Digital Commons Network^™

A Global Movement Takes Shape – Physical Activity, Health, And The New Era Of Responsibility: “Global Alliance For Promotion Of Physical Activity”, J. M. Steinacker, W. Van Mechelen, C. Joisten, S. Zanuso, C. A. Jaworski, Y. P. Pitsiladis

Research outputs 2022 to 2026

No abstract provided.

Tackling Data Quality Challenges In Remote Sensing: Solutions For Reliable Urban Heat Island Analysis, Wei Xia, Aqil Tariq, Hesham El-Askary, Rana Waqar Aslam, Elgar Barboza, Dmitry E. Kucher, Youssef M. Youssef, Habib Kraiem

Mathematics, Physics, and Computer Science Faculty Articles and Research

Urban heat islands (UHIs) pose critical challenges to public health, energy demand, and environmental sustainability, particularly in rapidly expanding urban regions. This study examines the complex relationship between building configurations and integrated green spaces, as well as their combined impact on thermal regulation. It focuses on addressing data quality issues commonly encountered in remote sensing applications. Using high-resolution multispectral and thermal imagery, we developed an integrated modeling approach that captures the collective influence of built form and green infrastructure on urban microclimates. A key finding is the significant linear inverse relationship between green space coverage and land surface temperature, underscoring …

Integrating Circulating Tumor Dna Into Clinical Management Of Colorectal Cancer: Practical Implications And Therapeutic Challenges, Nikhil Vojjala, Viktoriya Gibatova, Raj N Shah, Sakshi Singal, Rishab Prabhu, Geetha Krishnamoorthy, Karen Riggins, Nagaishwarya Moka

Faculty, Staff and Students Publications

The American Cancer Society estimates that over 152,000 new cases of colorectal cancer (CRC) were diagnosed in 2024, with more than 105,000 cases affecting the colon and 46,000 involving the rectum. CRC remains the second leading cause of cancer-related deaths in the United States, with an estimated 53,010 deaths in 2024. In the era of precision medicine, which incorporates molecular and environmental information into clinical decision-making, identifying patients harboring a deficiency in Deoxyribonucleic acid (DNA) repair allowed for targeted immunotherapies and significantly reduced CRC-related mortality. A significant advancement in this domain is the application of liquid biopsy, which has emerged …

Explore Toolkit, Kimberly Page, Janet Page Reeves, Ivan De La Rosa, Marie Alice Scott, Christina Phillips, Maria Sanchez, Andrew Gorvetzian, Joe Albright, Cynthia Killough, Randall Benalli

Epidemiology, Biostatistics, and Preventive Medicine

Welcome to the Exploring Health Beliefs for Community Engagement and Diversity in Clinical Trials (EXPLORE) Toolkit, a resource designed to support researchers and frontline workers addressing substance use in the Borderlands. The EXPLORE Toolkit was designed by an interdisciplinary team of epidemiologists, social workers, anthropologists, and public health professionals to enhance the engagement of underrepresented communities in substance use clinical trials. Utilizing a strength-based approach, the toolkit addresses equity, stigma, and participation barriers, promoting culturally sensitive and community-centered research practices. This toolkit is an ideal tool for clinical trials researchers and community health workers who are interested in learning more …

Association Between Homelessness And Maternal Health Outcomes Among Non-Hispanic Black Women In Georgia, Miranda Weaver

Walden Dissertations and Doctoral Studies

Maternal health disparities among homeless non-Hispanic Black women in Georgia represent a critical public health concern, driven by inequitable access to care and elevated risks of adverse pregnancy outcomes. This study examined how homelessness influences perinatal care utilization (timing and frequency of prenatal visits and postpartum checkups) and pregnancy complications (gestational diabetes, hypertension, and depression), and whether these associations differ by geographic context (urban versus rural). Grounded in the Social Determinants of Health framework, the study used a quantitative cross-sectional design, analyzing secondary data (n = 1,540; weighted ≈ 203,571) from Phase 8 (2017–2021) of the Pregnancy Risk Assessment Monitoring …

The Protective Factors Of Trauma-Informed Care For Parents With Autistic Children, Carolynn J. Redd-Recksiek

Doctoral Dissertations and Projects

The purpose of this current phenomenological study is to understand the experience of parents with autistic children and their lack of trauma-informed care from direct care providers in Northern Utah. This study is guided by trauma-informed theory, which is a model of care delivery created by Maxine Harris and Roger D. Fallot (2001). Trauma-informed care recognizes how adverse experiences can impact a person and have a negative impact on the health and well-being of that person and how those negative experiences have a direct impact on the health and well-being of the family, which directly impacts the health and well-being …

Analyzing Environmental Health: Air Pollution And Human Health Using Geospatial Data Science, Yanhong Huang

Geography ETDs

Air pollution from industrial emissions and wildfire smoke poses growing threats to public health. This dissertation employs geospatial data science to examine these challenges through three interrelated studies. The first study investigates the relationship between maternal residential exposure to industrial pollutants and low birth weight, identifying five chemicals as significant risk factors. The second study assesses the impact of industrial air pollution on lung and bronchus cancer survival, finding that exposure to 1,1,1-trichloroethane and cobalt is associated with reduced survival. The third study explores disparities in wildfire smoke PM_2.5 exposure and its association with asthma exacerbations. Results show disparities …

Alfred Russel Wallace Notes 37. What About Wallace On Vaccination . . . ?, Charles H. Smith

Faculty/Staff Personal Papers

Best known for his natural history studies on evolution and biogeography, Alfred Russel Wallace (1823−1913) had a significant second career as a social critic. One of his most controversial stances was his position on (smallpox) vaccination. Anti-vaxxers of the present frequently bring up his name as a resource for their side, but the situation is not so easily reducible to that.

Navigating Child Oral Health In Western Australia: A Caregiver's Perspective, Lesley Andrew, Elizabeth Wenden, Mohamed Estai, Ruth Wallace

Research outputs 2022 to 2026

Background: Early childhood caries (ECC) is the most common chronic health condition among Australian preschool-aged children. Untreated, ECC can affect children's physical and emotional health and future social opportunities. ECC is largely preventable through primary caregivers' correct understanding of oral health promoting diets, oral hygiene practices and dental service engagement. The study aim is to explore Western Australian (WA) primary caregivers' child oral health knowledge, experience and practices. The Fisher-Owens socioecological model of child oral health was applied across the study to structure and interpret the findings across the complex, interactive sociocultural influences on child oral health. Methods: The mixed-methods …

Models Of Care For Indigenous Children In Rural And Remote Settings: A Global Scoping Review, Joseph Freeman, Thomas Stubbs, Verity Chadwick, Anita Pickard, Tuguy Esgin, Elizabeth J. Elliott, Alexandra Martiniuk

Research outputs 2022 to 2026

Indigenous communities internationally have demonstrated remarkable strength despite significant challenges. Health disparities among Indigenous peoples persist due to historical injustices and ongoing racial discrimination, not inherent vulnerabilities. Disparities are rooted in a legacy of colonisation, systemic exclusion, and socio-economic inequities impacting access to healthcare, education, and employment. Preliminary searches show limited literature on models of care for remote living Indigenous children. This review aimed to identify internationally, effective models of care for Indigenous children in rural and remote areas. A scoping review was conducted, analysing literature on models of care for remote Indigenous children. This study followed the JBI’s Scoping …

Unfolding The Mystery Of Autoimmunity: The Environmental Determinants Of Diabetes In The Young (Teddy) Study, Marian Rewers, Daniel Agardh, Suzanne Bennett Johnson, Ezio Bonifacio, Helena Elding Larsson, Patricia Gesualdo, William Hagopian, Michael J Haller, Heikki Hyöty, Randi Johnson, Richard Mcindoe, Eoin Mckinney, Jessica Melin, Åke Lernmark, Richard E Lloyd, Kristian F Lynch, Jill M Norris, Stephen S Rich, Roswith Roth, Desmond Schatz, Jorma Toppari, Eric Triplett, Kendra Vehik, Suvi M Virtanen, Anette-G Ziegler, Beena Akolkar, Jeffrey P Krischer, Teddy Study Group

Faculty, Staff and Students Publications

In 2025, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the National Institutes of Health celebrates 75 years of leadership in diabetes research. The NIDDK serves people of the U.S. affected by or at risk for many chronic diseases, including diabetes and other endocrine, metabolic, and digestive disorders, by funding innovative research to develop better treatment and prevention and a cure for these conditions. Autoimmunity that leads to type 1 diabetes or celiac disease or thyroid autoimmunity affects 1 in 20 children and adolescents in the U.S. While treatments are available, prevention of these common autoimmune …

Living Heritage, Resilience And Ethically Informed Infrastructures In Malawi, Martha B. Lerski, Frank Puluputu Mwale

Publications and Research

Rooted in a rural community’s needs, this paper explores how historically, and ethically informed infrastructures can support community engagement towards identification, documentation, and dissemination of local, traditional, and indigenous knowledge relating to climate change. The paper examines climate adaptation and sustainability issues through the lenses of community organizing and Library & Information Science best practices. It draws on a growing body of literature identifying a role for expanded epistemological and subject discipline perspectives. While the impacts of climate on material culture are increasingly recognized, intangible, and biocultural heritage have not received as much attention. Living heritage traditions and knowledge systems …

Do Minorities Attend Culturally Competent Hospitals? The Case Of Minority-Serving And Safety-Net Hospitals, Rumel Mahmood

Journal of Social, Behavioral, and Health Sciences

Minorities disproportionately attend minority-serving hospitals (MSHs) and safety-net hospitals (SNHs). This study examines whether MSHs or SNHs are more culturally competent than their counterparts. No research to date has examined the cultural competency of MSHs and SNHs with hospitals outside of these categories. The literature on the determinants of hospital-level cultural competence is sparse, with limited measures used nationally and a robust measure used in a single U.S. state. I calculated a 100-point score of hospital cultural competence from a nationally representative survey of hospitals (N = 849 respondents). Using multilevel regression models, I found that MSHs are culturally …

Profiling Of Physical Activity Usage In Selected Urban Green Spaces In Marikina City, Trizsa Jasmin C. Ty, Alberto L. Dimarucut, Camille B. Castro, Danielle Naomi L. Uy

CSID Journal of Infrastructure Development

Urban Green Spaces (UGS) play an important role in providing opportunities for physical activity in urbanized cities. This observational cross-sectional study aims to profile two selected UGS, namely Marikina River Park and Marikina Heights Park Complex, in Marikina City, in the context of their use for physical activity and recreation. Interviews with two government officials were conducted to collect data on the historical background of the selected parks. Systematic observation, using the System for Observation of Play and Recreation in Communities tool, was conducted to observe park visitors and their physical activity for four days in each park. Each park’s …

Urban-Rural Divide In Inequality’S Impact On Substance Abuse, Jonathan E. Flores

Undergraduate Theses, Capstones, and Recitals

This thesis focuses on investigating the relationship between income inequality, measured through the Gini coefficient, and drug addiction, proxied through substance-related mortality. Specifically, this thesis focuses on how these dynamics vary across rural and urban counties in the United States, using population size as a proxy. County-level data from 2016 to 2020 were collected through both the CDC and the Census Bureau and subsequently analyzed using Stata, with crude death rates from drug and alcohol causes serving as a function of the Gini coefficient, labor force participation, racial composition, and other socioeconomic indicators. Through a quadratic version of the model, …

Adolescent Preventive Care Outcomes Before And After Covid-19 Onset: What Is The Role Of Telehealth?, Sarah Hayden Knipper

Dissertations and Theses

Adolescents are a developmentally distinctive population with unique primary health care needs; they comprise about 10% of Oregon's population and more than half are covered by the Oregon Health Plan (OHP). This dissertation investigated significant declines in preventive care utilization (well visits and HPV immunizations) among adolescents enrolled in OHP during the COVID-19 pandemic and the relationship between the decline in utilization and the rise in telehealth availability. The study focused specifically on the role of race/ethnicity, geography, and access to health systems in mitigating or exacerbating decreases in preventive care. A mixed methods approach was employed to understand not …

One Health Integration To Control And Prevent Zoonoses: Application Of Organizational Theory Literature, Lisset M. Dumet Poma, Sherril Gelmon, Julia M. Goodman, Seth E. O’Neal

Hatfield Graduate Journal of Public Affairs

Zoonoses are infectious diseases transmitted between animals and people that disproportionately affect low- and middle-income countries (LMICs). The One Health (OH) approach aims to integrate systems, incentivizing collaboration among animal, human, and environmental systems to address zoonoses and improve health. Innovative solutions for effectively and sustainably achieving systems integration are needed. Organizational theories can facilitate the study of the context of OH implementation, applying comprehensive approaches that recognize the interconnections among organisms, the environment, and social systems, including the diverse entities needing integration (e.g., policy, community, public organizations). This narrative review examines organization and systems literature to provide recommendations for …

Food Environments And Mental Health: Analyzing The Impact Of Fast-Food Availability On U.S. Adults (2011-2016), Nicole Tenner

NYMC Student Theses and Dissertations

This study investigates the relationship between the availability of fast food in US territories and mental health outcomes. Utilizing a cross-sectional design, the study examines data from the 2011 and 2016 Behavioral Risk Factor Surveillance System (BRFSS) from the CDC, along with data from the U.S. Department of Agriculture’s Food Environment Atlas. The analysis included a nationally representative sample of 351,823 participants across all 50 US states. Multiple regression models examined the association between fast food availability and two primary mental health outcomes: the number of self-reported poor mental health days and the likelihood of being diagnosed with a depressive …

Impact Of Sociodemographic Determinants On Enrollment Into Contemporary Lymphoma Clinical Trials: A Systematic Review, Jun Yang Jiang, Ang Li, Alexis Romero, Christopher R Flowers, Chijioke Nze

Faculty, Staff and Students Publications

While the incidence and survival associated with lymphoma have improved in recent years, outcome disparities related to sociodemographic factors such as age, sex, race, ethnicity, socioeconomic status (SES), and other social determinants of health (SDOH) remain prevalent in the modern era. Clinical trials are crucial for further improving outcomes, yet not all sociodemographic groups are equally represented in contemporary lymphoma trials. We conducted a systematic review of the literature evaluating the impact of SDOH on enrollment into clinical trials in the United States and identified 21 relevant studies. We confirmed that Black and Hispanic individuals are underrepresented in lymphoma clinical …

Functional Resilience Of Healthcare In The Critical Juncture Of The Covid-19 Pandemic, Avner Kronisch, Christian Bongiorno, Kerane Smith, John Baker

Working Papers Series

This paper offers a comparative analysis of eight national healthcare systems—spanning democracies, autocracies, and various institutional models—to evaluate resilience during the COVID-19 pandemic. Drawing on Shvetsova et al.’s framework of informational and authority redundancies, and Parker & Klein’s “choke point” theory of healthcare rationing, we examine how institutional structure shaped pandemic response, system adaptability, and continuity of non-COVID services. Using indicators like life expectancy, under-five mortality, hospital capacity, cancer survival, and excess mortality, we explore how systems absorbed shock and maintained essential care. We find that decentralized and polycentric governance structures, when paired with coordination and resource adequacy, enhanced resilience—exemplified …

Arts-Based Sustainability: From New York To Malawi, Martha B. Lerski

Publications and Research

Recognizing that libraries serve multiple constituencies and subject areas, this chapter documents and advocates for development of transdisciplinary arts-based research (ABR) and culture-related projects linked to environmental challenges. Libraries contribute collections and spaces, as well as the research of library and information scientists. Libraries are currently among invisible contributors to sustainability planning and services. The chapter will link this invisibility to the value of what visual arts refer to as negative space elements in subjects ranging from traditional ecological knowledge to environmental science. Library collections, projects, and research contribute to education for sustainable development (ESD) as required to achieve the …

Exploring Early Childhood Development Programming In Kenya’S Arid And Semi-Arid Lands, Phyllis Magoma, Amina Abubakar, Martha Kaniala, Barack Aoko, Moses Wesala, Joyce Marangu, Susan Nyamanya, Margaret Kabue, Anil Khamis, Esther Chongwo

Institute for Human Development, East Africa

Background: Promoting high-quality early childhood development (ECD) is vital for individuals’ physical and social well-being and yields significant societal returns. However, children in marginalised regions like Kenya’s arid and semi-arid lands (ASALs) face significant barriers to accessing quality ECD services.

Aim: This study aimed to document existing ECD services in Kenya’s ASAL areas, including their availability, types and key characteristics; identify gaps in their provision and propose solutions to enhance access and quality. Setting: This qualitative study was conducted in 10 ASAL counties in Kenya.

Methods: Using purposive and snowball sampling techniques, 103 key informants, including pre-primary …

Ecological Grief Among Farmers And Pastoralists In Ethiopia And Kenya, Syed Shabab Wahid, Christine Musyimi, Benjamin Oestericher, Linda Khakali, Lauren Carruth, Emily Mendenhall, Edna Bosire

Brain and Mind Institute

Climate change is a major cause of mental distress worldwide. In many ways, climate change has become a chronic disaster, while in other ways each acute event can accumulate and present challenges within and between communities. A growing body of evidence indicates that a changing climate can precipitate a cluster of negative affective states scholars call “ecological grief.” Ecological grief reflects psychological responses to climate changes and destruction of nature, species, culturally significant or sacred spaces. Until now, ecological grief has been conceptualized as a psychological response connected primarily to the destruction of the natural environment, and has not fully …

Access To Healthcare For Rural Transgender Adults In The United States, Devon Smith

University Honors Theses

Urban and rural healthcare differ significantly in the amount of facilities, providers and kinds of specialty care that are offered in each environment. The United States is split into urban and rural counties in any given region, and based on those population sizes, are the allocation of healthcare resources for residents. In rural areas in the U.S., transgender adults lack access to gender-affirming care and encounter a lack of gender-affirming care providers due to workforce shortages, discrimination, and a lack of cultural competency. To determine if these residents lacked access to care compared with their urban counterparts, I performed a …

Geographic Inequalities, And Social-Demographic Determinants Of Reproductive, Maternal And Child Health At Sub-National Levels In Kenya, Janette Karimi, Anitah Cherono, Victor Alegana, Martin Mutua, Hellen Kiarie, Rose Muthee, Marleen Temmerman, Peter Gichangi

Centre of Excellence in Women and Child Health

Background; Global initiatives have emphasized tracking indicators to monitor progress, particularly in countries with the highest maternal and child mortality. Routine data can be used to monitor indicators for improved target setting at national and subnational levels. Our objective was to assess the geographic inequalities in estimates of reproductive, maternal and child health indicators from routine data at the subnational level in Kenya.

Methods; Monthly data from 47 counties clustered in 8 regions, from January 2018 to December 2021 were assembled from the District Health Information Software version 2 (DHIS2) in Kenya. This included women of reproductive age receiving family …

Utilizing A Clinical Resource Hub To Improve Access And Workflow For Retinopathy Screenings In The Veteran Population, Erin Kelly Pope

Doctor of Nursing Practice Final Manuscripts

Abstract

Utilizing a Clinical Resource Hub to Improve Access and Workflow for Retinal Screenings in the Veteran Population

Erin K. Pope, MSN, RN, AGCNS-BC, AMB-BC

Scot Nolan, DNP, RN, CNS, PHN, CCRN, CNRN, SCRN, FCNS

Background: Diabetic retinopathy (DR), a progressive complication of diabetes mellitus (DM), is the leading cause of blindness among working-age adults. As DR can remain asymptomatic until advanced stages, annual screenings are critical for early detection and management. Teleretinal imaging is an evidence-based method for DR screening, offering cost efficiency and reduced demand on ophthalmology clinics. At the Veterans Administration’s (VA) Loma Linda Healthcare System …

Exposure To And Impact Of Unhealthy Food Marketing On Adolescents And Young Adults: A Narrative Review And Research Agenda, Nicholas Freudenberg, Rositsa Ilieva

Publications and Research

Consumption of unhealthy food has become a leading cause of premature deaths and preventable illnesses around the world. Research shows that marketing by the companies that produce, distribute, and sell unhealthy foods and beverages is associated with increased consumption of these products. To date, however, limited research has focused on the cumulative exposure and impact of various modes of marketing employed to reach distinct populations. In this narrative review, we summarize 25 years of scientific evidence and findings from 108 empirical studies and 19 systematic and scoping reviews of various forms of unhealthy food marketing to adolescents (aged 13 to …

Rural And Urban Disparities In Access To Glp-1 Agonists For Patients With Obesity, Christine J. Hackler-Moorman

MUSC Theses and Dissertations

The increasing interest in glucagon-like peptide-1 (GLP-1) agonists, such as semaglutide, which are often prescribed as a first-line treatment for managing Type II diabetes, as well as for non-diabetic purposes—such as weight management and improving metabolic health—highlights their potential in preventive care. This promise inspires hope for a future where preventive healthcare is more effective and accessible to a wider audience. Nonetheless, significant geographic disparities in access to healthcare, especially between rural and urban areas, create obstacles that prevent numerous patients from reaping the benefits of these essential medications. In rural communities, challenges like cost, availability, and awareness are often …

Generative Ai For Thematic Analysis In A Maternal Health Study: Coding Semistructured Interviews Using Large Language Models, Shan Qiao, Xingyu Fang, Junbo Wang, Ran Zhang, Xiaoming Li, Yuhao Kang

Faculty Publications

Study Objectives: The coding of semistructured interview transcripts is a critical step for thematic analysis of qualitative data. However, the coding process is often labor-intensive and time-consuming. The emergence of generative artificial intelligence (GenAI) presents new opportunities to enhance the efficiency of qualitative coding. This study proposed a computational pipeline using GenAI to automatically extract themes from interview transcripts. Methods: Using transcripts from interviews conducted with maternity care providers in South Carolina, we leveraged ChatGPT for inductive coding to generate codes from interview transcripts without a predetermined coding scheme. Structured prompts were designed to instruct ChatGPT to generate and summarize …

Framing The Future: A Community Health Analysis Of The Pee Dee Region, Stephen Borders, Jean Anton, Rian Fontaine, Donielle Phillips, Treyton Ringer, Jessica Robinson, Caitlin Thompkins

Public Health

This report presents a comprehensive, data-driven analysis of community health across South Carolina’s Pee Dee region, encompassing Florence, Darlington, Chesterfield, Marlboro, Marion, and Dillon Counties. Using tract-level data from CDC PLACES, the U.S. Census, and the National Provider Identifier registry, it assesses chronic health conditions, health behaviors, and social determinants of health. The analysis incorporates the South Carolina Healthy Communities Index (SCHCI) and a Suitability Analysis to identify the region’s most disadvantaged communities. The findings highlight persistent disparities, particularly in rural counties, where high rates of poverty, chronic disease, and unmet basic needs intersect with limited access to care. Despite …