Julie Zuniga

Julie Zuniga
  • PhD
  • Associate Professor at University of Texas at Austin

About

75
Publications
8,265
Reads
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911
Citations
Current institution
University of Texas at Austin
Current position
  • Associate Professor
Additional affiliations
August 2013 - August 2015
Emory University
Position
  • PostDoc Position

Publications

Publications (75)
Article
Purpose The purpose of the study was to examine the level of diabetes knowledge among Chinese Americans with type 2 diabetes (T2DM) and the influence of acculturation levels on diabetes knowledge. T2DM is a significant health issue for Chinese Americans because of the unique challenges they face that reflect a complex interplay of culture, language...
Article
The prevalence of HIV is higher in the transgender population than in the general population, and pre-exposure prophylaxis (PrEP) is an effective biomedical HIV prevention strategy for the prevention of HIV. However, the transgender and gender-expansive community faces several challenges to PrEP uptake and adherence. This community-based participat...
Article
The purpose of this article is to describe a model of chronic disease self-management that incorporates the complexity of social and environmental interactions experienced by people who self-manage chronic conditions. This study combines quantitative data from a large national research cohort and qualitative interviews to test and refine a self-man...
Article
Full-text available
Background Pulmonary exacerbations (PExs) in people with cystic fibrosis (PwCF) are associated with increased healthcare costs, decreased quality of life and the risk for permanent decline in lung function. Symptom burden, the continuous physiological and emotional symptoms on an individual related to their disease, may be a useful tool for monitor...
Article
Suicide and other self-injurious behaviors (SIB) are significant causes of morbidity and mortality as well as healthcare costs. Sexual risk behaviors are associated with many SIB, and sexual activities may act as SIB as well. In this scoping review, we consider ways in which sexual activity has been conceptualized as SIB - types of sexual activitie...
Article
In 2012, the Federal Drug Administration approved daily oral pre-exposure prophylaxis (PrEP) for HIV prevention in adults. Longer acting injectable PrEP (LA PrEP) has been approved and other formulations are in development. A successful LA PrEP rollout requires examining potential facilitators and barriers to PrEP uptake. Given that transgender and...
Article
Purpose The purposes of this study were to (1) examine the relationships between fatigue, its influencing factors, and diabetes self-management and (2) test the mediation effects of fatigue on the link between the influencing factors and diabetes self-management in adults with type 2 diabetes. Methods This cross-sectional, correlational study was...
Preprint
Full-text available
Background Pulmonary exacerbations (PExs) in people with cystic fibrosis (PwCF) are associated with increased healthcare costs, decreased quality of life and the risk for permanent decline in lung function. Symptom burden, the continuous physiological and emotional symptoms on an individual related to their disease, may be a useful tool for monitor...
Article
Full-text available
OBJECTIVE Diabetes knowledge is associated with health, including lower A1C levels. The Diabetes Knowledge Questionnaire (DKQ-24), developed 30 years ago for Mexican-Americans with type 2 diabetes and since used with diverse samples in many countries, contains outdated items that no longer accurately assess current knowledge needed for diabetes sel...
Article
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Purpose: The purpose of this study is to use text-mining methods to examine the dominant sources of online information and content about continuous glucose monitors (CGMs). Because the internet is the most popular source for health information, it is important to understand what is being said about CGMs in online sources of information. Methods:...
Article
Pre-exposure prophylaxis (PrEP) for HIV prevention is a highly effective tool in preventing HIV, yet PrEP is underprescribed. Primary care providers are ideally positioned to increase access to and awareness of PrEP, but health care providers' knowledge of PrEP greatly varies. To evaluate PrEP knowledge and attitudes of primary care providers, we c...
Article
Full-text available
Latinos’ type 2 diabetes (T2DM) and concurrent depression significantly lower quality of life (QoL). Patients’ beliefs about their diabetes, called illness perceptions (IP), may account for the impact of depression on QoL. Using secondary data, we explored predictive and mediation relationships among IP, depression, and QoL among Mexican American a...
Article
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Approximately 10–15% of people living with HIV are also diagnosed with diabetes. To manage their two chronic conditions, people must undertake certain activities and adopt behaviors. Due to overlapping symptoms, complex medication regimens, and heavy patient workloads, implementing these self-management practices can be difficult. In this focused e...
Article
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Aim To examine influences on screening of Latinx adults with type 2 diabetes for cognitive problems by identifying patient-, clinician-, and clinic-level factors. Methods This was a mixed methods study consisting of semi-structured interviews with Latinx adults with type 2 diabetes (n = 30; mean age = 68; 57% Mexican American) and surveys and inte...
Article
The purpose of this qualitative secondary analysis research was to describe the impact of the COVID-19 pandemic on self-management behaviors and practices for people living with the dual diagnoses of HIV/AIDS and type 2 diabetes mellitus and to identify early pandemic-specific disruptions or changes to their self-management practices. In-depth inte...
Article
Full-text available
Before development of overt type 2 diabetes (T2DM), changes in brain structure and activation patterns are found in insulin resistance, indicating many with T2DM may already have alterations in cognitive function. How best practices are met for screening for cognitive dysfunction, specifically Latinx adults with T2DM who are at higher risk, remains...
Article
Background: One in nine Latinx adults over 45 years old experience subjective cognitive decline (SCD). Yet less than half of people with SCD discuss symptoms with their provider (BRFSS, 2015-2018). Because current diagnostic criteria focus on dementia, a later stage pathology, the window of opportunity for effective interventions may be missed. Co...
Article
Background Nurses practicing in long-term care or rehabilitation settings face unique challenges from prolonged or repeated exposure to stressors, given their extended time with patients. This puts them at risk for compassion fatigue, burnout, and secondary traumatic stress, which can lead to decreased resilience and sleep problems. Aim The aim of...
Article
Full-text available
The objective of this study was to test a self-management model for self-management in people living with HIV and type 2 diabetes (PLWH + T2DM). We conducted a predictive, longitudinal study of data from a national research cohort of PLWH using lag analysis to test short- and long-term health outcomes for PLWH + T2DM. We used a dataset from the Cen...
Article
Full-text available
Background Self-Rated Health (SRH) is a valid proxy for individuals’ overall well-being and mortality risk. This study examined contributions of diabetes distress (stress from diabetes self-management) and depressive symptoms to SRH among Chinese Americans with type 2 diabetes (T2DM).Methods For this cross-sectional study, a survey measuring diabet...
Article
Background: Neonatal mortality (death within 0-28 d of life) in Kenya is high despite strong evidence that newborn care recommendations save lives. In public healthcare facilities, nurses counsel caregivers on term newborn care, but knowledge about the content and quality of nurses' recommendations is limited. Purpose: To describe the term newbo...
Article
Background Maternal mortality is a critical global public health concern, especially in low- and middle-income countries in sub-Saharan Africa. Although maternal mortality rates have declined by approximately 39% in sub-Saharan Africa over the last decade, maternal deaths during pregnancy and in childbirth remain high. Interventions to improve moth...
Article
Purpose The purpose of this study was to examine the prevalence of subjective cognitive decline (SCD) and SCD-related functional limitations among people with diabetes and to identify socioeconomic and comorbidity risk factors associated with SCD. Methods This study analyzed data from the 2017 Behavioral Risk Factor Surveillance System (BRFSS) wit...
Article
Full-text available
Cognitive complaints indicate risk for dementia, but few studies have examined the perspective of cognitive complaints in Latinx with type 2 diabetes (T2DM). This study explored the meaning of cognitive health from the perspective of Latinx adults with T2DM to assist in detecting problems with diabetes self-management. This was an exploratory quali...
Article
People living with HIV are living longer, high-quality lives; however, as they age, this population is at increased risk for developing chronic comorbidities, including cardiovascular disease, certain types of cancer (e.g., lung, anal, and liver), and diabetes mellitus. The purpose of this state-of-the-science review is to provide an evidence-based...
Article
Full-text available
Objective Health inequities and disparities are associated with non‐White race/ethnicity, immigrant status, income, and geographic location. Community engagement is essential to identify health and social needs and to plan health care and social services programs. To begin a larger community‐based participatory study, the purpose of this study was...
Article
Objective The objectives of this review are to (1) describe the state of the science of patient activation interventions for the self-management of chronic conditions; (2) identify effective intervention elements for improving patient activation; and (3) compare intervention effectiveness across chronic conditions. Methods This systematic review f...
Article
Objectives: Emotional distress and illness perceptions have been linked to patients’ self-efficacy for diabetes management. This study, guided by Leventhal’s Self-Regulatory Model, explores the direct effects of emotional distress (diabetes distress and depressive symptoms) on diabetes management self-efficacy, and the indirect effects through illn...
Article
Designing and conducting effective intervention research is an important domain of nursing science. Nurse scientists have long recognized people with chronic conditions need effective self-management strategies across the lifespan, so they have led the way in establishing theoretical and practical grounds for the science of self-management. Guidanc...
Article
Background: Resilience is crucial for students in health schools as care becomes more complex and as the adjustment to meet patient, environmental, and professional demands with success can seem a daunting challenge. Self-care activities can support the development of resilience in the student population. The purpose of this study is to explore and...
Article
Full-text available
Background: This study aimed to investigate the measures of retention in care (RIC) in persons living with HIV (PLWH) and type 2 diabetes mellitus (T2DM) by age group (younger vs. older adults). Methods: This was a longitudinal retrospective cross-sectional study that used secondary data from the Center for AIDS Research Network of Integrated Cl...
Article
Objective: An investigation of the prevalence of medication persistence and associated factors in order to inform effective strategies for improving medication persistence. Methods: A systematic review of the literature from 2010 to the present was performed, using the PRISMA protocol. Primary and empirical observational studies of adult ischemic s...
Article
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Background To address high neonatal mortality (from birth to 28 days of life), baccalaureate-level nursing school and continuing education curricula in western Kenya include content on most common causes of death in the first week of life and the prevention and treatment of complications such as low birthweight, respiratory distress, and sepsis. Ye...
Article
Background: People with diabetes face many challenges to following healthcare provider recommendations for self-management and few are able to achieve and maintain reductions in average blood glucose level. Interdisciplinary teams are a promising strategy to help patients with diabetes improve outcomes. Methods: An observational analysis of elec...
Article
Background: Persons living with HIV experience high symptom burden that can negatively impact medication adherence, work productivity, and quality of life. Symptoms are highly subjective, which can lead to under- or improper treatment. The purpose of this exploratory study was to examine relationships between circulating biomarkers representative...
Article
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The median age of the U.S. homeless population is increasing, and PEH often experience accelerated aging compared to the general population. Moreover, PEH have disproportionately high rates of chronic illness, psychological distress, and poor health status. The purpose of this study was to investigate associations between morbidity, psychological d...
Article
Diabetes is one of the most common comorbid conditions in people living with HIV (PLWH). Diabetes may affect health-related quality of life (HRQoL) for PLWH because they experience more symptoms, are prescribed more medications, and are required to do self-care activities. The purpose of our study was to compare predictors of the HRQoL for PLWH wit...
Article
Full-text available
Abstract People living with a diagnosis of HIV (PLWH) and type 2 diabetes (T2DM) can experience a synergistic negative impact on their vascular and immune systems if their conditions are poorly controlled. The purpose of this study was to adapt a community-based diabetes self-management intervention for people living with HIV and test the feasibili...
Article
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People living with HIV (PLWH) are dying of non-AIDS associated conditions, including type 2 diabetes and chronic kidney disease (CKD), but the impact of diabetes and CKD on HIV survival rates is unknown. The purpose of this retrospective longitudinal study was to investigate the impact of diabetes and CKD on the survival rates of PLWH, using a seco...
Article
Diabetes is the 7th leading cause of death in the U.S. and impacts patients’ physical health and also increases the risk for psychological distress. Sleep disturbance is a common complaint in patients with diabetes and likely impacts psychological well-being. This study examined the relationship between sleep characteristics and serious psychologic...
Article
Full-text available
Chronic immune activation and ensuing inflammation that accompany HIV infection lead to adverse metabolic consequences and an increased risk of type 2 diabetes (T2D). We examined the additive effects of T2D on circulating biomarkers involved in inflammation, coagulation, and vascular function along with plasma amino acids in people living with HIV...
Article
Aims: Type 2 diabetes mellitus (T2DM), serious and increasingly prevalent among Mexican Americans, produces symptoms related to high and low glucose levels, medication side effects, and long-term complications. This secondary analysis explored symptom prevalence, differences among symptom burden levels, and how symptoms clustered. Methods: Clini...
Article
Women who are homeless are less likely to receive preconception care or prenatal care in the first trimester, and they tend to have fewer prenatal visits overall than their housed counterparts. Homelessness during pregnancy can increase the risk for many maternal, fetal, and neonatal complications. Barriers to proper prenatal care can be categorize...
Article
Purpose The purpose of this systematic review of qualitative literature was (1) to identify self-management strategies, (2) to identify women’s barriers to self-management, and (3) to compare self-management strategies of diabetes and human immunodeficiency virus (HIV). African American women living with HIV are at high risk for developing diabetes...
Article
Beliefs and restrictions regarding acceptance of blood products by members of the Jehovah's Witness faith often provoke discussion among health care professionals regarding alternative interventions. Establishing and maintaining an open dialog with women and families of the Jehovah's Witness faith regarding their beliefs on the use of blood and blo...
Conference Paper
Full-text available
For people with diabetes, low literacy and low numeracy are risk factors for poor diabetes outcomes. Diabetes Numeracy is a predictor of diet management and A1C. The purpose of this study was to analyze the relationship between diabetes knowledge and numeracy in Latinos with type 2 diabetes (T2DM). Participants (n=139) from 3 clinics for un- and un...
Article
The purpose of our systematic review of research on chronic kidney disease (CKD) in persons living with HIV (PLWH) was to (a) compare and contrast diagnostic criteria for CKD, (b) identify risk factors of CKD in PLWH, and (c) elucidate the prevalence of CKD in PLWH. Keyword searches of PubMed and PsycInfo databases were followed by manual searches...
Article
Purpose: The primary purpose is to review diabetes workplace interventions and the degree to which they improve diabetes-related outcomes in employees diagnosed with or at risk for T2DM. Methods: Three electronic databases and ancestry searches were used to identify peer reviewed articles published in English from 2000 to June 2017. Results: T...
Article
Approximately 10-15% of persons living with HIV (PLWH) have a comorbid diagnosis of diabetes mellitus (DM). Both of these long-term chronic conditions are associated with high rates of symptom burden. The purpose of our study was to describe symptom patterns for PLWH with DM (PLWH+DM), using a large secondary dataset. The prevalence, burden, and bo...
Article
The purpose of this study was to exam the impact of type 2 diabetes mellitus (T2DM) on CD4 cell count trends in adults with HIV. In a longitudinal retrospective study in an urban primary care HIV clinic in the southeastern United States from 2010 to 2012, patients with HIV medical charts were audited to obtain their CD4 cell count, diabetes status,...
Article
With the increase in popularity of the CrossFit exercise program, occupational health nurses may be asked questions about the appropriateness of CrossFit training for workers. This systematic literature review was conducted to analyze the current research on CrossFit, and assess the benefits and risks of this exercise strategy. Thirteen studies ( N...
Article
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There are approximately 3.3 million people of the Muslim faith living in the United States. This article explores how Muslim women observe their religious beliefs during pregnancy and discusses implications for nursing care of pregnant Muslim women during Ramadan. Although pregnant Muslim women can be exempt from fasting, many still choose to fast...
Article
Full-text available
Background: Level of health literacy affects health status. The purpose of this study was to examine and evaluate studies related to picture-based health education materials for people with low health literacy. Methods: Articles from 2001 through October 2015 were searched in the PubMed, CINAHL, and ERIC databases on the web, followed by manual sea...
Article
Objective: The purpose of this integrative review is to examine the use of motivational interviewing (MI) to improve health outcomes in persons living with HIV (PLWH). Methods: We reviewed the existing literature, using the PRISMA model. The PubMed, Web of Science, Embase, and CINAHL databases were searched for all relevant studies, using the te...
Article
People from non-White racial groups and other underserved populations, including Latinos, are frequently reluctant to participate in research. Yet their participation into research is foundational to producing information that researchers and health care providers need to address health disparities. The purpose of this article is to describe challe...
Article
Diabetes is one of the most frequently diagnosed comorbidities in individuals living with HIV. Dual control of both conditions is essential because both diseases negatively impact the immune and vascular systems. The purpose of this retrospective study was to assess the factors associated with dual control of HIV and diabetes. Patients from a large...
Article
Full-text available
The Texas-Mexico border incidence rate of tuberculosis (TB) is 10 times the rate of TB in the United States. Additionally, this area is plagued by antibiotic-resistant TB at a rate that is 70% higher among those living along the border than among nonborder residents. Both the high rate of TB and the emergence of drug-resistant TB increases the impo...
Article
Full-text available
Stigma has become a gendered phenomenon that affects increasing numbers of HIV-infected women worldwide. This study examined the role of age as a possible moderator of the relationship between stigma and antiretroviral therapy adherence, CD4% and viral load among 120 HIV-infected women. A secondary analysis was conducted using data from the Keeping...
Article
Individuals infected with HIV experience high rates of depression when compared to their sero-negative counterparts. Although symptoms of depression have been consistently linked to poor medication adherence among persons living with HIV/AIDS, their relation to retention in care are less well-known. The purpose of this study was to examine whether...
Article
Tuberculosis (TB) continues to be one of the main causes of death in adults globally. Failure to complete TB treatment can lead to treatment-resistant TB and continued transmission of the infection. Directly observed therapy (DOT) is the treatment recommended by the World Health Organization. This article sought to synthesize DOT data to identify i...
Article
This article evaluates the Spoken Knowledge in Low Literacy in Diabetes (SKILLD) questionnaire, a measure of essential knowledge for type 2 diabetes self-management, after it was modified for English- and Spanish-speaking Mexican Americans. We collected surveys (SKILLD, demographic, acculturation) and blood for A1C analysis from 72 community-recrui...
Article
Purpose: This study produced a rich description of the lived experiences of tuberculosis (TB) treatment among Mexican Americans living in the Lower Rio Grande Valley (LRGV) of Texas. Design: This qualitative study used phenomenological methodology, guided by Merleau-Ponty's philosophical framework, particularly his theories on mind-body influenc...
Article
To review the literature on medication adherence for latent tuberculosis infection (LTBI) in Hispanics. Improving adherence to medication regimen could reduce the likelihood of further tuberculosis resistance. A literature review searched for studies of medication adherence in Hispanics in the United States. Data on study purpose, design, populatio...
Article
This is a case study to investigate the lived experience of tuberculosis (TB) treatment for a Hispanic female. The theme was accumulating aggravation. Her daily life was interrupted with appointments and negative side effects. She had to wear a mask that made her feel isolated. She felt ignored by her doctors. Although she experienced the opposite...

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