Ralph DiClemente
· Professor of Social and Behavioral SciencesNew York University · Department of Social and Behavioral Sciences
Active 2019–2024
About
Dr. Ralph DiClemente is a Health Psychologist trained at the University of California, San Francisco, where he received his PhD in 1984, following his ScM at Harvard School of Public Health. His undergraduate degree was earned at the City University of New York. His research focuses on developing interventions to reduce the risk of HIV/STD among vulnerable populations, enhancing vaccine uptake among high-risk adolescents and women, and implementing science interventions to improve the adoption and sustainability of HIV/STD prevention programs in community settings. Additionally, he develops diabetes screening and behavior change interventions aimed at identifying undiagnosed cases and reducing diabetes risk among vulnerable groups. Dr. DiClemente emphasizes blending community and technology-based approaches to optimize program effectiveness and sustainability. He has authored numerous evidence-based interventions, peer-reviewed publications, book chapters, and books, contributing significantly to public health knowledge and practice.
Research topics
- Medicine
- Psychology
- Sociology
- Political Science
- Gerontology
- Environmental health
- Family medicine
- Developmental psychology
- Social psychology
- Demography
- Immunology
Selected publications
Adolescent Health Medicine and Therapeutics · 2024 · 27 citations
Senior authorCorresponding- Medicine
- Environmental health
- Family medicine
Background: Lower- and middle-income countries (LMICs) are disproportionately impacted by human papillomavirus (HPV) and would benefit from implementing the HPV vaccine. In the context of competing health priorities, utilizing scarce domestic infrastructure and human resources for HPV vaccination remains challenging for many LMICs. Given the high benefits of the HPV vaccine, the World Health Organization (WHO) is now encouraging for all countries, particularly LMICs, to introduce HPV vaccines into their routine immunization programs. Understanding the barriers and facilitators to HPV adolescent vaccine programs in LMICs may help strengthen how LMICs implement HPV vaccine programs, in turn, increasing HPV vaccine acceptance, uptake, and coverage. Objective: To identify and assess barriers and facilitators to implementing adolescent HPV vaccination programs in LMICs. Methods: This study comprised a review of literature assessing adolescent HPV vaccination in LMICs published after 2020 from a sociocultural perspective. Results: Overall, the findings showed that LMICs should prioritize increasing HPV vaccine availability and HPV vaccine knowledge, particularly focusing on cancer prevention, as knowledge reduces misinformation and increases vaccine acceptance. Evidence suggests that factors promoting HPV vaccine uptake include fostering low vaccine hesitancy, integrating HPV vaccination as a primary school routine vaccination, and vaccinating both genders. A one-dose HPV vaccine may enable many LMICs to increase vaccine acceptance, uptake, and coverage while controlling financial, infrastructure, and human resource costs. Conclusion: As HPV is one of the leading causes of death in many LMICs, implementing the HPV vaccine may be highly beneficial. Cohesive national HPV vaccine buy-in and understanding the success and challenges of prior LMIC HPV vaccine implementation is crucial to developing effective, efficient, and sustainable HPV vaccination programs.
Current Developments in Nutrition · 2022 · 2 citations
Senior authorCorresponding- Psychology
- Developmental psychology
- Gerontology
Asian Americans (AAs) experience a complex and growing non-communicable disease burden linked with dietary behaviors. Dietary norms, which significantly contribute to eating behaviors, face a complex set of Western and Asian socio-ecological influences in AA communities. However, little is known of how dietary norms (such as definitions of a “healthy diet”) are transmitted, intersect, and differ in a multigenerational family environment. AA young adults and family members were recruited to participate in dyadic, 60-minute Zoom interviews (Jun - Dec 2021). Young adults and family members were interviewed separately on their respective eating behaviors, including perceived definition of a healthy diet. Recordings were inductively analyzed to identify themes related to different facets of a conceptualized healthy diet. A total of 41 AAs were interviewed (76% female, 61% US-born, age 19–69), including 20 young adults and 21 family members (10 parents, 9 siblings, 2 cousins). Diet healthfulness was defined in three dimensions: types of food, cooking methods, and intersection of diet with holistic wellbeing. Young adults consistently emphasized the role of their parents in shaping their idea of a healthy diet, particularly Asian-specific conceptualizations of balance (e.g., “yeet hay”). However, while these ideas were particularly influential among older participants, younger participants also emphasized the intersection of diet with emotional and spiritual well-being. Both stressed cooking methods as indicators of healthfulness. While a “healthy diet” was conceptualized through intake of food groups such as fruits, vegetables, and proteins, foreign-born and older participants put a larger emphasis on dietary restrictions (e.g., completely cutting out food groups, such as fast food), while US-born and younger participants stressed enjoying foods in moderation. The differential understanding and impact of AA norms related to diet healthfulness highlights the need for a disaggregated understanding of dietary attitudes and behaviors in health-based interventions for AAs of different generations, particularly family-based programs. Findings call for future mixed-methods research to explore the complex dietary norms identified. South Asian Health and Research Group (SAHARA).
Current Developments in Nutrition · 2022
Senior authorCorresponding- Sociology
- Political Science
- Demography
South Asians comprise most of the United Arab Emirates (UAE) population and face a complex non-communicable disease (NCD) burden linked with dietary behaviors. While past research has focused on disease risk factors of first-generation migrant workers, little is known on the dietary behaviors of the South Asians born or socialized within the UAE, who similarly face a growing NCD burden yet a distinct set of social forces relevant to health. 18–25-year-old UAE-based South Asians who spent at least 10 years of their life in the country were recruited via social media to participate in a mixed methods study. Participants first completed a survey to identify and rank factors contributing to their diet, including the strength (from 1 to 10) of the connection between different factors in jointly influencing eating behaviors. Descriptive and social network analysis (SNA) methods were used to analyze the factor data; all participants with contact details were invited for interviews to disentangle and interpret quantitative findings (analyzed using rapid qualitative analysis). A total of 150 young UAE-based South Asians completed the survey (mean age 20.8, 78% female, 48% born in the UAE). Drivers with the highest overall and rank-adjusted saliency were family (130; 90.5), taste (120; 80.3), and cost (109; 65.8). Strong connections were made between ease of preparation and religion (10.0) as well as mood and culture (10.0) as diet-contributing factors. SNA revealed family to consistently be the most central factor (degree: 28, betweenness: 37.2, closeness: 0.03), followed by taste and cost. Of the 71 participants who provided contact details, 11 agreed to be interviewed. Participants interpreted the saliency of family in diet and health to reflect the disconnect experienced by the South Asian community with other facets of UAE society and noted school environment to be a particularly influential yet less prominent factor in the quantitative data. Findings provide specific, actionable considerations in the development of nutritional interventions tailored to the underserved, understudied population of South Asians socialized within the UAE, and pathways for further research to better understand these interconnected contributors to diet. The NYU South Asian Health and Research Group (SAHARA).
Preventive Medicine · 2021 · 200 citations
- Medicine
- Psychiatry
- Demography
Alcoholism Clinical and Experimental Research · 2021 · 79 citations
- Medicine
- Internal medicine
- Environmental health
BACKGROUND: Objective measurement of alcohol consumption is important for clinical care and research. Adjusting for self-reported alcohol use, we conducted an individual participant data (IPD) meta-analysis to examine factors associated with the sensitivity of phosphatidylethanol (PEth), an alcohol metabolite, among persons self-reporting unhealthy alcohol consumption. METHODS: We identified 21 eligible studies and obtained 4073 observations from 3085 participants with Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) positive scores (≥3 for women and ≥4 for men) and PEth measurements. We conducted 1-step IPD meta-analysis using mixed effects models with random intercepts for study site. We examined the associations between demographic (sex, race/ethnicity, and age) and biologic (body mass index-BMI, hemoglobin, HIV status, liver fibrosis, and venous versus finger-prick blood collection) variables with PEth sensitivity (PEth≥8 ng/ml), adjusting for the level of self-reported alcohol use using the AUDIT-C score. RESULTS: One third (31%) of participants were women, 32% were African, 28% African American, 28% White, and 12% other race/ethnicity. PEth sensitivity (i.e., ≥8 ng/ml) was 81.8%. After adjusting for AUDIT-C, we found no associations of sex, age, race/ethnicity, or method of blood collection with PEth sensitivity. In models that additionally included biologic variables, those with higher hemoglobin and indeterminate and advanced liver fibrosis had significantly higher odds of PEth sensitivity; those with higher BMI and those living with HIV had significantly lower odds of PEth sensitivity. African Americans and Africans had higher odds of PEth sensitivity than whites in models that included biologic variables. CONCLUSIONS: Among people reporting unhealthy alcohol use, several biological factors (hemoglobin, BMI, liver fibrosis, and HIV status) were associated with PEth sensitivity. Race/ethnicity was associated with PEth sensitivity in some models but age, sex, and method of blood collection were not. Clinicians should be aware of these factors, and researchers should consider adjusting analyses for these characteristics where possible.
BMC Medical Research Methodology · 2020 · 257 citations
- Political Science
- Sociology
- Social Science
BACKGROUND: The COVID-19 pandemic has evolved into one of the most impactful health crises in modern history, compelling researchers to explore innovative ways to efficiently collect public health data in a timely manner. Social media platforms have been explored as a research recruitment tool in other settings; however, their feasibility for collecting representative survey data during infectious disease epidemics remain unexplored. OBJECTIVES: This study has two aims 1) describe the methodology used to recruit a nationwide sample of adults residing in the United States (U.S.) to participate in a survey on COVID-19 knowledge, beliefs, and practices, and 2) outline the preliminary findings related to recruitment, challenges using social media as a recruitment platform, and strategies used to address these challenges. METHODS: An original web-based survey informed by evidence from past literature and validated scales was developed. A Facebook advertisement campaign was used to disseminate the link to an online Qualtrics survey between March 20-30, 2020. Two supplementary male-only and racial minority- targeted advertisements were created on the sixth and tenth day of recruitment, respectively, to address issues of disproportionate female- and White-oriented gender- and ethnic-skewing observed in the advertisement's reach and response trends. RESULTS: In total, 6602 participant responses were recorded with representation from all U.S. 50 states, the District of Columbia, and Puerto Rico. The advertisements cumulatively reached 236,017 individuals and resulted in 9609 clicks (4.07% reach). Total cost of the advertisement was $906, resulting in costs of $0.09 per click and $0.18 per full response (completed surveys). Implementation of the male-only advertisement improved the cumulative percentage of male respondents from approximately 20 to 40%. CONCLUSIONS: The social media advertisement campaign was an effective and efficient strategy to collect large scale, nationwide data on COVID-19 within a short time period. Although the proportion of men who completed the survey was lower than those who didn't, interventions to increase male responses and enhance representativeness were successful. These findings can inform future research on the use of social media recruitment for the rapid collection of survey data related to rapidly evolving health crises, such as COVID-19.
Criminal Justice and Behavior · 2020 · 29 citations
- Psychology
- Clinical psychology
- Psychiatry
Black girls bear a higher burden of juvenile justice involvement in the United States, relative to other racial/ethnic female groups. Emerging evidence suggests that system involvement is related to trauma histories and post-traumatic stress disorder (PTSD). This study investigated the associations between individual, family, and peer factors, and their relationship to PTSD among Black girls with juvenile justice involvement. Cross-sectional data were collected from 188 Black girls in detention. Measures assessed were history of abuse, negative peer norms, future orientation, caregiver support, self-esteem, age, and PTSD symptoms. Major regression findings indicated that higher rates of caregiver support, higher negative peer norms, lower self-esteem rates, and lower future orientation rates were correlated with greater PTSD symptoms. Treatment programs for this population warrant a multisystemic approach, which includes caregivers and peers, and bolstering important constructs such as self-esteem and hopefulness.
JMIR Public Health and Surveillance · 2020 · 268 citations
- Political Science
- Sociology
- Psychology
BACKGROUND: During the COVID-19 pandemic, there is a heightened need to understand health information seeking behaviors to address disparities in knowledge and beliefs about the crisis. OBJECTIVE: This study assessed sociodemographic predictors of the use and trust of different COVID-19 information sources, as well as the association between information sources and knowledge and beliefs about the pandemic. METHODS: An online survey was conducted among US adults in two rounds during March and April 2020 using advertisement-based recruitment on social media. Participants were asked about their use of 11 different COVID-19 information sources as well as their most trusted source of information. The selection of COVID-related knowledge and belief questions was based on past empirical literature and salient concerns at the time of survey implementation. RESULTS: The sample consisted of 11,242 participants. When combined, traditional media sources (television, radio, podcasts, or newspapers) were the largest sources of COVID-19 information (91.2%). Among those using mainstream media sources for COVID-19 information (n=7811, 69.5%), popular outlets included CNN (24.0%), Fox News (19.3%), and other local or national networks (35.2%). The largest individual information source was government websites (87.6%). They were also the most trusted source of information (43.3%), although the odds of trusting government websites were lower among males (adjusted odds ratio [AOR] 0.58, 95% CI 0.53-0.63) and those aged 40-59 years and ≥60 years compared to those aged 18-39 years (AOR 0.83, 95% CI 0.74-0.92; AOR 0.62, 95% CI 0.54-0.71). Participants used an average of 6.1 sources (SD 2.3). Participants who were male, aged 40-59 years or ≥60 years; not working, unemployed, or retired; or Republican were likely to use fewer sources while those with children and higher educational attainment were likely to use more sources. Participants surveyed in April were markedly less likely to use (AOR 0.41, 95% CI 0.35-0.46) and trust (AOR 0.51, 95% CI 0.47-0.56) government sources. The association between information source and COVID-19 knowledge was mixed, while many COVID-19 beliefs were significantly predicted by information source; similar trends were observed with reliance on different types of mainstream media outlets. CONCLUSIONS: COVID-19 information source was significantly determined by participant sociodemographic characteristics and was also associated with both knowledge and beliefs about the pandemic. Study findings can help inform COVID-19 health communication campaigns and highlight the impact of using a variety of different and trusted information sources.
Frequent coauthors
- 2 shared
Alexis Merdjanoff
New York University
- 2 shared
Shahmir H. Ali
New York University
- 2 shared
Niyati Parekh
NYU Langone Health
- 1 shared
Julia Cai
New York University
- 1 shared
Andrea B. Troxel
Harvard University
- 1 shared
Rebecca Robbins
Circadian (United States)
- 1 shared
Tiffany Donley
New York University
- 1 shared
Raghib Ali
Awards & honors
- Past President of the Georgia chapter of the Society for Ado…
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