Faculty

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Shiela M Strauss

Associate Professor

1 212 998 5280

433 First Avenue
Room 664
New York, NY 10010
United States

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Professional overview

A Principal Investigator since 1999 on grants funded by NIH and private foundations, Dr. Strauss’ research has primarily focused on studying the drug treatment response to the hepatitis C virus, and support for alcohol reduction among HIV positive patients. Dr. Strauss has also applied innovative statistical methodology to examine the validity of self-report of HIV status among out-of-treatment drug users. A more recent focus has involved an examination of the relationship between periodontal disease and diabetes, and the potential of the dental office to serve as a site for diabetes screening.

Education
PhD, 1996, Graduate School and University Center of the City University of New York;
MA, 1972, Lehman College of the City University of New York;
BS, 1967, City College of the City University of New York
Honors and awards
Fulbright Senior Specialist Award: Bringing the hepatitis C research to Israel and the Middle East; (2005)
1996, Dissertation Year Fellowship Award: Graduate School and University Center of the City University of New York; (1996)
Edyth May Sliffe Award for Distinguished High School Mathematics Teaching, Mathematics Association of America; (1989)
Presidential Scholars Program Certificate of Excellence, The White House; (1988)
Election to Phi Beta Kappa (1966)
Specialties
Women's health
Oral-systemic health
Non-communicable disease
Infectious disease
Professional membership
Jewish Diabetes Association;
Phi Beta Kappa
Publications

A novel intraoral diabetes screening approach in periodontal patients: results of a pilot study.

Strauss, S. M., Tuthill, J., Singh, G., Rindskopf, D., Maggiore, J. A., Schoor, R., … Rosedale, M. (2012). Journal of periodontology, 83, 699-706, 10.1902/jop.2011.110386
Abstract

This pilot study examines whether a novel diabetes screening approach using gingival crevicular blood (GCB) could be used to test for hemoglobin A1c (HbA1c) during periodontal visits.

Identifying unaddressed systemic health conditions at dental visits: patients who visited dental practices but not general health care providers in 2008.

Strauss, S. M., Alfano, M. C., Shelley, D., & Fulmer, T. (2012). American journal of public health, 102, 253-5, 10.2105/AJPH.2011.300420
Abstract

We assessed the proportion and characteristics of patients who do not regularly visit general health care providers but do visit dentists and whose unaddressed systemic health conditions could therefore be identified by their dentist. Of the 26.0% of children and 24.1% of adults that did not access general outpatient health care in 2008, 34.7% and 23.1%, respectively, visited a dentist. They varied by census region, family income, and sociodemographics. Dental practices can serve as alternate sites of opportunity to identify health concerns among diverse groups of US patients.

Alcohol Education Provided to Opioid Treatment Program Patients: Results of a Nationwide Survey

Strauss, S.M., Harris, G., Katigbak, C., Rindskopf, D.M., Singh, S., Greenblum, I., … Parrino, M.W. (2010). Journal of Drug Education, 40, 379-393, 10.2190/de.40.4.d

The dental office visit as a potential opportunity for diabetes screening: an analysis using NHANES 2003-2004 data.

Strauss, S. M., Russell, S., Wheeler, A., Norman, R., Borrell, L. N., & Rindskopf, D. (2010). Journal of public health dentistry, 70, 156-62, 10.1111/j.1752-7325.2009.00157.x
Abstract

The bidirectional relationship between periodontitis and diabetes suggests that the dental visit may offer a largely untapped opportunity to screen for undiagnosed diabetes. To better examine this potential opportunity, data from the National Health and Nutrition Examination Survey (NHANES) 2003-2004 were used to determine if a larger proportion of patients with periodontal disease as compared with those without periodontitis would be recommended for screening according to American Diabetes Association (ADA) guidelines. The data were also used to determine whether at-risk individuals with periodontitis visited a dental professional recently, so that they could avail themselves of this opportunity for screening, if offered.

HIV care providers' implementation of routine alcohol reduction support for their patients.

Strauss, S. M., Tiburcio, N. J., Munoz-Plaza, C., Gwadz, M., Lunievicz, J., Osborne, A., … Norman, R. (2009). AIDS patient care and STDs, 23, 211-8, 10.1089/apc.2008.0008
Abstract

Screening and brief intervention (SBI) for alcohol reduction is an important health promoting strategy for patients with HIV, and HIV care providers are optimally situated to support their patients' reduction efforts. We report results from analyses that use data collected from providers (n = 115) in 7 hospital-based HIV care centers in the New York City metropolitan area in 2007 concerning their routine use of 11 alcohol SBI components with their patients. Providers routinely implemented 5 or more of these alcohol SBI components if they (1) had a specific caseload (and were therefore responsible for a smaller number of patients), (2) had greater exposure to information about alcohol's effect on HIV, (3) had been in their present positions for at least 1 year, and (4) had greater self efficacy to support patients' alcohol reduction efforts. Findings suggest the importance of educating all HIV care providers about both the negative impact of excessive alcohol use on patients with HIV and the importance and value of alcohol SBIs. Findings also suggest the value of promoting increased self efficacy for at least some providers in implementing alcohol SBI components, especially through targeted alcohol SBI training.

The potential use of gingival crevicular blood for measuring glucose to screen for diabetes: an examination based on characteristics of the blood collection site.

Strauss, S. M., Wheeler, A. J., Russell, S. L., Brodsky, A., Davidson, R. M., Gluzman, R., … Tzvetkova, K. (2009). Journal of periodontology, 80, 907-14, 10.1902/jop.2009.080542
Abstract

This study examined conditions under which gingival crevicular blood (GCB) could be used to obtain a useful glucose reading to screen for undiagnosed diabetes during routine dental visits.

Using latent class analysis to identify patterns of hepatitis C service provision in drug-free treatment programs in the U.S.

Strauss, S. M., Rindskopf, D. M., Astone-Twerell, J. M., Des Jarlais, D. C., & Hagan, H. (2006). Drug and alcohol dependence, 83, 15-24, 10.1016/j.drugalcdep.2005.10.005
Abstract

Hepatitis C virus (HCV) infection is a global health problem, and in many countries (including the U.S.), illicit drug users constitute the group at greatest risk for contracting and transmitting HCV. Drug treatment programs are therefore unique sites of opportunity for providing medical care and support for many HCV infected individuals. This paper determines subtypes of a large sample of U.S. drug-free treatment programs (N=333) according to services they provide to patients with HCV infection, and examines the organizational and aggregate patient characteristics of programs in these subtypes. A latent class analysis identified four subtypes of HCV service provision: a "Most Comprehensive Services" class (13% of the sample), a "Comprehensive Off-Site Medical Services" class (54%), a "Medical Monitoring Services" class (8%) and a "Minimal Services" class (25%). "Comprehensive" services class programs were less likely to be outpatient and private for profit than those in the other two classes. It is of concern that so many programs belong to the "Minimal Services" class, especially because some of these programs serve many injection drug users. "Minimal Services" class programs in the U.S. need to innovate services so that their HCV infected patients can get the medical and support care they need. Similar analyses in other countries can inform their policy makers about the capacity of their drug treatment programs to provide support to their HCV infected patients.

Residential Substance User Treatment Programs as Venues for HCV Pharmacological Treatment: Client and Staff Perspectives

Strauss, S.M., Astone, J.M., Munoz-Plaza, C., Hagan, H., & Jarlais, D.D. (2005). Substance Use & Misuse, 40, 1811-1829, 10.1080/10826080500261097

A comparison of HCV antibody testing in drug-free and methadone maintenance treatment programs in the United States.

Strauss, S. M., Astone, J. M., Jarlais, D. D., & Hagan, H. (2004). Drug and alcohol dependence, 73, 227-36, 10.1016/j.drugalcdep.2003.08.009
Abstract

Drug treatment programs are uniquely situated to screen patients for antibodies for hepatitis C virus (HCV), an infectious disease that has reached epidemic proportions among drug users. This paper compares the accessibility and patients' use of opportunities for HCV antibody testing in a large sample of methadone and drug-free treatment programs (N=256) in the US, and reports programs' recent changes and future plans concerning it. Results indicate that almost all methadone and about two-thirds of drug-free programs in the sample provided HCV antibody screening to at least some patients in 2001. While about two-thirds of the methadone and close to one-third of the drug-free programs offered this service to all patients, these programs report that only about 3/5 of their patients actually provided specimens for testing for HCV antibodies. Some drug treatment programs were planning to increase the availability and accessibility of HCV antibody screening, but others were planning to cut back on these services, primarily due to limited resources. These results can inform policymakers who advocate for increased HCV antibody screening in drug treatment programs about the current level and future plans for implementing these services, illuminating where resources and motivational efforts need to be targeted.

The content and comprehensiveness of hepatitis C education in methadone maintenance and drug-free treatment units.

Strauss, S. M., Astone, J. M., Hagan, H., & Des Jarlais, D. C. (2004). Journal of urban health : bulletin of the New York Academy of Medicine, 81, 38-47, 10.1093/jurban/jth086
Abstract

Although drug users are at elevated risk for hepatitis C virus (HCV) infection, many are uniformed or misinformed about the virus. Drug treatment programs are uniquely situated to provide comprehensive risk-modifying educational programs for decreasing HCV transmission, a strategy advocated in the most recent National Institutes of Health Consensus Development Conference Statement on the Management of Hepatitis C. Given the large proportion of patients that inject drugs in methadone maintenance treatment programs and the high prevalence of HCV among drug injectors, we compared a nationwide sample (N = 246) of methadone maintenance treatment programs and drug-free programs regarding the content and comprehensiveness of HCV education. All of these programs provide HCV education to at least some of their patients. Results indicated that, compared to drug-free programs, methadone maintenance treatment programs cover a significantly greater number of HCV-related topics, and that a significantly greater proportion of the methadone programs cover specific topics (e.g., how to avoid transmitting HCV, the importance of testing for HCV, treatment options if HCV positive). Of special concern is that fewer than three quarters of the drug-free programs address what to do if co-infected with human immunodeficiency virus (HIV) and HCV and how to maintain health if HCV positive, and only about half of the drug-free and methadone maintenance treatment programs educate HCV-positive patients about the importance of obtaining vaccinations for hepatitis A and B. Drug treatment programs need to educate patients about the proactive steps these individuals can take to deal with HCV, provide critically needed HCV services, and encourage patients to make full use of these services.

A nationwide survey of hepatitis C services provided by drug treatment programs

Strauss, S.M., Falkin, G.P., Vassilev, Z., Des Jarlais, D.C., & Astone, J. (2002). Journal of Substance Abuse Treatment, 22, 55-62, 10.1016/s0740-5472(01)00213-6

Concurrence of drug users' self-report of current HIV status and serotest results.

Strauss, S. M., Rindskopf, D. M., Deren, S., & Falkin, G. P. (2001). Journal of acquired immune deficiency syndromes (1999), 27, 301-7,
Abstract

This study examines the concurrence of drug users' self-reports of current HIV status with serotest results. The analyses are based on data obtained from face-to-face interviews with 7,256 out-of-treatment injection drug and/or crack users in 10 sites that participated in the Cooperative Agreement for AIDS Community-Based Outreach/Intervention Research Program (funded by the U.S. National Institute on Drug Abuse ). Although the degree of concurrence between HIV-negative individuals' self-reports of their current HIV status and their serotest results was high (specificity, 99%), this was not the situation for individuals who tested positive for HIV (sensitivity, 44%).

Modeling Relationships Between Two Categorical Variables When Data Are Missing: Examining Consequences of the Missing Data Mechanism in an HIV Data Set.

Strauss, S. M., Rindskopf, D. M., & Falkin, G. P. (2001). Multivariate behavioral research, 36, 471-500, 10.1207/S15327906MBR3604_01
Abstract

Analysts evaluating the strengths of relationships between variables in behavioral science research must often contend with the problem of missing data. Analyses are typically performed using data for cases that are either complete in all the variables, or assume that the data are missing at random. Often, these approaches yield biased results. Using empirical data, the current work explores the implications and consequences of using various statistical models to describe the association of two variables, one ordinal and one dichotomous, in which data are incomplete for the dichotomous variable. These models explicitly reflect the missing data mechanism; models that hypothesize nonignorable nonresponse are given particular attention. Both the statistical fit and substantive consequences of these models are examined. This new methodological approach to examining nonignorable nonresponse can be applied to many behavioral science data sets containing an ordinal variable.

Barriers and facilitators in implementing "prevention for positives" alcohol-reduction support: the perspectives of directors and providers in hospital-based HIV care centers.

Strauss, S. M., Munoz-Plaza, C. E., Tiburcio, N. J., & Gwadz, M. The Journal of the Association of Nurses in AIDS Care : JANAC, 23, 30-40, 10.1016/j.jana.2011.03.001
Abstract

HIV-infected patients have considerable need for alcohol reduction support, and HIV care providers are strategically placed to implement a "prevention for positives" alcohol-reduction approach through alcohol screening and brief interventions (SBIs). To facilitate this approach, we provided alcohol SBI education and training to HIV care providers in four hospital-based, New York City HIV Care Centers in 2007. Interviews with the medical directors and 14 of the HIV care providers who attended the training identified barriers to implementing alcohol SBIs. These included limited time for alcohol screening, patients' incomplete disclosure of alcohol use, providers' perceptions that alcohol use is not a major problem for their patients, and provider specialization that assigns patients with problematic alcohol use to specifically designated providers. Identified facilitators for alcohol SBI implementation included adequate time to conduct the SBI; availability of information, tools, and key points to emphasize with HIV-infected patients; and use of a brief alcohol screening tool.

Screening patients in busy hospital-based HIV care centers for hazardous and harmful drinking patterns: the identification of an optimal screening tool.

Strauss, S. M., & Rindskopf, D. M. Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002), 8, 347-53, 10.1177/1545109709350509
Abstract

Because many HIV care providers fail to detect patients' hazardous drinking, we examined the potential use of the AUDIT-C, the first 3 of the 10 items comprising the Alcohol Use Disorders Identification Test (AUDIT), to efficiently screen patients for alcohol abuse. To perform this examination, we used Item Response Theory (IRT) involving individual AUDIT items and AUDIT instruments completed by patients (N = 400) at a Designated AIDS Center (DAC) in New York City. At various AUDIT-C cutoff scores, specificities and sensitivities were then examined using the AUDIT as a ''gold standard.'' For cutoff scores on the AUDIT from 4 to 8, cutoff scores on the AUDIT-C of 3 and 4, respectively, resulted in sensitivities between .94-.98 and .81-.89, respectively, and specificities between .82-.91 and .91-1.0, respectively. In busy HIV care centers, the AUDIT-C with cutoff scores of 3 or 4 is a reasonable alternative to the full AUDIT as an alcohol screening instrument.