Nancy L Van Devanter

Faculty

Nancy L Van Devanter headshot

Nancy L Van Devanter

PhD

Professor Emerita

1 212 998 5328

433 FIRST AVENUE
NEW YORK, NY 10010
United States

Nancy L Van Devanter's additional information

Nancy L. Van Devanter, PhD, is a professor emerita at the Rory Meyers College of Nursing. Since the 1990s, she has conducted behavioral intervention research integrating a community-based participatory research approach into the development and testing of theory-driven interventions to promote health and reduce disease in populations with significant health disparities in HIV, STDs, and tobacco-related disease. She has also worked in close collaboration with state and local health departments to develop programs improve community-level health and public health practice. Since coming to NYU, she has been involved in numerous interdisciplinary collaborative studies with the NYU School of Medicine, Dentistry, and Public Health Program.

She received a PhD from Columbia University School of Public Health, MPH from Harvard School of Public Health, and EdM from Boston University.

 

PhD - Columbia University School of Public Health (1992)
MPH - Harvard School of Public Health (1985)
EdM - Boston University (1975)
BS - Boston University (1974)
Diploma - St Agnes School of Nursing (1964)

HIV/AIDS

American Nurses Association
American Public Health Association
American Sociological Association
Council for the Advancement of Nursing Science
Public Health Association of New York City

Faculty Honors Awards

Fellow, American Academy of Nursing (2011)
Fellow, New York Academy of Medicine (2011)
Fellowship in STD Prevention Association of Teachers of Preventive Medicine, Centers for Disease Control and Prevention (1999)
Public Health Achievement Award, New York City Department of Health/ Mailman School of Public Health, Columbia University (1999)
Commendation, Office the Secretary, US Department of Health and Human Services for contribution to the National AIDS Education Prevention Program (1998)

Publications

Psychological mediating factors in an intervention to promote adolescent health care-seeking

Hogben, M., Ledsky, R., Middlestadt, S., Vandevanter, N., Messeri, P., Merzel, C., Bleakley, A., Malotte, C. K., Sionean, C. K., & St. Lawrence, J. S. (2005). Psychology, Health and Medicine, 10(1), 64-78. 10.1080/13548500512331315370
Abstract
Abstract
Some of the highest rates of curable sexually transmitted diseases in the USA are found among adolescents. Routine, comprehensive health care that includes a sexual history may contribute to alleviating this problem. We designed and ran a three-session small-group workshop for adolescents, using local community organizations as intervention sites, with peers (typically 2-3 years older) helping facilitate the interactive sessions. Outcomes are summarized elsewhere: in this paper, we present an examination of theoretically based psychological mediating factors that we sought to influence during the intervention, Adolescents' health care-seeking beliefs, general attitudes to seeking care, and intentions to do so all changed such that they held more positive beliefs, evaluated health care more favorably, and developed stronger intentions to seek care. Furthermore, relationships among these constructs were strengthened according to theoretical precepts. Adolescents' self-efficacy and their perceptions of social norms pertaining to health care-seeking, however, were unaffected by the intervention. We explored gender differences in mediating factors, finding no interaction, although females did score higher on post-intervention attitude and intention measures.

Attitudinal and contextual factors associated with discussion of sexual issues during adolescent health visits

Merzel, C. R., Vandevanter, N. L., Middlestadt, S., Bleakley, A., Ledsky, R., & Messeri, P. A. (2004). Journal of Adolescent Health, 35(2), 108-115. 10.1016/S1054-139X(03)00394-X
Abstract
Abstract
Purpose To examine attitudinal and contextual factors associated with the occurrence of sexual health assessments during adolescent primary care visits. Methods A total of 313 primarily African-American youth aged 11-21 years from 16 community-based organizations in suburban Maryland and in New York City completed questionnaires focusing on sexually transmitted diseases (STD) and health care. The analysis examined the relationship of sexual activity, attitudes, and presence of the parent at the health care visit with discussion of three sexual health topics and testing for STD at the most recent health care visit. Data were analyzed using Chi-square tests and logistic regression. Results Overall, 74% of respondents reported that they had talked about at least one sexual health topic at their last health care visit but only 32% had discussed all three topics of sexual behavior, birth control, and STD. Females were more likely than males to discuss birth control although there were no gender differences in the overall likelihood of talking about a sexual health topic. Few adolescents initiated discussion of sexual issues. Positive attitudes toward discussing sexual issues with a provider and absence of a parent at the visit were independently associated with higher odds of discussing at least one sexuality topic and STD testing. Conclusions Although relatively large numbers of adolescents in the sample received sexual health assessments, the proportion was below recommended guidelines. The opportunity to speak privately with a clinician and having positive attitudes about discussing sex with a doctor appear to be important influences on the receipt of sexual health assessments. Improving the quality of adolescent preventive care will require creating a health care environment that facilitates discussion of sexual health issues.

Comparison of methods to increase repeat testing in persons treated for gonorrhea and/or chlamydia at public sexually transmitted disease clinics

Malotte, C. K., Ledsky, R., Hogben, M., Larro, M., Middlestadt, S., St. Lawrence, J. S., Olthoff, G., Settlage, R. H., Van Devanter, N. L., Paxton, K., Smith, L. V., Davis, R., Richwald, G. A., Penniman, T. V., Gaines, J., Merzel, C., Messeri, P., Bleakley, A., Weifuse, I., … Pequegnat, W. (2004). Sexually Transmitted Diseases, 31(11), 637-642. 10.1097/01.olq.0000143083.38684.9d
Abstract
Abstract
Background: Retesting 3 to 4 months after treatment for those infected with chlamydia and/or gonorrhea has been recommended. Goal: We compared various methods of encouraging return for retesting 3 months after treatment for chlamydia or gonorrhea. Study: In study 1, participants were randomly assigned to: 1) brief recommendation to return, 2) intervention 1 plus $20 incentive paid at return visit, or 3) intervention 1 plus motivational counseling at the first visit and a phone reminder at 3 months. In study 2, participants at 1 clinic were randomly assigned to 4) intervention 1,5) intervention 1 plus phone reminder, or 6) intervention 1 plus motivational counseling but no telephone reminder. Results: Using multiple logistic regression, the odds ratios for interventions 2 and 3, respectively, compared with intervention 1 were 1.2 (95% confidence interval [CI], 0.6-2.5) and 2.6 (95% CI, 1.3-5.0). The odds ratios for interventions 5 and 6 compared with intervention 4 were 18.1 (95% CI, 1.7-193.5) and 4.6 (95% CI, 0.4-58.0). Conclusions: A monetary incentive did not increase return rates compared with a brief recommendation. A reminder phone call seemed to be the most effective method to increase return.

Computer Access and Internet Use among Urban Youths

Bleakley, A., Merzel, C. R., VanDevanter, N. L., & Messeri, P. (2004). American Journal of Public Health, 94(5), 744-746. 10.2105/AJPH.94.5.744
Abstract
Abstract
This report presents data on computer access, Internet use, and factors associated with health information seeking on the Internet among a sample of youths aged 15 to 30 years in New York City. Findings from street intercept surveys indicate substantial computer access at home (62%) and frequent (everyday or a few times a week) Internet use (66%). Fifty-five percent of the sample reported seeking health information on the Internet, which was associated with positive beliefs about getting a health checkup and frequent Internet use.

Predictors of acceptance of hepatitis B vaccination in an urban sexually transmitted diseases clinic

Samoff, E., Dunn, A., Vandevanter, N., Blank, S., & Weisfuse, I. B. (2004). Sexually Transmitted Diseases, 31(7), 415-420. 10.1097/01.OLQ.0000130533.53987.78
Abstract
Abstract
Background: Individuals who use sexually transmitted disease (STD) clinics are at high risk for hepatitis B virus (HBV). While HBV vaccine is frequently offered to clients in this setting, reported vaccination rates are low. More information is needed about HBV vaccine knowledge, attitudes, beliefs, and behavior among high risk populations. The current study assesses these issues at an urban STD clinic. Methods: A survey assessing knowledge, attitudes, and beliefs concerning HBV vaccine was administered to individuals seeking services at an STD clinic before seeing the physician. Immediately after the clinical visit these individuals were interviewed and asked whether they had accepted vaccination and their reasons for acceptance or rejection. Results: Fifty percent of unvaccinated study subjects elected to receive an HBV vaccine dose at the current visit. Significant predictors in a multiple logistic regression model for choosing to be vaccinated were: having a vaccinated acquaintance, perceived risk of disease, perceived healthfulness of vaccine, and clinician's recommendation. Knowledge regarding hepatitis B risks and outcomes was not related to vaccine choices. Patients expressed concern about vaccine safety and provider motivation. Conclusions: The role of acquaintances and the physician are central to the decision to be vaccinated, as are risk perception and familiarity with the vaccine. Mistrust of the medical establishment and of vaccines is a barrier to acceptance of HBV vaccine.

The Role of Social and Behavioral Science in Public Health Practice: A Study of the New York City Department of Health

VanDevanter, N., Shinn, M., Niang, K. T., Bleakley, A., Perl, S., & Cohen, N. (2003). Journal of Urban Health, 80(4), 625-634. 10.1093/jurban/jtg069
Abstract
Abstract
Studies over the last decade have demonstrated the effectiveness of public health interventions based on social and behavioral science theory for many health problems. Little is known about the extent to which health departments are currently utilizing these theories. This study assesses the application of social and behavioral science to programs in the New York City Department of Health (NYCDOH). Structured open-ended interviews were conducted with executive and program management staff of the health department. Respondents were asked about the application of social and behavioral sciences within their programs, and about the benefits and barriers to increasing the use of such approaches. Themes related to the aims of the study were identified, a detailed coding manual developed, narrative data were coded independently by two investigators (κ .85), and data analyzed. Interviews were conducted with 61 eligible individuals (response rate 88%). The most common applications of social and behavioral science were individual-level behavior change to prevent HIV transmission and community-level interventions utilizing community organizing models and/or media interventions for health promotion and disease prevention. There are generally positive attitudes about the benefits of utilizing these sciences; however, there are also reservations about expanded use because of resource constraints. While NYCDOH has successfully applied social and behavioral sciences in some areas of practice, many areas use them minimally or not at all. Increasing use will require additional resources. Partnerships with academic institutions can bring additional social and behavioral science resources to health departments and benefit researchers understanding of the health department environment.

Use of Social and Behavioral Sciences by Public Health Departments in Major Cities

Shinn, M., VanDevanter, N., Bleakley, A., Niang, K. T., Perl, S., & Cohen, N. L. (2003). Journal of Urban Health, 80(4), 616-624. 10.1093/jurban/jtg068
Abstract
Abstract
Individual behavior and social contexts are critical determinants of health. We surveyed commissioners or their designees in 22 departments of health serving US cities of at least 500,000 people to examine their use of scientific approaches to influence individual behavior and social contexts. Each department used behavioral or social science in its work, but only four departments were judged to have integrated these approaches throughout their operations, using both centralized and decentralized structures. Degree of integration was unrelated to collaboration with universities or communities but was related to use of explicit theories. Behavioral and social sciences were employed most frequently in the areas of HIV/AIDS and maternal and child health and in the service of changing individual behavior rather than larger contexts, although across departments many health problems and approaches were involved. Commissioners generally found the approaches valuable, but articulated barriers to more widespread adoption.

Developing a collaborative community, academic, health department partnership for std prevention: The gonorrhea community action project in harlem

VanDevanter, N., Hennessy, M., Howard, J. M., Bleakley, A., Peake, M., Millet, S., Cohall, A., Levine, D., Weisfuse, I., & Fullilove, R. (2002). Journal of Public Health Management and Practice, 8(6), 62-68. 10.1097/00124784-200211000-00009
Abstract
Abstract
Community interventions are rare in the field of sexually transmitted disease (STD) control and prevention. The goals of the Gonorrhea Community Action Project are to design and implement interventions for the reduction of gonorrhea in high-prevalence areas and to increase the appropriateness and effectiveness of STD care in the participating communities. Key to conducting the formative research and developing the interventions was the creation of a community-academic-health department collaborative partnership. Using a staged model, this article presents a case study of collaboration development in the community of Harlem, New York.

Effect of an STD/HIV behavioral intervention on women's use of the female condom

Van Devanter, N., Gonzales, V., Merzel, C., Parikh, N. S., Celantano, D., & Greenberg, J. (2002). American Journal of Public Health, 92(1), 109-115. 10.2105/AJPH.92.1.109
Abstract
Abstract
Objectives. This study assessed the effectiveness of a sexually transmitted disease (STD)/HIV behavior change intervention in increasing women's use of the female condom. Methods. A total of 604 women at high risk for STDs and HIV in New York City, Baltimore, Md, and Seattle, Wash, enrolled in a randomized controlled trial of a small-group, skills-training intervention that included information and skills training in the use of the female condom. Results. In a logistic regression, the strongest predictors of use were exposure to the intervention (odds ratio [OR] = 5.5; 95% confidence interval [CI] = 2.8, 10.7), intention to use the female condom in the future (OR= 4.5; 95% CI = 2.4, 8.5), having asked a partner to use a condom in the past 30 days (OR= 2.3; 95% CI = 1.3, 3.9), and confidence in asking a partner to use a condom (OR = 1.9; 95% CI= 1.1, 3.5). Conclusions. Clinicians counseling women in the use of the female condom need to provide information, demonstrate its correct use with their clients, and provide an opportunity for their clients to practice skills themselves.

Relation of health literacy to gonorrhoea related care

Fortenberry, J. D., McFarlane, M. M., Hennessy, M., Bull, S. S., Grimley, D. M., St Lawrence, J., Stoner, B. P., & Vandevanter, N. (2001). Sexually Transmitted Infections, 77(3), 206-211. 10.1136/sti.77.3.206
Abstract
Abstract
Objective: To assess the relation between health literacy and receipt of a screening test for gonorrhoea in the past year. Methods: Study design was multisite, cross sectional survey of subjects enrolled from clinics, from community based organisations, and by street intercept. Data were obtained using face to face interview. The dependent variable was self reported receipt of a test for gonorrhoea in the past year. Health literacy was measured by the Rapid Estimate of Adult Literacy in Medicine (REALM), recoded to represent 8th grade or lower reading or 9th grade and higher reading level. Statistical analyses were adjusted to account for selection bias in literacy assessment. Results: 54% of the sample reported at least one gonorrhoea test in the previous year. 65% of the sample read at a 9th grade level or higher. REALM score was moderately correlated with the respondent's years of education. After adjustment for missing REALM data, past suspicion of gonorrhoea, self inspection for gonorrhoea, self efficacy for care seeking, REALM score of 9th grade reading level or higher, and younger age were independently associated with gonorrhoea testing in the previous year. For the average respondent, REALM reading grade level of 9th grade or higher is associated with a 10% increase in the probability of having a gonorrhoea test in the past year. Conclusions: Low literacy appears to pose a barrier to care for sexually transmitted infections such as gonorrhoea.