S Raquel Ramos

Faculty

S. Raquel Ramos headshot

S Raquel Ramos

FNP-BC MBA MSN PhD

Assistant Professor

1 212 992 5994

433 First Avenue
Room 402
New York, NY 10010
United States

Accepting PhD students

S Raquel Ramos's additional information

S. Raquel Ramos, PhD, MBA, MSN, FNP-BC, is an assistant professor at New York University Rory Meyers College of Nursing. She has over a decade of direct-care experience in various settings, such as intensive care, cardiac cath lab, long-term care, LGBTQ+ community health, and clinical research. Ramos's research examines how user-centered design and technology-enabled interventions can facilitate informed decision-making in sexual minority men of color living with HIV or at risk of HIV. She designs interventions that prioritize health-information needs from the perspectives of patients, providers, and non-clinical personnel. As a nurse investigator, her research falls under the realm of consumer health informatics, specifically focusing on user-centered design, preference, health literacy, and autonomy support as tools for enhancing informed decision-making.

Ramos's earlier work focused on the facilitators and barriers to health information exchange consent. Using a sociotechnical analysis, she found that comprehension was a strong barrier. She also found that patients preferred both human and computer interaction. This highlights the importance of maintaining personal interaction while recognizing the ubiquity of mobile devices used in research. As part of her international work, she traveled to two academic teaching hospitals in Accra and Kumasi, Ghana, to study how literacy and numeracy influenced decision-making in Ghanaian caregivers of children living with HIV. Through the use of formative informatics-based approaches, Ramos found that multiple complexities inherent to cultural norms, gender, and education influenced decision-making.

Ramos has two active grants: an administrative supplement granted by NHLBI's PRogram to Increase Diversity Among Individuals Engaged in Health-Related Research (PRIDE-CVD) and a five-year NIH/NHLBI K01. For her PRIDE-CVD study, Ramos is developing a community engaged intervention mapping protocol for CVD prevention in sexual minority men living with HIV.  In her NHLBI mentored career development award, she will test the feasibility and acceptability of a virtual environment to prevent HIV-related comorbid conditions.

Ramos was a postdoctoral fellow at Yale University. She earned her PhD from Columbia University and her MSN as a family nurse practitioner, MBA in management, and BSN in nursing from Purdue University. 

PhD - Columbia University
MS, Family Nurse Practitioner - Purdue University
MBA, Management - Purdue University
BS, Nursing - Purdue University
AS, Nursing - Ivy Tech State College
Technical Certificate Licensed Practical Nursing - Ivy Tech State College

Informatics
HIV/AIDS
LGBTQ
Technology
Underserved populations
Chronic disease

American Medical Informatics Association (AMIA)
American Nurses Credentialing Center (ANCC)
Association of Nurses in AIDS Care (ANAC)
Eastern Nursing Research Society (ENRS)
National Research Mentoring Network (NRMN)
Sigma Theta Tau International (STTI)

Faculty Honors Awards

PRIDE-CVD Summer Scholar (R25HL105446) (2020-2021) (2021)
HIV Prevention Trials (HPTN) Scholar (UM1AI068619) (2019-2020) (2020)
mHealth Scholar, MD2K Summer Training Institute (U54EB020404) (2019)
40 Under 40 Leader in Minority Health, National Minority Quality Forum (2016)
Visiting Fellow 2016–2019, Research Education Institute for Diverse Scholars (R25MH087217) (2016)
Predoctoral Trainee, Training Nurse Scientists in Interdisciplinary & Translational Research (D09HP14667)
Predoctoral Trainee, Reducing Health Disparities Through Informatics (T32NR007969)
Postdoctoral Trainee, Self and Family Management of Chronic Illness (T32NR008346)

Publications

Nursing Science Throughout the Epidemic: Lessons Learned and the Way Forward

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Purely Behavioral: A Scoping Review of Nonpharmacological Behavioral and Lifestyle Interventions to Prevent Cardiovascular Disease in Persons Living With HIV

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A State of the Science on HIV Prevention Over 40 Years Among Black and Hispanic/Latinx Communities

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Substance Use, General Health and Health Literacy as Predictors of Oral Health in Emerging Adult Sexual Minority Men of Color: A Secondary Data Analysis

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Bringing Research to Life for Undergraduate Nursing Students Using a Design Thinking Model

Seltzer Uribe, J., Boyar, K., & Ramos, S. R. (2020). In K. Rodriguez, K. Boyar, & E. Ea (Eds.), Innovative use of concept care planning in a large class. Innovative strategies in teaching nursing. Springer.

Prototype development, usability, and preference of a culturally-relevant pictorial aid to facilitate comprehension of likert-type levels of agreement in caregivers of children living with HIV in Ghana

Ramos, S. R., Paintsil, E., Ofori-Atta, A., Kusah, J. T., Amissah, K. A., Alhassan, A., Ofori, I. P., & Reynolds, N. R. (2020). CIN - Computers Informatics Nursing, 38(1), 45-52. 10.1097/CIN.0000000000000584
Abstract
Abstract
Pictorial illustrations of Likert-type scales are culturally useful and may reduce error associated with usage of Westernized self-report measures in low- and middle-income countries. Pictorial illustrations can be encounter-specific decision aids in populations with low literacy or English proficiency. In an unanticipated finding from the SANKOFA study, caregivers of children living with human immunodeficiency virus experienced challenges comprehending Likert-type scales. A cross-sectional, qualitative study was conducted with a SANKOFA participant subset (n = 30) in Ghana. Using an informatics-based formative design approach, we developed a culturally-relevant pictorial aid to assess usability and preference when compared to a Likert-type self-report measure. Ninety percent (n = 27) of substudy participants preferred the pictorial of a traditional Bolga basket over a shallow basket. Forty-three percent (n = 13) preferred the pictorial aid over the Likert-type measure. Fifty percent reported the pictorial aid was easy to use. Fifty-seven percent preferred the Likert-type measure, potentially because English proficiency is regarded in Ghana as a means of upward social and financial mobility. Such cultural norms may have contributed to the lack of consensus and must be considered for pictorial aids to be meaningful. Pictorial aids have been designed for use in clinical and research settings. They reduce barriers associated with lower textual literacy while facilitating comprehension and decision-making.

A web-based intervention to reduce decision conflict regarding hiv pre-exposure prophylaxis: Protocol for a clinical trial

Nelson, L. R. E., Ajiboye, W., Djiadeu, P., Odhiambo, A. J., Pedersen, C., Ramos, S. R., Lofters, A., Mbuagbaw, L., & Williams, G. (2020). JMIR Research Protocols, 9(6). 10.2196/15080
Abstract
Abstract
Background: HIV pre-exposure prophylaxis (PrEP) is recommended for populations at high ongoing risk for infection. There are noted racial disparities in the incidence of HIV and other sexually transmitted infections (STIs) for African, Caribbean, and Canadian Black (ACB, black) populations in Ontario, Canada. Although blacks represent only 4.7% of the Ontario population, they account for 30% of HIV prevalence and 25% of new infections in the province. The existing clinical public health practice toolkit has not been sufficient to optimize PrEP uptake, despite the overwhelming evidence of PrEP's efficacy for reducing HIV transmission risk. Since its establishment as an effective HIV prevention tool, the major focus in behavioral research on PrEP has been on understanding and improving adherence. To date, there is no known formalized intervention in place designed to support ACB men and women at high risk of making high-quality decisions regarding the adoption of PrEP as an HIV prevention practice. Objective: We propose 2 aims to address these gaps in HIV prevention and implementation science. First, the Ottawa Decision Support Framework (ODSF) for use in the PrEP decisional needs of black patients was adapted. Second, the decision support intervention to estimate effect size compared with control conditions in reducing decision conflict and predicting adherence over 60 days was pilot tested. Methods: In aim 1, we propose a cross-sectional qualitative descriptive study using data collected from key informant interviews with eligible PrEP patients (n=30) and surveys with health professionals (n=20) involved in HIV PrEP management. Data obtained from aim 1 will be used to develop a decision support intervention based on the ODSF. In aim 2, the adopted decision support intervention using a block-randomized design to estimate effect size compared with control conditions in reducing decision conflict and predicting adherence over 60 days was pilot tested. Hypothesis testing will be de-emphasized in favor of generating effect size estimates. Results: A research award was funded on March 25, 2017 (Multimedia Appendix 1). Ethical approval was received on March 25, 2019 (with supplemental approval received on May 10, 2019). Data collection started on April 9, 2019. As of September 30, 2019, we enrolled 29 patients and 24 health care providers for aim 1. We are currently analysing the data collected for aim 1. Aim 2 is scheduled to start in May 2020. Conclusions: This study will provide evidence-based information on the decisional needs of black patients who are at risk of HIV and have been offered PrEP. The study will also test the effect of decision support intervention in reducing decision conflict, adoption of PrEP, and adherence to PrEP.

A Framework for Using eHealth Interventions to Overcome Medical Mistrust Among Sexual Minority Men of Color Living with Chronic Conditions

Ramos, S. R., Warren, R., Shedlin, M., Melkus, G., Kershaw, T., & Vorderstrasse, A. (2019). Behavioral Medicine, 45(2), 166-176. 10.1080/08964289.2019.1570074
Abstract
Abstract
The purpose of this paper is to present a stepwise, multi-construct, innovative framework that supports the use of eHealth technology to reach sexual minority populations of color to establish trustworthiness and build trust. The salience of eHealth interventions can be leveraged to minimize the existing paradigm of medical mistrust among sexual minority populations of color living with chronic illnesses. These interventions include virtual environments and avatar-led eHealth videos, which address psychosocial and structural-level challenges related to mistrust. Our proposed framework addresses how eHealth interventions enable technology adoption and usage, anonymity, co-presence, self-disclosure, and social support and establish trustworthiness and build trust.

LEveraging A viRtual eNvironment (LEARN) to Enhance Prevention of HIV-related Comorbidities in at-risk Minority MSM (Men who have sex with men)

Ramos, S. R. (2019). Ethnicity and Disease, 29. 10.18865/ed.29.S1.209

Utilization of an animated electronic health video to increase knowledge of post- A nd pre-exposure prophylaxis for HIV among African American Women: Nationwide cross-sectional survey

Bond, K. T., & Ramos, S. R. (2019). JMIR Formative Research, 3(2). 10.2196/formative.9995
Abstract
Abstract
Background: Despite renewed focus on biomedical prevention strategies since the publication of several clinical trials highlighting the efficacy of pre-exposure prophylaxis (PrEP), knowledge of postexposure prophylaxis (PEP) and PrEP continues to remain scarce among women, especially among African American women who are disproportionally affected by HIV. In an effort to address this barrier and encourage uptake of PEP and PrEP, an electronic health (eHealth) video was created using an entertainment-education format. Objective: The study aimed to explore the feasibility, acceptability, and preference of an avatar-led, eHealth video, PEP and PrEP for Women, to increase awareness and knowledge of PEP and PrEP for HIV in a sample of African American women. Methods: A cross-sectional, Web-based study was conducted with 116 African American women aged 18 to 61 years to measure participants' perceived acceptability of the video on a 5-point scale: Poor, fair, good, very good, and excellent. Backward stepwise regression was used to the find the outcome variable of a higher rating of the PEP and PrEP for Women video. Thematic analysis was conducted to explore the reasons for recommending the video to others after watching the eHealth video. Results: Overall, 89% of the participants rated the video as good or higher. A higher rating of the educational video was significantly predicted by: No current use of drugs/alcohol (beta=-.814; P=.004), not having unprotected sex in the last 3 months (beta=-.488; P=.03), higher income (beta=.149; P=.03), lower level of education (beta=-.267; P=.005), and lower exposure to sexual assault since the age of 18 years (beta=-.313; P=.004). After watching the eHealth video, reasons for recommending the video included the video being educational, entertaining, and suitable for women. Conclusions: Utilization of an avatar-led eHealth video fostered education about PEP and PrEP among African American women who have experienced insufficient outreach for biomedical HIV strategies. This approach can be leveraged to increase awareness and usage among African American women.