Natalie D Hernandez

University of South Florida | USF · Department of Community and Family Health

BACKGROUND The increasing use of social media to share lived and living experiences of substance use presents a unique opportunity to obtain information on side-effects, usage patterns, and opinions on novel psychoactive substances (NPS). However, due to the large volume of data, obtaining useful insights through natural language processing (NLP) t...

Background Cisgender Black women in the southern United States are at heightened risk for HIV and adverse sexual and reproductive health outcomes. Mobile health interventions that target HIV risk while being adapted to the needs and lived experiences of Black women are remarkably limited. Objective The study aims to refine SavvyHER, a mobile app fo...

BACKGROUND Cisgender Black women in the southern United States are at heightened risk for HIV and adverse sexual and reproductive health outcomes. Mobile health interventions that target HIV risk while being adapted to the needs and lived experiences of Black women are remarkably limited. OBJECTIVE The study aims to refine SavvyHER , a mobile app...

Objectives Data are scarce regarding the prevalence and predictors of perinatal mood and anxiety disorders (PMADs) among Black women. The purpose of this study was to examine the prevalence and predictors of symptoms of PMADS among Black women. Methods Black women completed a paper survey between August 2019 and October 2019. Binomial logistic reg...

Background In addressing the sexual and reproductive health (SRH) disparities for Black and Latina women, there is a need for the development of innovative programs, framed using theoretical underpinnings that are culturally and contextually tailored so that they align with lived experiences. Mobile health (mHealth) interventions offer considerable...

Although there has been an increase focus on recruitment of minority populations at safety-net hospitals into cancer clinical trials, there is still a paucity of research exploring minority participation in cancer clinical trials at safety-net settings. The study utilized a multi-level, qualitative approach to assess the clinical and non-clinical f...

Objectives Coronavirus disease 2019 (COVID-19) has burgeoned into a pandemic that highlights the countless social and health disparities that have existed in Black communities within the United States for centuries. Recent epidemiological data show that Black communities are being disproportionately impacted by COVID-19, resulting in higher morbidi...

Black women carry a disproportionate number of new HIV infections in the USA. Studies that have assessed HIV risk perception along with HIV prevention interventions for Black women have primarily focused on Black women of low socioeconomic status. Few studies have assessed HIV risk perceptions and sexual behavior among college-educated Black women...

Background: Safety-net hospitals, often in inner-city communities, provide a considerable level of care to low-income, uninsured, Medicare, Medicaid, and vulnerable populations. Establishing and performing research studies at safety-net hospitals may require additional planning due to the protections provided to ensure ethical research and the char...

Introduction: Clinical trial participation is essential to the progress of optimizing cancer care outcomes; however, there is a paucity of African American (AA) participation in cancer clinical trials (CCTs) resulting in significant gaps in treatment efficacy. There has been a robust amount of research on ways to increase AA participation in CCTs,...

Introduction: Recent studies suggest where patients receive cancer care is a determinant of survivorship outcomes. As a culturally and individually tailored approach to addressing barriers to cancer care and other contributors to cancer disparities, patient navigation (PN) is an effective strategy to enhance the efficiency of healthcare systems and...

In rural Georgia, African American men are burdened by chronic health diseases such as cancer, diabetes, and cardiovascular disease. Community-academic partnerships that leverage community-based participatory research (CBPR) principles can facilitate the adaptation and translation of multilevel programs to address chronic disease prevention and man...

Current measures of unintended pregnancy underestimate the co-occurring, complex set of social, cultural, economic and structural factors that influence how women interpret unintended pregnancy. The purpose of this study was to prospectively explore young adult US-born Latinas’ thoughts, feelings and beliefs about pregnancy, specifically unintended...

Research at safety-net hospitals may require additional planning to ensure the ethical conduct of research with vulnerable populations. This report discusses application of the principles of community-based participatory research and bioethics to establish a research partnership with a safety-net hospital in the southern U.S.

Background: HPV-related diseases and cancers disproportionately affect low-income and ethnoracial minorities. HPV vaccines have the potential to reduce ethnoracial disparities in HPV-related diseases and cancers; however, HPV vaccine uptake has remained sub optimal. To achieve the greatest impact, public health campaigns should focus on improving H...

Background: HPV plays a significant role in cancers and diseases that impact males directly including penile, oral, and anal malignancies, but awareness and positive vaccine intention in males remain problematic. HPV research largely focuses on cervical cancer prevention, ultimately feminizing HPV and erroneously portraying HPV as an infection that...

Objectives: There are disparities in the uptake of HPV vaccine among racial/ethnic minority women. The strongest predictor of HPV vaccine uptake among adult women is health care provider (HCP) recommendation; however, it is unclear how issues relating to race/ethnicity may mitigate these recommendations. Research shows that racial/ethnic and gende...

The objective of this study was to assess the factorial invariance and convergent validity of the Group-Based Medical Mistrust Scale (GBMMS) across gender (male and female) and ethnoracial identity (Latino and Black). Minority students (N = 686) attending a southeastern university were surveyed in the fall of 2011. Psychometric analysis of the GBMM...

Introduction: To date, reasons for higher rates of unintended pregnancy among Latinas are understudied. In order to understand the causes of disparities in unintended pregnancy rates, we must first explore the meaning of unintended pregnancy and consider cultural expectations and norms regarding pregnancy among Latinas. Purpose: To explore Latina...

Introduction: Medical mistrust is associated with disparities in a variety of health outcomes. The human papillomavirus (HPV) vaccine has the potential to decrease disparities in cervical cancer by preventing infection with the virus that causes these malignancies. No study has examined associations between medical mistrust and preventative health...

Compared with young people across the U.S., Florida youth engage in first sex at younger ages and are less likely to report using condoms/birth control pills at last intercourse. Although school-based sexuality education (sex-ed) is one strategy to address these outcomes, such education is locally determined and inconsistent across the state. Recen...

Compared with young people across the U.S., Florida youth engage in first sex at younger ages and are less likely to report using condoms/birth control pills at last intercourse. Although school-based sexuality education (sex-ed) is one strategy to address these outcomes, such education is locally determined and inconsistent across the state. Recen...

Compared with youth across the U.S., Florida youth experience poorer sexual/reproductive health outcomes. Although school-based sexuality education (sex-ed) is one strategy to address these outcomes, such education is locally determined and inconsistent across the state. Recently, some Florida districts have changed from an abstinence-only approach...

Recently, some Florida districts have changed from an abstinence-only approach to a more progressive form of sex-ed. The purpose of this study was to better understand the process of sex-ed curricular/policy change at local levels. We conducted a series of case studies involving multiple phases/data collection methods. First, sex-ed policies from a...

Although poor Latinas experience the highest unintended pregnancy rate among U.S. women, they have comparatively lower rates of abortion. These low rates are attributed to the myriad of challenges that impede access to abortion, including lack of insurance coverage, cultural factors, and religious beliefs, among others. There is a dearth of studies...

Background: Young adults engage in sexual behaviors that can result in unintended health outcomes, including HPV. HPV-related diseases disproportionately affect ethno-racial women and men. Prophylactic vaccination can prevent HPV-related cancers, yet there are disparities in HPV vaccine uptake. Number of sexual partners has been associated with HPV...

We investigated the cognitive and emotional reactions resulting from a human papillomavirus-related illness threat (i.e. testing positive for human papillomavirus) and the potential behavioral implications resulting from these psychosocial processes among men (N = 536). Structural equation modeling was used to explore a theoretical model explaining...

Background: The impact of the Papanicolaou (Pap) smear on the prevention of cervical cancer is one of the greatest public health success stories. However, it is not clear if women understand the purpose of the Pap smear despite recent advancements and national attention over cervical cancer prevention. The purpose of this study was to examine Pap...

Introduction: Cervical cancer disproportionately affects minority women. Although 2 FDA-approved vaccines are available to prevent HPV, the virus responsible for cervical cancer, little is known about the relationship between minority women's HPV knowledge and vaccination behaviors. Purpose: To examine levels of HPV knowledge among women 1) who w...

Introduction: Research shows that increased diversity of health care providers (HCP) can improve patient satisfaction, access and quality of care. Diversity of providers may be related to rates of acceptance of the HPV vaccination: although HPV-related disparities can be explained in part by differences in access to care and socioeconomics, the rol...

Background: The HPV vaccine has the potential to reduce cervical cancer disparities. Evidence suggests that cervical cancer incidence and mortality are higher among racial/ethnic minority females due to low utilization of preventive services. Research studies have found that acculturation has a mixed effect on cervical cancer screening, yet little...

Introduction: Suspicion and apprehension about vaccination is common, particularly among specific disenfranchised communities in the U.S. Growing evidence suggests that medical mistrust is a barrier to health care participation, including mistrust concerning the HPV vaccine. Due to the disproportionate burden of HPV-related disease among racial/eth...

BACKGROUND: A growing number of empirical studies have investigated the contributing role of medical mistrust in observed health disparities among racial/ethnic minorities in the U.S. The Group-Based Medical Mistrust Scale (GBMMS) was developed to measure an individual's beliefs regarding the unequal treatment of minorities by medical providers and...

Background: HPV-related diseases disproportionately affect racial/ethnic minority men. Black men have higher rates of HPV- related cancers of the oropharynx/oral cavity, while Hispanic men have higher rates of HPV- related penile cancer. Understanding factors related to HPV vaccine intentions among racial/ethnic minority populations is critical, as...

Background: Two FDA-approved vaccines are available that protect against some types of HPV, the virus responsible for cervical cancer. Vaccination rates are sub-optimal among U.S. women in the catch-up ages of 18-26, a public health concern because women of college-age and of minority status are at increased risk for HPV infection. Purpose: To ex...

Background: HPV has become identified as a female-only issue, since its role in cervical cancer was established years ago, and the HPV vaccine was initially approved for females-only. Its role in men's health is not well-defined, despite recent vaccine approval for men. We compare findings from four HPV studies in men. Methods: Men in a longitudina...

Background: The HPV vaccines that protect against 4 types of HPV associated with ano-genital lesions and cancers in women and men received FDA-approval in 2006 for women ages 9-26 and in 2009 for men ages 9-26. Uptake among college students, who are high-risk for HPV infection, is disappointingly low. Purpose: To explore HPV vaccine intentions in...

Background: HPV, the most common STI, can cause genital warts and ano-genital cancers in men and women. The HPV vaccine protects against the four most common types of HPV and received FDA-approval for men 9-26 years in 2009. Little research has examined barriers to HPV vaccination among men. Purpose: To examine barriers to HPV vaccination among m...

Background: HPV's role in cervical cancer is well-established; studies of the HPV vaccine's effectiveness against oncogenic HPV infection resulted in the first FDA-approved HPV vaccine for females ages 9-26 in 2006. Subsequent research provided the rationale for approval for males in 2009, but the delay between approval for females and males, and t...

Background: Cervical cancer mortality in the U.S. is rare in the general population due to effective screening efforts and should decrease even further with the introduction of two FDA-approved HPV vaccines. However, disparities in prevention efforts and outcomes among high-risk groups remain. Furthermore, it is unclear whether women's Pap smear kn...

Introduction: Men's roles in cervical cancer prevention are both in the transmission of HPV, the fundamental cause of cervical cancer, and as possible sources of influence in women's knowledge, access, and utilization of preventive health services. Men's knowledge of screening tools has not been widely explored; thus, this study's purpose was to id...

Introduction: Sexually transmitted infections are often socially stigmatizing. Those infected may experience feelings of shame and guilt, which can have deleterious effects on mental health. The objective of the current study was to identify psychosocial correlates of HPV-related stigma among men testing positive for HPV. Methods: Men participating...

Background: Human papillomavirus (HPV), the most common sexually transmitted infection, can cause cervical cancer and is associated with anal, penile, vulvar, and oral cancers. Cervical cancer screening, the Pap test, can detect cervical lesions before they become cancerous. Objectives: Examine associations of HPV-related stigma and negative emot...

Background: Women and men in the U.S. experience high rates of HPV, yet little is known about differences in emotional responses to HPV infection. Purpose: To examine gender differences in psychosocial responses to HPV test results. Methods: As part of a natural history study of HPV in men, psychosocial responses to receiving an HPV-positive te...

We examined factors associated with HPV vaccine intentions by racial/ethnic group among men participating in a HPV natural history study. HPV knowledge, vaccine intentions and perceived barriers were assessed among non-Hispanic White, non-Hispanic Black and Hispanic men. Men were tested for HPV every 6 months. After receiving test results from thei...

Background: Hispanic women have twice the cervical cancer rate than non-Hispanic White women, and rates of penile cancer are higher among Hispanic men than non-Hispanic men. In 2009, the HPV vaccine was approved for males ages 9-26 to prevent genital warts. To effectively disseminate the vaccine among Latino males, factors that may promote or inhib...

Background: Hispanic women have twice the cervical cancer rate than non-Hispanic White women, and rates of penile cancer are higher among Hispanic men than non-Hispanic men. In 2009, the HPV vaccine was approved for males ages 9-26 to prevent genital warts. To effectively disseminate the vaccine among Latino males, factors that may promote or inhib...

In 2006, the Food and Drug Administration (FDA) approved the human papillomavirus (HPV) vaccine Gardasil® (Merck) for girls and women aged 9-26 years. Although the vaccine is ideally administered to 11 and 12 year olds, college-aged women may be uniquely at risk for HPV due to high rates of sexual activity and, thus, serve as an important catch-up...

Human papillomavirus (HPV), the most common sexually transmitted virus in the United States, remains a considerable public health problem. HPV has been associated with anogenital warts and cancers in males and females, affecting the cervix, penis, anus, vulvar, and vaginal regions; and more recently, has been associated with oropharyngeal cancers....

Background: Although the HPV vaccine was approved for women between ages 9-26, HPV prevalence among this group remains high. Despite immunization recommendations by the ACIP, uptake of the HPV vaccine among college-aged women is the lowest. Few studies have examined college women's knowledge, perceptions, and intentions since vaccination licensure....

Background: Cervical cancer prevention efforts in the US are generally encouraging both because of Pap smear rates and an FDA-approved HPV vaccine for women; however, it is unclear whether women's HPV and Pap smear knowledge has improved despite public health advances. Purpose: To explore women's HPV and Pap smear knowledge among pre- and post-HP...

Latinos are the largest minority group in the United States, with a much younger median age than the total U.S. population. Furthermore, nearly half of the Hispanic population is under the age of 29. The fact that nearly a quarter of the population is in its prime reproductive years necessitates an understanding of how to effectively provide Latino...

Introduction: In 2004, Georgia had the fastest-growing Latino population in the U.S., thus increasing awareness of the health concerns and challenges faced by the Hispanic community and those who serve it. Nevertheless, there was no comprehensive resource available which detailed the health needs of the Latino community in Georgia or how to best re...