Digital Commons Network^™

Childhood Sexual Abuse And Compulsive Sexual Behavior Among Men Who Have Sex With Men Newly Diagnosed With Hiv, Monique J. Brown, Medinat Omobola Osinubi, Daniel Amoatika, Mohammad Rifat Haider, Sally Kirklewski, Patrick Wilson, Nathan B. Hansen

Faculty Publications

Childhood sexual abuse (CSA) continues to be a public health challenge. The prevalence of experiencing CSA is higher among men who have sex with men (MSM) than the general population. CSA has been linked to compulsive sexual behavior (CSB) among varying populations but has not been examined among MSM who were newly diagnosed with HIV. Therefore, the aims of this study were to assess the direct association between CSA and CSB among newly diagnosed MSM living with HIV, and to identify the potential mediating roles of depressive symptoms and emotion regulation in the association between CSA and CSB. The study …

Clonal Hematopoiesis Driven By Mutated Dnmt3a Promotes Inflammatory Bone Loss, Hui Wang, Kimon Divaris, Bohu Pan, Xiaofei Li, Jong-Hyung Lim, Gundappa Saha, Marko Barovic, Danai Giannakou, Jonathan M Korostoff, Yu Bing, Souvik Sen, Kevin Moss, Di Wu, James D Beck, Christie M Ballantyne, Pradeep Natarajan, Kari E North, Mihai G Netea, Triantafyllos Chavakis, George Hajishengallis

Faculty, Staff and Student Publications

Clonal hematopoiesis of indeterminate potential (CHIP) arises from aging-associated acquired mutations in hematopoietic progenitors, which display clonal expansion and produce phenotypically altered leukocytes. We associated CHIP-DNMT3A mutations with a higher prevalence of periodontitis and gingival inflammation among 4,946 community-dwelling adults. To model DNMT3A-driven CHIP, we used mice with the heterozygous loss-of-function mutation R878H, equivalent to the human hotspot mutation R882H. Partial transplantation with Dnmt3a

Framing The Path To Fitness: Age Differences In Response To Framed Exercise Messages, Iliya Sherif, David B. Taullahu, Alyssa R. Minton, Joseph A. Mikels

DePaul Discoveries

Physical activity is one of the most protective health behaviors one can engage in, yet 75% of active adults in the US, meaning those who exercise regularly, fall short of the recommended levels of physical activity, with an even greater percentage of older adults living inactive lives, meaning they exercise minimally and engage in prolonged sedentary behavior (CDC, 2019). The goal of the current study was to explore different types of message framing targeted at encouraging older and younger adults to exercise. We recruited older adults (n = 184; Mage = 69.45 years, age range: 65- 80 years) and younger …

Combating Disparities In A Pandemic: Increasing Dissemination Of Coronavirus Disease 2019 Resources In Spanish., Romina Barral, Nicholas Clark, Fernando Zapata, Lines Vargas Collado, July Jean Cuevas, Cristina Fernandez Md

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Disparities exist in access to coronavirus disease 2019 (COVID-19)-related health information. We aimed to close a gap in online traffic between English and Spanish COVID-19-related health information on our institution's publicly-facing website by 50% within ten months.

METHODS: We used A3 improvement methodology. Outcome measures were the mean monthly difference between English and Spanish COVID-19 online traffic vis-a-vis (1) total webpage views and (2) unique webpage visits. Process measures were stratification of outcome measures by language. Plan-Do-Study-Act cycles included: Recurring advertisements on a local Spanish television station disseminating up-to-date COVID-19 information, including our institution's Spanish COVID-19 online resources, incorporation …

Community-Based Participatory Obesity Prevention Interventions In Rural Communities: A Scoping Review, Saagar Dhanjani, Haley Allen, Beatriz Varman, Chishinga Callender, Jayna M Dave, Debbe Thompson

Library Staff Publications

Child obesity is a worldwide public health concern. In America, children from rural areas have greater odds of obesity in comparison to those from urban areas. Community-engaged research is important for all communities, particularly under-represented communities. This paper reports the results of a scoping review investigating community-engaged research in obesity prevention programs tested with school-aged children in rural America. A literature search of Medline Ovid was conducted to identify interventions reporting the results of obesity prevention interventions that promoted a healthy diet or physical activity (PA) behaviors to school-age children in rural communities of the United States (US). After title …

Barriers To And Facilitators Of Implementing Colorectal Cancer Screening Evidence-Based Interventions In Federally Qualified Health Centers: A Qualitative Study, Emanuelle M Dias, Joe R Padilla, Paula M Cuccaro, Timothy J Walker, Bijal A Balasubramanian, Lara S Savas, Melissa A Valerio-Shewmaker, Roshanda S Chenier, Maria E Fernandez

Faculty, Staff and Student Publications

Background: There is an urgent need to increase colorectal cancer screening (CRCS) uptake in Texas federally qualified health centers (FQHCs), which serve a predominantly vulnerable population with high demands. Empirical support exists for evidence-based interventions (EBIs) that are proven to increase CRCS; however, as with screening, their use remains low in FQHCs. This study aimed to identify barriers to and facilitators of implementing colorectal cancer screening (CRCS) evidence-based interventions (EBIs) in federally qualified health centers (FQHCs), guided by the Consolidated Framework for Implementation Research (CFIR).

Methods: We recruited employees involved in implementing CRCS EBIs (e.g., physicians) using data from a …

Discordant Prenatal Cell-Free Dna Screening Vs. Diagnostic Results Of Sex Chromosome Aneuploidies: Implications For Newborn Screening And Genetic Counseling, Susan Howell, Shanlee M. Davis, Billie Carstens, Mary Haag, Judith L. Ross, Nicole R. Tartaglia

Department of Pediatrics Faculty Papers

Sex chromosome aneuploidies (SCAs) collectively occur in 1 in 500 livebirths, and diagnoses in the neonatal period are increasing with advancements in prenatal and early genetic testing. Inevitably, SCA will be identified on either routine prenatal or newborn screening in the near future. Tetrasomy SCAs are rare, manifesting more significant phenotypes compared to trisomies. Prenatal cell-free DNA (cfDNA) screening has been demonstrated to have relatively poor positive predictive values (PPV) in SCAs, directing genetic counseling discussions towards false-positive likelihood rather than thoroughly addressing all possible outcomes and phenotypes, respectively. The eXtraordinarY Babies study is a natural history study of children …

Perceived Stress, Social Media Usage, And Sleep Quality In United States Adults, Justine P. Scott

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to explore the intricate connections among perceived stress, sleep quality, and social media usage metrics, challenging prior assumptions by highlighting social media as a noteworthy stress coping mechanism. The research aimed to understand the relationship between sleep quality, perceived stress, and the frequency and quality of social media use, guided by the biopsychosocial model as the theoretical framework.The study involved adults aged 20-65. A questionnaire incorporated four validated instruments to assess these variables: the Epworth Sleepiness Scale (ESS), Internet Addiction Diagnostic Questionnaire (IADQ), Perceived Stress Scale (PSS), and Social Media Quality Measure (SMQM). …

America Is Unprepared To Meet The Needs Of Its Growing Older Adult Population, Sierra Kaplan

Population Health Research Brief Series

In 2030, nearly 73 million Americans will be aged 65 years or older. As Americans continue to have fewer children than in the past, the number of older adults will outnumber children. Thus, fewer young adults will be around to support and care for the older adult population. Coupled with COVID-19 pandemic-driven disruptions to the healthcare industry, America’s health and aging care system is unprepared to support its large and growing older adult population. Over time, we will see increased health care scarcity and inequality in the distribution of elder care services, especially with continued healthcare worker shortages and drastic …

Rna 2′-O-Methylation Promotes Persistent R-Loop Formation And Aid-Mediated Igh Class Switch Recombination, Muzaffer Ahmad Kassab, Yibin Chen, Xin Wang, Bo He, Eric J Brown, Xiaochun Yu

Faculty, Staff and Student Publications

BACKGROUND: RNA-DNA hybrids or R-loops are associated with deleterious genomic instability and protective immunoglobulin class switch recombination (CSR). However, the underlying phenomenon regulating the two contrasting functions of R-loops is unknown. Notably, the underlying mechanism that protects R-loops from classic RNase H-mediated digestion thereby promoting persistence of CSR-associated R-loops during CSR remains elusive.

RESULTS: Here, we report that during CSR, R-loops formed at the immunoglobulin heavy (IgH) chain are modified by ribose 2'-O-methylation (2'-OMe). Moreover, we find that 2'-O-methyltransferase fibrillarin (FBL) interacts with activation-induced cytidine deaminase (AID) associated snoRNA aSNORD1C to facilitate the 2'-OMe. Moreover, deleting AID C-terminal tail impairs …

Computational Insights Into Sars-Cov-2 Main Protease Mutations And Nirmatrelvir Efficacy: The Effects Of P132h And P132h-A173v, Yuan-Ling Xia, Wen-Wen Du, Yong-Ping Li, Yan Tao, Zhi-Bi Zhang, Song-Ming Liu, Yun-Xin Fu, Ke-Qin Zhang, Shu-Qun Liu

Faculty, Staff and Student Publications

Nirmatrelvir, a pivotal component of the oral antiviral Paxlovid for COVID-19, targets the SARS-CoV-2 main protease (Mpro) as a covalent inhibitor. Here, we employed combined computational methods to explore how the prevalent Omicron variant mutation P132H, alone and in combination with A173V (P132H-A173V), affects nirmatrelvir’s efficacy. Our findings suggest that P132H enhances the noncovalent binding affinity of Mpro for nirmatrelvir, whereas P132H-A173V diminishes it. Although both mutants catalyze the rate-limiting step more efficiently than the wild-type (WT) Mpro, P132H slows the overall rate of covalent bond formation, whereas P132H-A173V accelerates it. Comprehensive analysis of noncovalent and covalent contributions to the …

Characteristics Associated With Early Vs. Late Adoption Of Lung Cancer Screening, Christine S. Shusted, Jan M. Eberth, Hee-Soon Juon, Julie Barta

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

Background: Although lung cancer screening (LCS) reduces lung cancer mortality among high-risk individuals, uptake overall remains low. With all cancer screening modalities, a period of diffusion among medical providers and the public is expected, with screening uptake exhibiting a distribution among early vs. late adoption. We aimed to characterize individuals undergoing LCS based upon the timeframe of screening adoption. Methods: This retrospective study examined patients who underwent LCS between January 2015 – December 2022 in a centralized LCS program. Based on United States Preventive Services Task Force (USPSTF) criteria for LCS, early and late adopters of LCS – defined by …

What Constitutes Adequate Control Of High Blood Pressure? Current Considerations, Donald E. Casey, Alexander J. Blood, Stephen D. Persell, Daniel Pohlman, Jeff D. Williamson

College of Population Health Faculty Papers

An estimated 45% of adult Americans currently have high blood pressure (HBP). Effective blood pressure (BP) control is essential for preventing major adverse events from cardiovascular and other vascular-related diseases, such as chronic kidney disease, stroke and dementia. A large and growing number of medical professional societies, health care organizations, and governmental agencies have now endorsed a clinical practice guideline-based target for adequate control of HBP to a systolic BP of less than 130 mm Hg. However, adequate BP control to this goal has been recently estimated to be as low as 30%. The first and most important steps to …

Comorbidity Of Disordered Eating And Depression: Examining Intersectional Inequities And Cardiometabolic Health Consequences Across The Life Course, Franklin Hunter Mcguire

Brown School Graduate Student Theses and Dissertations

Traditional epidemiologic research has often neglected the degree to which interlocking systems of oppression may (1) describe the distribution of population health inequities and (2) moderate health exposure-outcome associations. Grounded in an intersectional framework, this three-aim dissertation used an intersectional multilevel modeling approach (i.e., intersectional MAIHDA) and US nationally representative data to answer a series of intersectionality-informed research questions relevant to disordered eating, depression, and cardiometabolic health. With data from the National Health and Nutrition Examination Survey, Aim 1 quantified the population distribution of weight loss-oriented disordered eating behaviors (DEBs) among US adults across intersectional groups defined by race/ethnicity, sex/gender, …

Intersectional Analysis Of Vaccination Inequity Among Individuals With Disabilities In The United States During Covid-19 Pandemic, Philip Ndoki Ndoki

Walden Dissertations and Doctoral Studies

This study was an investigation of how disability status, types, sociodemographic indicators, and reasons for not receiving vaccinations influenced COVID-19 vaccination rates among individuals with disabilities in the United States. Despite efforts, vaccination disparities persisted, necessitating an understanding of barriers to uptake. Using intersectionality theory and the social determinants of health framework, this study examined the impact of marginalized identities and structural inequalities. Key questions included the association between disability status and vaccination uptake, differences among disability types moderated by sociodemographic factors, and the interaction between disability status and reasons for not vaccinating. Household Pulse Survey data from the US …

The Protective Efficacy Of A Sars-Cov-2 Vaccine Candidate B1351v Against Several Variant Challenges In K18-Hace2 Mice, Jie Yang, Huifen Fan, Anna Yang, Wenhui Wang, Xin Wan, Fengjie Lin, Dongsheng Yang, Jie Wu, Kaiwen Wang, Wei Li, Qian Cai, Lei You, Deqin Pang, Jia Lu, Changfu Guo, Jinrong Shi, Yan Sun, Xinguo Li, Kai Duan, Shuo Shen, Shengli Meng, Jing Guo, Zejun Wang

Faculty, Staff and Student Publications

The emergence of SARS-CoV-2 variants of concern (VOCs) with increased transmissibility and partial resistance to neutralization by antibodies has been observed globally. There is an urgent need for an effective vaccine to combat these variants. Our study demonstrated that the B.1.351 variant inactivated vaccine candidate (B.1.351V) generated strong binding and neutralizing antibody responses in BALB/c mice against the B.1.351 virus and other SARS-CoV-2 variants after two doses within 28 days. Immunized K18-hACE2 mice also exhibited elevated levels of live virus-neutralizing antibodies against various SARS-CoV-2 viruses. Following infection with these viruses, K18-hACE2 mice displayed a stable body weight, a high survival …

Which Types Of People Were Least Likely To Get The Covid-19 Vaccine?, Xue Zhang, Shannon M. Monnat

Population Health Research Brief Series

Vaccine hesitancy is a long-standing challenge that worsened during the COVID-19 pandemic. Understanding the reasons behind different types of vaccine hesitancy is crucial for developing effective vaccine messaging strategies that can increase confidence in and uptake of future vaccines. This brief summarizes the findings from a study that used data from the 2022 National Wellbeing Survey on 7,612 U.S. adults aged 18-64 to identify characteristics of adults who were least likely to get the COVID-19 vaccine and the characteristics associated with different types of vaccine hesitancy. The authors considered three non-mutually exclusive types of vaccine hesitancy: 1) watchful (concerned about …

Multicountry Spread Of Influenza A(H1n1)Pdm09 Viruses With Reduced Oseltamivir Inhibition, May 2023-February 2024, Mira C Patel, Ha T Nguyen, Philippe Noriel Q Pascua, Rongyuan Gao, John Steel, Rebecca J Kondor, Larisa V Gubareva

Faculty, Staff and Student Publications

Since May 2023, a novel combination of neuraminidase mutations, I223V + S247N, has been detected in influenza A(H1N1)pdm09 viruses collected in countries spanning 5 continents, mostly in Europe (67/101). The viruses belong to 2 phylogenetically distinct groups and display ≈13-fold reduced inhibition by oseltamivir while retaining normal susceptibility to other antiviral drugs.

Mixed-Methods Assessment Of Farmworkers’ Perceptions Of Workplace Compliance With Worker Protection Standards And Implications For Risk Perceptions And Protective Behaviors, Carly Hyland, Lisa Meierotto, Rebecca L. Som Castellano, Cynthia L. Curl

Public and Population Health Faculty Publications and Presentations

Introduction: The Environmental Protection Agency (EPA)’s Worker Protection Standards is the primary set of legislation aimed at protecting farmworkers from occupational pesticide exposure in the United States. Previous studies suggest that worker adoption of Pesticide Protective Behaviors (PPBs) promoted by WPS is associated with lower urinary pesticide concentrations. However, adoption of PPBs is often outside of the control of individual farmworkers and dependent on workplace factors such as employer provisioning of Personal Protective Equipment (PPE) and access to trainings/resources.

Methods: We conducted a mixed-method study including urinary pesticide biomonitoring, surveys, and interviews with 62 Latinx farmworkers in southwestern Idaho from …

Community Health Volunteers’ Experiences Of Implementing Covid-19 Vaccine Education And Promotion In Kenya: A Qualitative Descriptive Study, Constance Shumba, Peterson Kiraithe, Isabel Kambo, Sheila Shaibu

School of Nursing & Midwifery, East Africa

Background: Vaccination was a key measure in the COVID-19 pandemic response, though much work was needed to promote vaccine uptake and acceptance. In Kenya, Community Health Volunteers (CHVs) played a key role in vaccine education and promotion. We conducted this study to explore CHVs’ experiences of implementing COVID-19 vaccine education and promotion during the pandemic to increase COVID-19 vaccine uptake in two areas of Kenya.

Methods: In a qualitative descriptive study, we conducted 30 structured in-depth interviews with 20 CHVs and 10 Community Health Assistants from rural Kilifi County and Kangemi, an urban informal settlement of Nairobi County in Kenya …

Provider Experiences With Daily Use Of Elastomeric Half-Mask Respirators In Health Care, Morgan Lane, Lisa Pompeii, Janelle Rios, Elisa Benavides, Marie Kasbaum, Scott Patlovich, Luis Ostrosky-Zeichner, Adam Hornbeck, Caitlin Mcclain, Rohan Fernando, Margaret Sietsema, Colleen Kraft

Faculty, Staff and Student Publications

Background: During public health emergencies, demand for N95 filtering facepiece respirators (N95 FFRs) can outpace supply. Elastomeric half-mask respirators (EHMRs) are a potential alternative that are reusable and provide the same or higher levels of protection. This study sought to examine the practical aspects of EHMR use among health care personnel (HCP).

Methods: Between September and December 2021, 183 HCPs at 2 tertiary referral centers participated in this 3-month EHMR deployment, wearing the EHMR whenever respiratory protection was required according to hospital protocols (ie, when an N95 FFR would typically be worn) and responding to surveys about their experience.

Results: …

Health Care Workers’ Comfort Ratings For Elastomeric Half-Mask Respirators Versus N95® Filtering Facepiece Respirators During The Covid-19 Pandemic, Lisa Pompeii, Janelle Rios, Colleen S Kraft, Marie Kasbaum, Elisa Benavides, Scott J Patlovich, Luis Ostrosky-Zeichner, Adam Hornbeck, Caitlin Mcclain, Rohan D Fernando, Margaret Sietsema, Morgan Lane

Faculty, Staff and Student Publications

BACKGROUND: Reusable elastomeric half-mask respirators (EHMR) are an alternative to address shortages of disposable respirators. While respirator discomfort has been noted as a barrier to adherence to wearing an N95 filtering facepiece respirator (FFR) among health care personnel (HCP), few have examined EHMR comfort while providing patient care, which was the purpose of this study.

METHOD: Among a cohort of 183 HCP, we prospectively examined how HCP rated EHMR tolerability using the Respirator Comfort, Wearing Experience, and Function Instrument (R-COMFI) questionnaire at Study Week 2 and Week 10. At the completion of the study (Week-12), HCP compared EHMR comfort with …

The Blessed Assembly: Irreplaceable Physical Co-Presence In Worship And Healthy Hybridity Reimagined After The Pandemic In The Digital Age, Yvette, Ying Wai Lau

Doctor of Pastoral Music Projects and Theses

Because of the unprecedented and unexpected force of the pandemic since 2020, most churches around the world have experienced some online worship during the lockdown of their cities or the mandated closure of the church buildings. For many people, online worship seems to be an equivalent, if not better, alternative for gathering together—a physical co-presence in worship—even after the pandemic has ended. As necessary and vital as online worship experiences have been for Christians during the pandemic, the witness of the church from Pentecost throughout Christian history indicates that gathered worship in physical spaces is irreplaceable for faith formation and …

Social-Ecological Determinants Of Affective States Among College Students: A Cross-Cultural Ecological Momentary Assessment Study, Abhishek Aggarwal

Theses and Dissertations

Background: College students experience a complex and diverse array of stressors during their college life, making them vulnerable to severe mental health issues. Momentary affective states are linked to major mental health disorders and overall well-being; however, the current social-ecological model of affect lacks a temporal dimension, failing to account for within-person dynamics of affective states over time. This study disentangles the complex temporal dynamics among the momentary, multilevel social-ecological factors and affective states in the real-world setting of college students across the United States (US) and India. However, establishing invariance of the affect model across time, people, and cultures …

Understanding Cancer Grade And Survival Disparities Among Young Adults Diagnosed With Non-Hodgkin’S Lymphoma (Nhl) Residing In South Carolina, Prema S. Bhattacharjee

Theses and Dissertations

Introduction. Previous research has shown that age and cancer grade differences must be carefully considered when developing initiatives to improve outcomes for NHL among the young adult population. The aims of this study are 1) to examine differences between low vs. high grade in NHL by race/ethnicity, healthcare insurance, and geographic factors among YAs aged 18-39 years of age in South Carolina, 2) to examine delays in the first course of cancer treatment for NHL by race/ethnicity, healthcare insurance, and county of residence (urban vs. rural) among YAs aged 18-39 years of age in South Carolina, and 3) examine differences …

Parenting Identity And Parental Mental Health In Chinese Parents In Mainland China, Zhenqiao Yang

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

In the modern context of mainland China, parents of young children face unique parenting stressors, making parental mental health during the early stages of parenting a significant public concern. Increasing awareness of the role of self-concepts in mental health underscores the importance of exploring the relationships between parenting identity concepts, parenting stress, parental mental health, and familial factors. This study aims to examine the relationship between parenting identity and parental mental health, specifically depression and anxiety, in the context of early childhood parenting stress. Data were collected from 456 parents at four daycare centers and public spaces in an Eastern …

In Their Voices: Kenyan Women's Experiences With Cancer Treatment–Related Side Effects, Tayreez Mushani, Dinah Kassaman, Sharon Brownie, Peterson Kiraithe, Margaret Barton-Burke

School of Nursing & Midwifery, East Africa

Objective This article reports on a secondary analysis of a qualitative study conducted in Nairobi, Kenya that reported several initial themes. In this article, the authors explore the theme of treatment-related side effect management by women receiving treatment for breast or cervical cancer.

Methods Women were interviewed at three points during their active treatment trajectory. Participants were purposefully selected and saturation was reached when interviews did not yield any new themes. The interviews were transcribed and analyzed for internal consistency, frequency, extensiveness, intensity and specificity. The Nvivo pro 12 software was used in organizing and managing the data to facilitate …

Financial Incentives For Smoking Cessation Among Socioeconomically Disadvantaged Adults: A Randomized Clinical Trial, Darla Kendzor, Michael Businelle, Summer Frank-Pearce, Joseph Waring, Sixia Chen, Emily Hébert, Michael Swartz, Adam Alexander, Munjireen Sifat, Laili Kharazi Boozary, David Wetter

Kimmel Cancer Center Faculty Papers

IMPORTANCE: Socioeconomically disadvantaged individuals (ie, those with low socioeconomic status [SES]) have difficulty quitting smoking and may benefit from incentive-based cessation interventions.

OBJECTIVES: To evaluate the impact of incentivizing smoking abstinence on smoking cessation among adults with low SES.

DESIGN, SETTING, AND PARTICIPANTS: This study used a 2-group randomized clinical trial design. Data collection occurred between January 30, 2017, and February 7, 2022. Participants included adults with low SES who were willing to undergo smoking cessation treatment. Data were analyzed from April 18, 2023, to April 19, 2024.

INTERVENTIONS: Participants were randomized to usual care (UC) for smoking cessation (counseling …

Pediatric Oral Health Literacy Among Caregivers Of Young Children, Melissa L. Sullivan

Health Services Research Dissertations

Early childhood caries (ECC) is a common dental condition that affects the primary teeth of infants and young children. ECC can have a significant negative impact on a child’s oral health and overall well-being. Caregivers have an important role in the prevention of early childhood caries through knowledge, understanding, and awareness of good oral hygiene practices. Caregivers who possess adequate oral health literacy (OHL) may be more likely to recognize the risks associated with ECC, implement proper oral hygiene practices, and make informed oral health choices for themselves and their child.

The overarching purpose of this dissertation is to explore …

What Are The Psychosocial Effects Of Service Dogs On Handlers With Disabilities, Kylie Kline

University Honors Theses

This study looks to explore the psychosocial effects that service dogs have on handlers with disabilities. A cross-sectional survey designed to gather information about this directly from service dog handlers was administered to a sample of 20 participants. Then, a qualitative analysis was conducted on data from the survey using an inductive coding scheme that identified themes in the data as key terms and ideas emerged.

Results revealed many nuances surrounding service dogs' effects on handlers' psychosocial health. Notable results include: 20 of 20 participants (100%) reporting their service dogs have had positive impacts on their quality of life; 19 …