexual transmission risk behaviors over time, these findings were not statistically significant. We also conducted 61 qualitative exit interviews with participants and two focus groups with a total of 16 providers. Conclusions: A computer-based counseling tool grounded in the TAM theoretical model and delivered in Spanish was acceptable and feasible to implement in a high-volume HIV clinic setting. It was able to provide evidence-based, linguistically appropriate ART adherence support without requiring additional staff time, bilingual status, or translation services. We found that language preferences and cultural acceptability of a computer-based counseling tool exist on a continuum in our urban Spanish-speaking population. Theoretical frameworks of technology's usefulness for behavioral modification need further exploration in other languages and cultures.

Supporting breast-feeding when a woman is homelessijnt_1170 103..107

-Crespo-Fierro, M. (2011). International Journal of Nursing Terminologies and Classifications, 22(2), 103-107. 10.1111/j.1744-618X.2010.01170.x
Abstract
PURPOSE. This case study demonstrates use of standardized nursing languages in he care of new mothers in community settings. DATA SOURCES. The author collected data from clinical practice as an instructor in a baccalaureate nursing program and from the research literature. DATA SYNTHESIS. The appropriate nursing diagnoses, outcomes, and interventions were identified in partnership with the new mother. CONCLUSIONS. This case shows that NANDA International (NANDA-I), the Nursing Outcomes Classification (NOC), and the Nursing Interventions Classification (NIC) are useful to direct nursing care in community settings. IMPLICATIONS FOR NURSING. When teaching nursing students in a baccalaureate program, nurse faculty can use NANDA-I, NOC, and NIC classifications to guide the growing practice of nursing students in community settings.

The value of certification in HIV/AIDS nursing.

Reif, M., Berger, B., -Crespo-Fierro, M., Mallinson, R. K., & Miller-Hardwick, C. (2004). The Journal of the Association of Nurses in AIDS Care : JANAC, 15(1), 60-64. 10.1177/1055329003261982

Compliance/adherence and care management in HIV disease

-Crespo-Fierro, M. (1997). The Journal of the Association of Nurses in AIDS Care : JANAC, 8(4), 43-54.
Abstract
With the changing perspectives of the HIV epidemic and the introduction of protease inhibitors to treat human immunodeficiency virus (HIV) disease, the issue of compliance has gained considerable interest among health care providers. The idea that clients with HIV disease should succumb to a patriarchal system of medical care has been challenged by AIDS activists since the beginning of the epidemic. The concept that there is only one explanation for "noncompliance" is outdated. The reasons for noncompliance are multifaceted in nature and include psychosocial factors, complex medication and treatment regimens, ethnocultural concerns, and in many instances substance use. Therefore, the notion that there is one intervention to resolve noncompliance is at best archaic. Interventions to enhance compliance include supervised therapy, improving the nurse-client relationship, and patient education, all of which should be combined with ethnocultural interventions. Plans to enhance compliance must incorporate person-specific variables and should be tailored to individualized needs.

Who says there's nothing we can do?

Schmidt, J., & -Crespo-Fierro, M. (1995). RN, 58(10), 30-35.