Daniel Siconolfi

Behavioral and Social Scientist

Pittsburgh Office

Education

Ph.D., Johns Hopkins University; M.P.H., New York University

One Page Bio

Overview

Daniel Siconolfi (he/him) is a behavioral scientist at the RAND Corporation. His research portfolio addresses health disparities, healthy aging, and access to home and community-based services with focal populations including sexual and gender minority persons, older adults, persons living with or affected by HIV, and persons with dementia. His recent projects and collaborations include the evaluations of a task-shifting mental health intervention in community settings and mental health first aid training, research assessing disparities in Medicaid home- and community-based services, barriers and facilitators to informal and formal advance care planning, and research focused on behavioral health among adolescents and emerging adults. Prior to joining RAND, he was a T32 postdoctoral scholar at the University of Pittsburgh Graduate School of Public Health. He received his Ph.D. from Johns Hopkins University.

Research Focus

Publications

Journal Article
Advance Care Planning Among Sexual Minority Men: Sociodemographic, Health Care, and Health Status Predictors
There is a dearth of contemporary information about advance care planning among sexual minority men, a population with disparities in health care and health status. We sought to address some of these gaps in a large, longitudinal cohort.
Jun 21, 2023
Journal Article
History of Incarceration Is Associated with Unmet Socioeconomic Needs and Structural Discrimination Among Young Black Sexual Minority Men (SMM) in the United States
This study aimed to assess the prevalence and association between unmet socioeconomic and structural needs and history of incarceration among young Black sexual minority men.
May 24, 2023
Journal Article
Barriers and Facilitators to Home- and Community-Based Services Access for Persons With Dementia and Their Caregivers
Barriers to HCBS access for persons with dementia range from community and infrastructure barriers (e.g., clinicians and cultural differences), to interpersonal and individual-level barriers (e.g., caregivers, awareness, and attitudes).
May 4, 2023
Journal Article
Low Tech, High Potential: Using Technology to Improve Communication Across Home Care Workers
Our findings suggest that a basic workflow process—communication among HCWs—is limited in many home care settings. Simple technologies could be developed to support HCWs to navigate the challenges of providing care to clients in their homes.
Apr 1, 2023
Research Brief
Large-Scale Training in Mental Health First Aid: An Evaluation of New York City's 2016–2020 Efforts
In an evaluation of a city-wide effort to train New Yorkers in Mental Health First Aid, RAND researchers found that the majority of participants had used their skills to help friends, family, neighbors, and coworkers in the past six months.
Feb 7, 2023
Report
Evaluation of Mental Health First Aid in New York City
More than 155,000 New Yorkers were trained in Mental Health First Aid (MHFA) between 2016 and 2020. The authors evaluated this citywide dissemination of MHFA and needs for future training.
Feb 7, 2023
Journal Article
A Latent Class Approach to Understanding Longitudinal Sleep Health and the Association with Alcohol and Cannabis Use During Late Adolescence and Emerging Adulthood
Persistent poor sleep health was associated with higher levels of alcohol and cannabis use and consequences, and greater increases in alcohol-related consequences during the transition from late adolescence to emerging adulthood.
Nov 1, 2022
Journal Article
Low Exposure to Home- and Community-Based Services Among U.S. Adults: Cause for Concern?
A lack of knowledge about HCBS is a barrier to access, and exposure to HCBS users is one source of knowledge. There are no contemporary estimates of exposure in the U.S. population. Overall, service exposure was more home- than community-based.
Oct 11, 2022
Journal Article
Trajectories of Emerging Adults' Binge Drinking and Depressive Symptoms and Associations With Sexual Violence Victimization: Examining Differences by Sexual and Gender Minority Status
We examined longitudinal associations between binge drinking (BD), depressive symptoms, and sexual violence (sexual harassment and sexual assault) among sexual and gender minority (SGM) and non-SGM emerging adults.
Oct 11, 2022
Journal Article
Standardized Assessment of Depression Symptoms in Post-Acute Care: A Screening Threshold Approach
The present study tested a gateway version of a depression screening protocol (PHQ-2 to 9). Findings suggest the feasibility of a gateway scoring approach to standardized assessment of depression symptoms among PAC patients.
Mar 8, 2022
Journal Article
Loneliness and Multiple Health Domains: Associations Among Emerging Adults
We examine associations of loneliness with physical, behavioral, and health behavior outcomes, and investigate moderating effects by sex, race/ethnicity, and sexual/gender minority status.
Feb 8, 2022
Journal Article
Alcohol Use and Cannabis Use Trajectories and Sexual/Gender Minority Disparities in Young Adulthood
At the same levels of alcohol/cannabis use from middle school through young adulthood, SGM individuals show disparities in multiple domains compared to non-SGM peers. Efforts to reduce substance use and structural disadvantages experienced by SGM youths are needed.
Feb 8, 2022
Journal Article
Longitudinal Associations of PROMIS-29 Anxiety and Depression Symptoms With Low Back Pain Impact in a Sample of U.S. Military Service Members
This study examines longitudinal associations between psychological symptoms and the Impact Stratification Score among military service members.
Nov 19, 2021
Journal Article
Perceived Impacts of a Medicaid Rebalancing Initiative to Increase Home- and Community-Based Services
Stakeholders reported that BIP participation had a range of impacts on the HCBS ecosystem, often beyond the structural reforms. Our findings highlight BIP impacts to monitor over the long term and to consider in evaluations of future rebalancing efforts.
Jul 16, 2021
Research Brief
Use of Tobacco Products Among Unaccompanied Youth Experiencing Homelessness
To understand patterns of use and interest in quitting different types of tobacco products among youth experiencing homelessness, a RAND team surveyed these youth in Los Angeles County to inform efforts to reduce their use of tobacco products.
May 5, 2021
Journal Article
Project SLIP: Implementation of a PrEP Screening and Linkage Intervention in Primary Care
The study developed and pilot-tested a PrEP screener for use in primary care clinics to help facilitate PrEP uptake. Findings suggest that brief HIV risk screening in primary care is acceptable, feasible, and shows preliminary effects in increasing PrEP referral rates.
Mar 5, 2021
Journal Article
Trends In Home Care Versus Nursing Home Workforce Sizes: Are States Converging Or Diverging Over Time?
Since 2009, most states have increased the size of their home care workforces and decreased the size of their nursing home workforces, but there is substantial variation across states. More targeted efforts may be needed to ensure that people with disabling conditions can have their needs met in their desired setting across the nation.
2021
Report
Mental Health Task-Shifting in Community-Based Organizations: Implementation, Impact, and Cost — Evaluation of the Connections to Care Program
In this report, RAND researchers describe the Connections to Care task-shifting model and their evaluation of how it was implemented, its intended impact on mental health and other outcomes, and how much it costs community-based organizations.
Nov 12, 2020
Journal Article
Promises and Pitfalls of Health Information Technology for Home and Community-Based Services
Structural reforms required by the Medicaid Balancing Incentive Program gave states an opportunity to modernize their HCBS systems through health information technology. Barriers to technology adoption persist, underscoring the need for continued support in future rebalancing efforts.
Sep 15, 2020
Journal Article
Factors Explaining State Differences in Applying for a Recent Long-Term Care Program That Promotes Aging in Place: Perspectives of Medicaid Administrators
This article examines the reasons underlying states' decisions regarding their applications to the Balancing Incentive Program.
Aug 4, 2020
Journal Article
Advancing LGBTQ Health Equity Via Human-Centered Design
Human-centered design (HCD; also known as user-centered design) is well-suited to advance the field of substance use prevention interventions for LGBTQ youths by designing interventions that simultaneously target several the complex, multilevel factors that drive health disparities.
Feb 4, 2020
Journal Article
Co-use of Tobacco and Marijuana Among Young People Experiencing Homelessness in Los Angeles County
The present study is a first step in understanding the prevalence, types, and correlates of co-use in a probability sample of young tobacco users experiencing homelessness.
Feb 1, 2020
Journal Article
Engagement of Providers and Advocates in a Rebalancing Initiative to Increase HCBS Access for Medicaid Beneficiaries
Rebalancing long-term services and supports toward increased home- and community-based services will engage and affect multiple stakeholder groups, including governmental and nongovernmental stakeholders. This study describes stakeholder engagement in a LTSS rebalancing initiative.
Jan 29, 2020
Journal Article
Individual, Interpersonal, and Health Care Factors Associated with Informal and Formal Advance Care Planning in a Nationally-Representative Sample of Midlife and Older Adults
This paper examines correlates of advance care planning among midlife and older adults in the U.S., with attention to informal planning (e.g., conversations) and formal planning (e.g., legal documentation) and factors at the individual, interpersonal, and health care levels.
2020
Journal Article
Associations of Tobacco Advertising Appeal With Intentions to Use Alternative Tobacco Products Among Young Tobacco Users Experiencing Homelessness
The primary goal of this study was to examine the relationship between the appeal of advertising for five classes of tobacco product and future intentions to use those products, among youth experiencing homelessness who had some level of experience with it.
Dec 12, 2019
Journal Article
Roll-your-own Cigarette Smoking Among Youth Experiencing Homelessness
Roll-your-own cigarettes may encourage continued tobacco use among youth experiencing homelessness and pose additional health risks, despite users' beliefs to the contrary.
Dec 12, 2019
Journal Article
Health, Homelessness Severity, and Substance Use Among Sexual Minority Youth Experiencing Homelessness: A Comparison of Bisexual Versus Gay and Lesbian Youth
We examined subgroup differences in homelessness severity, depression, physical health, and substance use, focusing on differences between bisexual and gay/lesbian youth, among homeless youth in Los Angeles.
Dec 11, 2019
Journal Article
Rural-Urban Disparities in Access to Home- and Community-Based Services and Supports: Stakeholder Perspectives From 14 States
This paper presents findings from a qualitative study examining the impact of the Medicaid Balancing Incentive Program. The analysis in this paper examines factors associated with rural disparities in access to home and community-based services.
Jun 26, 2019
Journal Article
Correlates of Cigarette and Alternative Tobacco Product Use Among Young Tobacco Users Experiencing Homelessness
This study examines past month use and correlates of cigarettes and alternative tobacco products among young tobacco users experiencing homelessness.
2019
Journal Article
Motivation to Quit Cigarettes and Alternative Tobacco Products: Prevalence and Correlates Among Youth Experiencing Homelessness
Use of alternative tobacco products, as well as regular cigarettes, is widespread among unaccompanied youth experiencing homelessness. However, little is known about their level of motivation for quitting use of these products, factors associated with motivation to quit, or how these might vary by type of tobacco product.
2019
Journal Article
Patterns of Alternative Tobacco Product Use Among Youth Experiencing Homelessness
Findings suggest efforts to reduce the use of tobacco products among youth experiencing homelessness should focus on the combined use of these products and screen for substance use disorder and housing stability to include those that need help the most.
2019
Journal Article
Sources of Resilience as Mediators of the Effect of Minority Stress on Stimulant Use and Sexual Risk Behavior Among Young Black Men Who Have Sex with Men
Minority Stress Theory proposes that stigma, prejudice, and discrimination facing sexual and racial minorities are stressors that lead to increased risk behaviors. This study examined whether minority stress is associated with stimulant use and sexual risk by depleting resiliencies.
2019
Report
Evaluation of the Connections to Care (C2C) Initiative: Interim Report
This interim report presents preliminary evaluation findings for New York City's Connections to Care program, which seeks to expand access to mental health support for low-income New Yorkers via a task shifting model.
Nov 29, 2018
Journal Article
An Event-Level Analysis of Condomless Anal Intercourse with a HIV-Discordant or HIV Status-Unknown Partner Among Black Men Who Have Sex with Men from a Multi-site Study
Sexual event factors—characteristics of partners, positions, and partner-seeking venues—associated with condomless anal intercourse among black men who have sex with men vary by HIV status and knowledge of partner status.
Jul 6, 2018
Journal Article
Psychosocial Health Disparities Among Black Bisexual Men in the U.S. Effects of Sexuality Nondisclosure and Gay Community Support
Compared with Black gay men, Black bisexual men experience significant psychosocial health disparities; interventions to decrease biphobia could improve sexual minority community support for these men.
Jun 1, 2018