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Wayne State University Dissertations

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Global Identity: Conceptualization, Measurement, And Implications For Marketing Strategy, Irem Yoruk Jan 2022

Global Identity: Conceptualization, Measurement, And Implications For Marketing Strategy, Irem Yoruk

Wayne State University Dissertations

Identity is an important predictor in consumer behavior; but marketing managers’ understanding of global identity is limited. This dissertation develops a more comprehensive conceptualization of the construct of global identity than those currently proposed in the literature. Anchored in identity and social identity theories, this work develops a multidimensional scale for measuring global identity, and validates this scale across two cultural environments, Turkey and the United States. This new scale is composed of four dimensions that explain the domain of global identity, three of which are comprised of two sub-dimensions. This work shows that these converge into a third-order global …


Design Of Computer Vision Systems For Optimizing The Threat Detection Accuracy, Sina Gholamnejad Davani Jan 2022

Design Of Computer Vision Systems For Optimizing The Threat Detection Accuracy, Sina Gholamnejad Davani

Wayne State University Dissertations

This dissertation considers computer vision (CV) systems in which a central monitoring station receives and analyzes the video streams captured and delivered wirelessly by multiple cameras. It addresses how the bandwidth can be allocated to various cameras by presenting a cross-layer solution that optimizes the overall detection or recognition accuracy. The dissertation presents and develops a real CV system and subsequently provides a detailed experimental analysis of cross-layer optimization. Other unique features of the developed solution include employing the popular HTTP streaming approach, utilizing homogeneous cameras as well as heterogeneous ones with varying capabilities and limitations, and including a new …


Aproximaciones Críticas Innovadoras En La Narrativa Española Del Siglo Xxi, Paula Silvana Fecay Jan 2022

Aproximaciones Críticas Innovadoras En La Narrativa Española Del Siglo Xxi, Paula Silvana Fecay

Wayne State University Dissertations

The purpose of this work is to investigate and analyze the concepts of death and absence in 5 Spanish novels of the XXI century. The novels are Esta pared de hielo (2005) by José María Guelbenzu, Mi querida Eva (2007) by Gustavo Martín Garzo, Laura y Julio (2008) by Juan José Millás, Nada que no sepas (2018) by María Tena and La llave 104 (2019) by Paz Castelló. These five Spanish novels are very different but have common elements that will be analyzed through a common lens, focusing on the death and absences in the novels but without ceasing to …


Electrochemical Gelation Of Metal Chalcogenide Quantum Dots, Chathuranga Chinthana Hewa Rahinduwage Jan 2022

Electrochemical Gelation Of Metal Chalcogenide Quantum Dots, Chathuranga Chinthana Hewa Rahinduwage

Wayne State University Dissertations

Quantum dots (QDs) are attractive because of their unique size-dependent optical and electronic properties and high surface area. They are tested in research for diverse applications, including energy conversion, catalysis, and sensing. Assembling QDs into functional solid-state devices while preserving their attractive properties is a challenge. Methods currently under the research are not effective in directly fabricating QDs onto devices, making large area assemblies, maintaining the high surface area by forming 3D porous structures, and conducting electricity for applications such as sensing. QD gels are an example of QD assemblies that consist of a 3D porous interconnected QD network. They …


Impacts And Dispersal Of Invasive Bivalves, Dreissena And Corbicula Spp., On Stream Benthic Communities, Darrin Scott Hunt Jan 2022

Impacts And Dispersal Of Invasive Bivalves, Dreissena And Corbicula Spp., On Stream Benthic Communities, Darrin Scott Hunt

Wayne State University Dissertations

Asian clams (Corbicula spp.), zebra and quagga mussels (Dreisenna spp.) have invaded and spread throughout North American surface waters. Corbicula and Dreisenna species bio foul aquatic systems, occupy benthic substrates and degrade environments through shell deposition. I explored how Dreissena and Corbicula invasions affect benthic fish and macroinvertebrate communities, and examine how their impacts differ between urban and rural systems, and temperate and tropical climates. Macroinvertebrate and fish communities were evaluated at sites with increasing shell densities in the Rouge, and Huron rivers (MI, USA) using the United States Environmental Protection Agency’s Rapid Bioassessment Protocols (RBP). Urban and rural macroinvertebrate …


How Do Nonprofits Increase Civic Engagement? Testing A Model Of Online And Offline Advocacy And Activism., Maria Clara Bello Martucci Jan 2022

How Do Nonprofits Increase Civic Engagement? Testing A Model Of Online And Offline Advocacy And Activism., Maria Clara Bello Martucci

Wayne State University Dissertations

The current landscape of Americans’ civic engagement has changed and taken new forms that are strongly impacted by the internet and social media communication. This dynamic can potentially influence nonprofit organizational effectiveness and nonprofit public relations strategies, yet it lacks in-depth scholarly investigation and understanding. Therefore, this dissertation sought to understand public support behaviors from the general population toward nonprofits, considering four different modes of civic engagement activities and three geographic levels of nonprofit organizations. Specifically, this dissertation introduced a conceptual model to explain individual factors that lead Americans to engage in online and offline advocacy and activism through and …


Backward Walking: A Novel Marker Of Fall Risk, Cognitive Dysfunction, And Myelin Damage In Persons With Multiple Sclerosis, Erin Edwards Jan 2022

Backward Walking: A Novel Marker Of Fall Risk, Cognitive Dysfunction, And Myelin Damage In Persons With Multiple Sclerosis, Erin Edwards

Wayne State University Dissertations

Multiple sclerosis (MS) is a progressive, neurologic disease of the central nervous system that causes debilitating motor, sensory and cognitive impairments. As a result, persons with MS are at an increased risk for falls and falls represent a serious public health concern for the MS population. The current clinical measures used to assess fall risk in MS patients lack sensitivity and predictive validity for falls and are limited in their ability to capture to multiple functional domains (i.e., motor, sensory, cognitive and pathological domains) that are impaired by MS. Backward walking sensitively detects falls in the elderly and other neurologic …


Study Of The Decay B^± → K^0_S Π^± Π^0 At The Belle Experiment, Suravinda Janaka Kumara Kospalage Jan 2022

Study Of The Decay B^± → K^0_S Π^± Π^0 At The Belle Experiment, Suravinda Janaka Kumara Kospalage

Wayne State University Dissertations

Belle is a particle physics experiment based at the KEK laboratory in Tsukuba Japanwhich ran from 1999 to 2010 and collected 1ab−1 of data. The Belle experiment is focused on studying the properties of particles called B mesons which are produced by accelerating and colliding electron and positron beams. These B mesons show the biggest differences between the properties of matter and anti-matter of any known particles. One of the main goals of the Belle experiments is to understand the differences between matter and anti-matter, specifically violations of charge-parity symmetry (CP violation) and how anti-matter vanished and we come to …


Hearing And Other Factors Influencing Memory Performance In Remote Assessment, Erika Squires Jan 2022

Hearing And Other Factors Influencing Memory Performance In Remote Assessment, Erika Squires

Wayne State University Dissertations

With the revitalization of aural rehabilitation (AR) and increased use of telepractice services, there is a paucity of research examining factors that have the potential to affect remote assessment. An assessment of memory is commonly included in a comprehensive AR assessment because recently developed auditory-cognitive training programs include auditory-based cognitive activities, such as auditory memory tasks. This investigation explored the effect of presentation modality on speech discrimination performance and whether self-reported hearing ability correlated with remote memory assessment in older adults.Older adults self-reported their hearing abilities and completed speech discrimination and memory tasks. Data were collected remotely via a telephone …


The Lived Experiences Of Muslim Women With Infertility, Samia Abdelnabi Jan 2022

The Lived Experiences Of Muslim Women With Infertility, Samia Abdelnabi

Wayne State University Dissertations

Background: Infertility, ranked as the 5th highest global disability, is estimated to impact 180 million couples worldwide. Muslim couples associate parenthood or the ability to have children as an accomplishment in their marriage, adulthood, social status, and security in later life. A failure to conceive in Muslim societies may lead to stigma, social isolation, grief, and despair. There is a gap in the literature on how Muslim women perceive, understand, and cope with infertility in the U.S. This knowledge gap limits the ability in to understand how social, religious, and cultural practices impact a diagnosis of infertility on Muslim American …


Integral Representations Of Sl_2(Z/Nz), Yatin Dinesh Patel Jan 2022

Integral Representations Of Sl_2(Z/Nz), Yatin Dinesh Patel

Wayne State University Dissertations

The aim of this work is to determine for which commutative rings integral representations of SL_2(Z/nZ) exist and to explicitly compute them. We start with R = Z/pZ and then consider Z=p^\lambda Z. A new approach will be used to do this based on the Weil representation. We then consider general finite rings Z/nZ by extending methods described in [26]. We make extensive use of group theory, linear representations of finite groups, ring theory, algebraic geometry, and number theory. From number theory we will employ results regarding modular forms, Legendre symbols, Hilbert symbols, and quadratic forms. We consider the works …


Phenanthroline-Catalyzed 1,2-Cis Glycosylation: Scope And Mechanism, Jiayi Li Jan 2022

Phenanthroline-Catalyzed 1,2-Cis Glycosylation: Scope And Mechanism, Jiayi Li

Wayne State University Dissertations

Phenanthroline, a rigid and planar organic compound with two fused pyridine rings, has been used as a powerful ligand for metals and a binding agent for DNA/RNA. We recently discovered that phenanthroline could be used as a nucleophilic catalyst to access high yielding and diastereoselective α-1,2-cis glycosides through the coupling of hydroxyl acceptors with α-glycosyl bromide donors. The utility of the phenanthroline catalysis is expanded to sterically hindered hydroxyl nucleophiles and chemoselective coupling of an alkyl hydroxyl group in the presence of a free C1-hemiacetal functionality. In addition, the phenanthroline-based catalyst has a pronounced effect on site-selective couplings of triol …


Optical Signal Processing With Discrete-Space Metamaterials, Mohammad Moein Moeini Jan 2022

Optical Signal Processing With Discrete-Space Metamaterials, Mohammad Moein Moeini

Wayne State University Dissertations

As digital circuits are approaching the limits of Moore’s law, a great deal of efforthas been directed to alternative computing approaches. Among them, the old concept of optical signal processing (OSP) has attracted attention, revisited in the light of metamaterials and nano-photonics. This approach has been successful in realizing basic mathematical operations, such as derivatives and integrals, but it is difficult to be applied to more complex ones. Inspired by digital filters, we propose a radically new OSP approach, able to realize arbitrary mathematical operations over a nano-photonic platform. We demonstrate this concept for the case of spatial differentiation, image …


Sequences Of Random Matrices Modulated By A Discrete-Time Markov Chain, Huy Nguyen Jan 2022

Sequences Of Random Matrices Modulated By A Discrete-Time Markov Chain, Huy Nguyen

Wayne State University Dissertations

In this dissertation, we consider a number of matrix-valued random sequences that are modulated by a discrete-time Markov chain having a finite space.Assuming that the state space of the Markov chain is large, our main effort in this work is devoted to reducing the complexity. To achieve this goal, our formulation uses time-scale separation of the Markov chain. The state-space of the Markov chain is split into subspaces. Next, the states of the Markov chain in each subspace are aggregated into a ``super'' state. Then we normalize the matrix-valued sequences that are modulated by the two-time-scale Markov chain. Under simple …


Electrochemistry Of Bubbles: Developing New Sensors, Promoting Gas Evolution Reactions, And Extraction Of Rare Earth Elements, Ruchiranga R. Ranaweera Jan 2022

Electrochemistry Of Bubbles: Developing New Sensors, Promoting Gas Evolution Reactions, And Extraction Of Rare Earth Elements, Ruchiranga R. Ranaweera

Wayne State University Dissertations

This dissertation presents new analytical, electrocatalysis, and separation strategies that utilize bubble behaviors in different electrochemical systems. The first part of this dissertation focuses on the method development for PFAS preconcentration and detection. First, we present the bubble-nucleation-based electrochemical method for the selective and sensitive detection of surfactants. Our method utilizes the high surface activity of surfactant analytes to affect the electrochemical bubble nucleation and then transduces the change in nucleation condition to an electrochemical signal for determining the surfactant concentration. Using this method, we demonstrate the quantitation of perfluorinated surfactants in water, a group of emerging environmental contaminants, with …


Optimization-Based Uav Fleet Routing And Safety Assurance – Models, Algorithms, And Prototyping, Zhenyu Zhou Jan 2022

Optimization-Based Uav Fleet Routing And Safety Assurance – Models, Algorithms, And Prototyping, Zhenyu Zhou

Wayne State University Dissertations

Unmanned aerial vehicles (UAVs), especially multi-rotor drones, have been increasingly used in various scenarios in the last decade. With the reduced hardware costs, improved battery life, and enhanced processor performance, we can eventually allow all kinds of drones to automatically travel through the low-altitude airspace. The large-scale application of drones will extend the basic transportation facilities from the ground to the air and form 3D transportation networks for the future. Compared to current ground-vehicle and aircraft traffic systems, multi-UAV systems are far from well-developed. Most current multi-UAV systems are human-operated or pre-programmed to perform specific tasks. The current application of …


Romantic Miscalculations On Dating Applications: Definitions And Experiences Of Mobile Dating Micro-Rejection, Sean James Kolhoff Jan 2021

Romantic Miscalculations On Dating Applications: Definitions And Experiences Of Mobile Dating Micro-Rejection, Sean James Kolhoff

Wayne State University Dissertations

Millions of emerging adults use mobile dating applications (MDAs) daily in their efforts to find a romantic partner. However, the processes these daters use to interpret and react to rejection have received little attention. Not every attempt to develop a relationship can be successful. As daters evaluate profiles on these apps and interact with potential partners, they may miscalculate their perceptions of compatibility hand encounter rejection. Within MDAs, rejection could be a passive or active declaration by an individual signifying they do not want to initiate or escalate a potential relationship. These various forms of rejection are conceptualized in this …


The Association Between School Spending And Academic Growth Among Seventh Grade Students In Michigan, Angela M. Jack Jan 2021

The Association Between School Spending And Academic Growth Among Seventh Grade Students In Michigan, Angela M. Jack

Wayne State University Dissertations

The purpose of this quantitative ex-post facto research study was two-fold: (a) to investigate the association, if any, between school spending and student academic performance, and (b) to identify what, if any, student and school-level structural characteristics mediated a relationship. Multilevel linear regression models were estimated to identify the association between total site-level per-pupil expenditures and school aggregated student academic growth measures in mathematics and ELA among 7th-grade students in Michigan for the 2018-2019 academic year. The data for 847 traditional public and charter public-school academies from 667 districts in Michigan were collected from the Michigan Center for Educational Performance …


The Role Of Biomaterial Substrate In Stem Cell Fate Determination, Zhenjie Liu Jan 2021

The Role Of Biomaterial Substrate In Stem Cell Fate Determination, Zhenjie Liu

Wayne State University Dissertations

The physical cues, which included topography, stiffness, and mechanical forces, can influence the stem cell renewal, differentiation, and maturation in vivo and in vitro. The nano-topography of the ECM can stimulate the neural differentiation of the stem cells, while the micro-topography of the ECM can guide the neurite outgrowth. However, the role and functional size of the micro- and nano-topography in the stem cell fate determination is not clear yet. To study this aim, two biomaterial based aligned fiber platforms (ACMFP and ASMFP) were designed, fabrication and evaluated to cover the micro-, submicro-, and nano-fiber topography, which used to study …


Multiparametric Quantitative Acoustic Imaging Of Cervical Remodeling During Pregnancy, Yan Yan Jan 2021

Multiparametric Quantitative Acoustic Imaging Of Cervical Remodeling During Pregnancy, Yan Yan

Wayne State University Dissertations

The uterine cervix plays a central role in the maintenance of pregnancy and the process of parturition. Untimely cervical ripening in early gestation predisposes to preterm labor and delivery, the leading cause of infant mortality worldwide. The current approach to evaluate the status of the cervix relies on digital and sonographic examination, which indicates the morphological changes of the cervix (cervical length). Therefore, assessing cervix tissue composition changes may provide more sensitive evaluations about cervix status beyond cervical length. Photoacoustic (PA) imaging is a relatively new, non-invasive ultrasound (US) based technology that captures acoustic signals emitted by tissue components in …


Singing Solidarity: Class Consciousness, Emotional Pedagogy, And The Songs Of The Industrial Workers Of The World, Tara Forbes Jan 2021

Singing Solidarity: Class Consciousness, Emotional Pedagogy, And The Songs Of The Industrial Workers Of The World, Tara Forbes

Wayne State University Dissertations

Singing Solidarity looks at songs and song culture in the Industrial Workers of the World (IWW) from its inception to its decline near the start of WWI and examines how IWW songs engaged with, transformed, and directed workers’ feelings to “spur [them] to action” (Gould 47). Songs in the IWW repertoire created a sense of group identity and cohesion, supporting the IWW’s project of class consciousness and working-class solidarity. This solidarity, I argue, was felt rather than theorized. The felt solidarity of the IWW collective was intensified through the act of singing as a group, which was simultaneously an instantiation …


A Multispecies Perspective Into Dietary Genetic Adaptations And Ancient Migration In The Peruvian Andes, Kelsey Jorgensen Jan 2021

A Multispecies Perspective Into Dietary Genetic Adaptations And Ancient Migration In The Peruvian Andes, Kelsey Jorgensen

Wayne State University Dissertations

Successful adaptation to the high-elevation Andes would have required both cultural and biological adaptations by early human populations. These past adaptations continue to shape the evolutionary outcomes of both humans and non-human species today. A multispecies perspective was used to examine how humans and non-human creatures, specifically insects, were shaped by past human adaptations. This dissertation asked two primary questions: 1) Given the importance and evolutionary history of potato consumption in the Peruvian Andes, is a genetic adaptation to better digest potato starch detectable in present-day Peruvians? and 2) Using the Andean Potato Weevil (APW) phylogeny as a proxy, what …


Identifying Biologically Relevant Mechanisms And Biomarkers Using Novel Bioinformatics Methods, Samer Hanoudi Jan 2021

Identifying Biologically Relevant Mechanisms And Biomarkers Using Novel Bioinformatics Methods, Samer Hanoudi

Wayne State University Dissertations

There is a tremendous need to analyze molecular and patient clinical data to identify biomarkers, biological mechanisms, or to simply classify samples accurately. Issues such as: i) limited tools to diagnose many diseases, ii) not considering biological interactions, or iii) damaged DNA samples could cause a challenge in identifying valuable insights. In this work, I try to address these issues by developing different bioinformatic frameworks.First, I present three frameworks to identify i) Sarcoidosis biomarkers, ii) Tuberculosis biomarkers and iii) Cystic fibrosis (CF) biomarkers. I identified Sarcoidosis biomarkers I applied them to classify Sarcoidosis samples from non-Sarcoidosis (healthy controls, Tuberculosis, and …


Understanding Pre-Service Elementary Mathematics Teacher Learning In An Early Lesson Study Experience, Christopher Dennis Nazelli Jan 2021

Understanding Pre-Service Elementary Mathematics Teacher Learning In An Early Lesson Study Experience, Christopher Dennis Nazelli

Wayne State University Dissertations

As the most important in-school factor in student learning, elementary school teachers must be able to offer all students the quality mathematical learning experiences that they deserve; and the opportunities to learn that pre-service teachers (PSTs) encounter during their preparation programs impact their ability to do so. Content courses are crucial components of the mathematical education of elementary teachers and can be sites for the early development of Mathematical Knowledge for Teaching (MKT) (Ball, Thames, & Phelps, 2008). These courses, often taken early in their preparation programs, can provide PSTs opportunities to create a new vision of mathematics, build new …


Accumulation-Type Ohmic Van Der Waals Contacts To Nearly Intrinsic Wse2, Upendra Rijal Jan 2021

Accumulation-Type Ohmic Van Der Waals Contacts To Nearly Intrinsic Wse2, Upendra Rijal

Wayne State University Dissertations

We report the fabrication of ohmic van der Waals (vdW) contacts to WSe2 using degenerately p-doped MoS2 (p+-MoS2) as a contact-metal. We demonstrate in WSe2 field-effect transistors (FETs) that accumulation-type ohmic contacts and high device performance are achieved without electrostatically gating the drain/source contact regions despite the nearly intrinsic nature of WSe2. Back-gated WSe2 FETs with p+-MoS2 bottom-contacts (which screen the back-gate electric field in the drain/source regions) exhibit linear output characteristics, a high on/off ratio of 108, and a high two-terminal field-effect mobility up to ~200 cm2V-1s-1 at room temperature. Our theoretical modeling reveals that the p+-MoS2/WSe2 vdW contact …


The Probiotic Effect Of Clostridium Cochlearium Is Associated With Significant Change In Short-Chain Fatty Acid Metabolism And Gut Microbiota, Qing Ai Jan 2021

The Probiotic Effect Of Clostridium Cochlearium Is Associated With Significant Change In Short-Chain Fatty Acid Metabolism And Gut Microbiota, Qing Ai

Wayne State University Dissertations

The prevalence of obesity is rising steadily across the world, which increases the risk of many metabolic diseases and life-threatening illnesses. A specific strain, Clostridium cochlearium (C. cochlearium), reported as a butyrate producer, could have potential probiotic effects against obesity. The objective of this study was to evaluate the effects of dietary supplementation of C. cochlearium on a high-fat diet-induced obese (DIO) mouse model. The 16S rRNA sequencing of mice gut microbiome was performed at the end of the experimental period to identify the changes in gut microbial composition, investigate possible functional genes, and elucidate potential mechanisms. Thirty-six C57BL/6 6-8 …


Induction And Prevention Of Electron Transport In Langmuir-Blodgett Films Of 3d-Based Metallosurfactants: Studies On Current Rectification And Corrosion Inhibition, Aldora Devale Kapuralalage Isuri Weeraratne Jan 2021

Induction And Prevention Of Electron Transport In Langmuir-Blodgett Films Of 3d-Based Metallosurfactants: Studies On Current Rectification And Corrosion Inhibition, Aldora Devale Kapuralalage Isuri Weeraratne

Wayne State University Dissertations

The work reported in this thesis focused on the use of redox-active metallosurfactants for current rectification and redox-innocent metallosurfactants for corrosion inhibition. These studies were done based on the hypothesis that redox-active metallosurfactnats can promote electron transport, while redox-innocent metallosurfactants can hinder electron transport. As such, new redox-active phenolate based iron(III), chromium(III), oxovanadium(IV) and redox-innocent gallium(III) and zinc(II) complexes were synthesized and characterized for the aforementioned applications. First, we studied the current rectification ability of a homobimetallic iron(III) hydrophobe with [N4O6] ligand environment. This complex displayed rectification with rectification ratio ranges from 2.6 to 9.8 between -2.0 and 2.0 V …


Antiwar Literature In The United States Since 1945, Kelly Roy Polasek Jan 2021

Antiwar Literature In The United States Since 1945, Kelly Roy Polasek

Wayne State University Dissertations

This dissertation examines literary resistance to US militarism since 1945. I maintain that a requirement of antiwar literature is a disruption or break from the pro-war narrative that seeks to justify and normalize the wars and militarism that saturate this historical period; literary works about war that do not deviate from this narrative are simply war literature. In chapters on John Hersey’s Hiroshima (1946), poetry and performance protests of the Vietnam Veterans Against the War (1970-72), Rob Halpern’s Common Place (2015), and works of speculative fiction by Omar El Akkad (American War, 2017) and N.K. Jemisin (The Fifth Season, 2015), …


Murals In Motion: Mexican Muralism On The Silver Screen And Its Place In Culturally Sustaining Pedagogy, Angela Michelle Sherman Jan 2021

Murals In Motion: Mexican Muralism On The Silver Screen And Its Place In Culturally Sustaining Pedagogy, Angela Michelle Sherman

Wayne State University Dissertations

This research focuses on Mexican Muralism as a part of an educational initiative introduced following the Mexican Revolution of 1910. Functioning as a didactic art form, the intention of the murals was to educate the masses about its history, new national identity and promising modern future. This work not only examines Mexican Muralism and its recurring themes and representation of Indigenous subjects, but also tracks the appearance of these images from mural walls to movie screens in Mexican film of the Golden age. Using the 21st century theory developed by Django Paris and Samy Alim, Culturally Sustaining Pedagogy, this work …


The Efficacy Of A Novel Facebook-Based Psychosocial Intervention For Adults With Chronic Pain: A Randomized Clinical Trial, Bethany Danielle Pester Jan 2021

The Efficacy Of A Novel Facebook-Based Psychosocial Intervention For Adults With Chronic Pain: A Randomized Clinical Trial, Bethany Danielle Pester

Wayne State University Dissertations

Social networking-based groups such as Facebook groups have become increasingly popular among people with chronic conditions, and the affordances of such groups make them a promising platform for chronic disease intervention. Yet, there have been few controlled tests of the effects of social networking-based groups. Our team developed a Facebook-based intervention that focuses on enhancing social support by connecting adults with peers who also have chronic pain. Using a randomized controlled clinical trial, we aimed to understand the efficacy of this intervention and to explore whether a professional-led support group leads to greater effects than a support group alone. The …