Faculty

Michele Shedlin headshot

Michele G Shedlin

Professor

1 212 998 5714

433 First Avenue
Room 672
New York, NY 10010
United States

expand all

collapse all

Professional overview

Michele G. Shedlin, PhD, is a Professor in the Meyers College of Nursing and Adjunct Professor in the College of Dentistry, and Visiting Professor at the University of Szeged, Hungary. She is a medical anthropologist with extensive experience in qualitative reproductive health, substance abuse and HIV/AIDS research in Africa, Latin America and the U.S. She has designed and implemented behavioral studies at the community, university and national levels, to inform and evaluate prevention and care. Currently she teaches in the doctoral program and has taught Narrative Medicine in FAS. Dr. Shedlin mentors new researchers with the Center for Drug Use and HIV Research (CDUHR), at the VA and NYU School of Medicine. She is a member of the Meyers Faculty Council, Deputy Director, WHO Collaborating Center in Gerontologic Nursing, and the Provost’s Academic Advisory Committee and Cross University Faculty Forum. She has chaired the Council on Ethics and Professional Responsibility (Meyers and Dentistry) and is on the Advisory Committee of the NYU Center for Bioethics. Her past experience includes heading her own research consulting firm, and as faculty at Columbia University School of Public Health and the University of Texas (Leavell Chair in Nursing and Public Health and Co-Director, NIH Hispanic Health Disparities Research Center).

Education

PhD, 1982, Columbia University School of Arts and Sciences
MPhil, 1982, Columbia University School of Arts and Sciences
MA, 1975, Columbia University School of Arts and Sciences
BS, 1968, Columbia University School of General Studies
1961 & 1962, Universidad Nacional Autónoma de México, Summer Sessions

Honors and awards

Senior Fulbright Scholar (College of Dentistry, University of Szeged, Hungary (2013)
Honorary University Professorship, University of Szeged, Hungary (2013)

Specialties

Global
Immigrants
LGBTQ
Infectious disease
Women's health

Professional membership

Fellow, New York Academy of Medicine
Hungarian American Medical Association of America;American Anthropological Association
Society for Medical Anthropology;Population Association of America
American Public Health Association, Latino Caucus
Editorial Board, Advances in Population AIDS and Anthropology Research Group, Board of Directors, IMIFAP, Mexico
International Editorial Board, Journal of Sexuality Research & Social Policy
Editorial Board, EHQUIDAD: International Journal of Social Sciences and Social Work (Spain)

Publications

Publications

Ceremonial ‘Plant Medicine’ use and its relationship to recreational drug use: an exploratory study

Dorsen, C., Palamar, J., & Shedlin, M. G. (2018). Addiction Research and Theory, 1-8. 10.1080/16066359.2018.1455187
Abstract
Background: The ceremonial use of psychoactive/hallucinogenic plant based drugs, such as ayahuasca, psilocybin and others, is a growing trend in the United States (US) and globally. To date, there has been little research documenting how many people are using psychoactive substances in this context, who the users are, what benefits/risks exist in the use of these drugs and the relationship between ceremonial drug use and recreational drug use. In this paper we describe a cohort of plant medicine facilitators in the US and explore how they differentiate plant medicine use from recreational drug use. Methods: Using modified ethnography, individual interviews were conducted in 2016 with 15 participants who are currently facilitating plant medicine ceremonies in the US. Descriptive content analysis was performed to discover themes and to inform a larger mixed-method study. Results: Ceremonial drug use was seen by participants as a natural healing and treatment modality used in the context of community and ritual. Three main themes were identified relating to participants’ differentiation between ceremonial plant medicine use and recreational drug use: (1) participants see a clear delineation between plant medicine use and recreational drug use; (2) plant medicine is seen as a potential treatment for addiction, but concerns exist regarding potential interference with recovery; and (3) plant medicine use may influence recreational use. Conclusions: More research is needed on who is using plant medicine, motivators for use, perceived and real risks and benefits of plant medicine use and harm reduction techniques regarding safe ingestion.

Knowledge and behaviours related to oral health among underserved older adults

Shedlin, M. G., Birdsall, S. B., & Northridge, M. E. (2018). Gerodontology. 10.1111/ger.12367
Abstract
Objective: To examine the mouth and body knowledge, beliefs and behaviours of Dominican, Puerto Rican and African American older adults, and their relationships to oral and general health and health care. Background: In his seminal framework, Handwerker posited that the norms, attitudes and behaviours related to the experience of disease and treatment reflect where patients live and have lived and are seeking and have sought care, along with their webs of social and health relations. This framework guides the analysis for the present study, wherein qualitative data are used to understand mouth and body knowledge, beliefs and behaviours among racial/ethnic minority older adults, ie, why individuals do what they do and what it means to them. Materials and methods: Focus groups were conducted in Spanish or English with 194 racial/ethnic minority older adults living in northern Manhattan who participated in one of 24 focus group sessions about improving oral health. All groups were digitally audio-recorded, transcribed and translated into English from Spanish, where apt. Analysis involved the classification of evidence from all datasets, organised to identify patterns and relationships. Results: Four themes were manifest in the data regarding cultural understandings of the mouth, the body and health: (a) the ageing mouth and its components; (b) the mouth in relation to the body, health and disease; (c) social meanings of the mouth; and (d) care of the ageing mouth. Conclusion: Underserved older adults from diverse cultural backgrounds understand the importance of their mouths to both their overall health and social lives.

Emergency contraceptive pill users' risk perceptions for sexually transmitted infections and future unintended pregnancy

Hickey, M. T., & Shedlin, M. G. (2017). Journal of the American Association of Nurse Practitioners. 10.1002/2327-6924.12485
Abstract
Background and purpose: The availability of emergency contraception pills (ECP) over the counter (OTC) has the potential to reduce the incidence of unintended pregnancy; however, the increased risk for sexually transmitted infection (STI) acquisition, related to unprotected intercourse, has not been adequately addressed. The purpose of this study is to gain insight into risk perceptions for STIs and subsequent unintended pregnancy in women who have purchased ECP OTC. Methods: Twenty-one women, aged 18-24, attending a private university in an urban setting, who purchased and used ECP OTC participated in 1-h, individual interviews. Conclusions: Narrative, descriptive findings indicated that these women did not consider themselves at risk for STI or unintended pregnancy, despite having used ECP OTC. Pregnancy prevention was paramount for these women, which overshadowed concerns regarding STIs. Implications for practice: Women at risk for unintended consequences of sexual activity are not fully cognizant of those potential outcomes and do not take measures to prevent their occurrence. The availability of ECP OTC offers protection against unintended pregnancy; however, opportunities for health promotion and prevention counseling may be lost.

Recruitment of racial/ethnic minority older adults through community sites for focus group discussions

Northridge, M. E., Shedlin, M., Schrimshaw, E. W., Estrada, I., De La Cruz, L., Peralta, R., Birdsall, S., Metcalf, S. S., Chakraborty, B., & Kunzel, C. (2017). BMC Public Health, 17(1). 10.1186/s12889-017-4482-6
Abstract
Background: Despite a body of evidence on racial/ethnic minority enrollment and retention in research, literature specifically focused on recruiting racially/ethnically diverse older adults for social science studies is limited. There is a need for more rigorous research on methodological issues and the efficacy of recruitment methods. Cultural obstacles to recruitment of racial/ethnic minority older adults include language barriers, lack of cultural sensitivity of target communities on the part of researchers, and culturally inappropriate assessment tools. Methods: Guided by the Consolidated Framework for Implementation Research (CFIR), this study critically appraised the recruitment of racial/ethnic minority older adults for focus groups. The initial approach involved using the physical and social infrastructure of the ElderSmile network, a community-based initiative to promote oral and general health and conduct health screenings in places where older adults gather, to recruit racial/ethnic minority adults for a social science component of an interdisciplinary initiative. The process involved planning a recruitment strategy, engaging the individuals involved in its implementation (opinion leaders in senior centers, program staff as implementation leaders, senior community-based colleagues as champions, and motivated center directors as change agents), executing the recruitment plan, and reflecting on the process of implementation. Results: While the recruitment phase of the study was delayed by 6 months to allow for ongoing recruitment and filling of focus group slots, the flexibility of the recruitment plan, the expertise of the research team members, the perseverance of the recruitment staff, and the cultivation of change agents ultimately resulted in meeting the study targets for enrollment in terms of both numbers of focus group discussions (n = 24) and numbers of participants (n = 194). Conclusions: This study adds to the literature in two important ways. First, we leveraged the social and physical infrastructure of an existing program to recruit participants through community sites where older adults gather. Second, we used the CFIR to guide the appraisal of the recruitment process, which underscored important considerations for both reaching and engaging this underserved population. This was especially true in terms of understanding the disparate roles of the individuals involved in implementing and facilitating the recruitment plan.

Feasibility and acceptability of an audio computer-assisted self-interview version of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in primary care patients

Spear, S. E., Shedlin, M., Gilberti, B., Fiellin, M., & McNeely, J. (2016). Substance Abuse : Official Publication of the Association for Medical Education and Research in Substance Abuse, 37(2), 299-305. 10.1080/08897077.2015.1062460
Abstract
Background: This study explores the feasibility and acceptability of a computer self-administered approach to substance use screening from the perspective of primary care patients. Methods: Forty-eight patients from a large safety net hospital in New York City completed an audio computer-assisted self-interview (ACASI) version of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and a qualitative interview to assess feasibility and acceptability, comprehension, comfort with screening questions, and preferences for screening mode (interviewer or computer). Qualitative data analysis organized the participants' feedback into major themes. Results: Participants overwhelmingly reported being comfortable with the ACASI ASSIST. Mean administration time was 5.2 minutes (range: 1.6–14.8 minutes). The major themes from the qualitative interviews were (1) ACASI ASSIST is feasible and acceptable to patients, (2) Social stigma around substance use is a barrier to patient disclosure, and (3) ACASI screening should not preclude personal interaction with providers. Conclusions: The ACASI ASSIST is an appropriate and feasible approach to substance use screening in primary care. Because of the highly sensitive nature of substance use, screening tools must explain the purpose of screening, assure patients that their privacy is protected, and inform patients of the opportunity to discuss their screening results with their provider.

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. G., 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.

A qualitative study to understand guideline-discordant use of imaging to stage incident prostate cancer

Makarov, D. V., Sedlander, E., Braithwaite, R. S., Sherman, S. E., Zeliadt, S., Gross, C. P., Curnyn, C., & Shedlin, M. (2016). Implementation Science, 11(1). 10.1186/s13012-016-0484-5
Abstract
Background: Approximately half of veterans with low-risk prostate cancer receive guideline-discordant imaging. Our objective was to identify and describe (1) physician knowledge, attitudes, and practices related to the use of imaging to stage prostate cancer, (2) patient attitudes and behaviors related to use of imaging, and (3) to compare responses across three VA medical centers (VAMCs). Methods: A qualitative approach was used to explore patient and provider knowledge and behaviors relating to the use of imaging. We conducted 39 semi-structured interviews total-including 22 interviews with patients with newly diagnosed with prostate cancer and 17 interviews with physicians caring for them-between September 2014 and July 2015 at three VAMCs representing a spectrum of inappropriate imaging rates. After core theoretical concepts were identified, the Theoretical Domains Framework (TDF) was selected to explore linkages between themes within the dataset and existing domains within the framework. Interviews were audio-recorded, transcribed verbatim, and then coded and analyzed using Nvivo software. Results: Themes from patient interviews were categorized within four TDF domains. Patients reported little interest in staging as compared to disease treatment (goals), and many could not remember if they had imaging at all (knowledge). Patients tended to trust their doctor to make decisions about appropriate tests (beliefs about capabilities). Some patients expressed a minor concern for radiation exposure, but anxiety about cancer outcomes outweighed these fears (emotion). Themes from physician interviews were categorized within five TDF domains. Most physicians self-reported that they know and trust imaging guidelines (knowledge) yet some were still likely to follow their own intuition, whether due to clinical suspicion or years of experience (beliefs about capabilities). Additionally, physicians reported that medico-legal concerns, fear of missing associated diagnoses (beliefs about consequences), influence from colleagues who image frequently (social influences), and the facility where they practice influences rates of imaging (environmental context). Conclusions: Interviews with patients and physicians suggest that physicians are the primary (and in some cases only) decision-makers regarding staging imaging for prostate cancer. This finding suggests a physician-targeted intervention may be the most effective strategy to improve guideline-concordant prostate cancer imaging.

Lessons learned

Kurth, A., Squires, A., Shedlin, M., & Kiarie, J. (2015). In Global health nursing in the 21st century: Interdisciplinary collaborations in global health research (pp. 547-563).

Ethics-in-the-Round: A guided peer approach for addressing ethical issues confronting nursing students

Katherine Hutchinson, M., Shedlin, M. G., Gallo, B., -Krainovich-Miller, B., & Fulmer, T. (2014). Nursing Education Perspectives, 35(1), 58-60.

In our country tortilla doesn’t make us fat: Cultural factors influencing lifestyle goal-setting for overweight and Obese Urban, Latina patients

Jay, M., Gutnick, D., Squires, A., Tagliaferro, B., Gerchow, L., Savarimuthu, S., Chintapalli, S., Shedlin, M. G., & Kalet, A. (2014). Journal of Health Care for the Poor and Underserved, 25(4), 1603-1622. 10.1353/hpu.2014.0165
Abstract
Obesity disproportionately affects Latina adults, and goal-setting is a technique often used to promote lifestyle behavior change and weight loss. To explore the meanings and dimensions of goal-setting in immigrant Latinas, we conducted four focus groups arranged by language ability and country of origin in an urban, public, primary care clinic. We used a narrative analytic approach to identify the following themes: the immigrant experience, family dynamics, and health care. Support was a common sub-theme that threaded throughout, with participants relying on the immigrant community, family, and the health care system to support their goals. Participants derived satisfaction from setting and achieving goals and emphasized personal willpower as crucial for success. These findings should inform future research on how goal-setting can be used to foster lifestyle behavior change and illustrate the importance of exploring the needs of Latino sub-groups in order to improve lifestyle behaviors in diverse Latino populations.