Digital Commons Network^™

Dyadic Internalized Stigma, Resilience, And Psychological Distress Among People With Hiv And Their Family Members: An Actor-Partner Interdependence Mediation Model Analysis, Fanghui Shi, Xueying Yang, Shan Qiao Ph.D., Cheuk Chi Tam Ph.D., M.S., M.A., Shuaifeng Liu, Yuejiao Zhou, Xiaoming Li Ph.D.

Faculty Publications

Despite robust evidence showing the mediation role of psychological resilience in the impacts of HIV-related stigma on psychological distress, most studies were conducted from an intrapersonal perspective. Limited studies have examined the dyadic effects of HIV-related stigma and resilience on psychological distress for people with HIV (PWH) and their family members. This study aimed to explore the actor-partner effect and the mediation role of resilience in the relationship between internalized stigma and psychological distress among PWH and family members dyads. Between October 2023 and December 2023, a total of 800 PWH-family member dyads were recruited from two urban cities and …

A Livelihood Intervention Improved Nutritional, Mental Health And Sexual Health Outcomes Among Hiv-Affected Adolescents In Western Kenya: Results From The Shamba Maisha Randomised Controlled Trial, Sheri D. Weiser, Lila Aziz Sheira, Pauline Wekesa, Jennifer Monroe Zakaras, Edward A. Frongillo Jr. Ph.D., Elly Weke, Jason M. Nagata, Amy A. Conroy, Marguerita Lightfoot, Torsten B. Neilands, Lisa M. Butler, Elizabeth A. Bukusi, Craig R. Cohen, Maricianah Atieno Onono

Faculty Publications

Introduction Interventions that address household-level factors, including food insecurity (FI) and poverty, may reduce HIV risk and improve sexual and reproductive health (SRH) among adolescent girls and young women (AGYW).

Methods This cluster randomised controlled trial in Kenya assessed AGYW living in households of adults enrolled in Shamba Maisha (SM). SM was a multisectoral agricultural livelihood intervention designed to improve HIV health. At the trial end, we used linear and logistic regressions to compare differences between the intervention and control arms in FI, and mental health among AGYW-caregiver pairs and SRH outcomes among the AGYW, accounting for clusters with robust …

What Factors Influence Health Professions Trainees’ Preferences For Employment In Rural Appalachia? A Qualitative Study To Inform The Design Of A Discrete Choice Experiment, Chris Gillette, Jan Ostermann Ph.D., Aylin A. Aguillar, Sarah O'Neal, Chris Everett, Dawn Caviness, Esita Patel, Laiton Steele, Dawn Goel, Quazi Minhaz Tabassum

Faculty Publications

Optimizing the geographic allocation of health care providers has the potential to improve health care access and health outcomes for rural populations. To inform the design of a discrete choice experiment (DCE) survey to elicit health professions trainees' preferences for rural practice, this formative research aimed to: (1) elicit factors that influence job selection among health profession trainees, including medical residents physician assistant (PA) and nurse practitioner (NP) students, (2) identify how these trainees evaluate trade-offs for rural job placement and (3) inform attribute selection for inclusion into a future DCE to identify health professions trainees’ preferences for rural practice. …

Transformational Leadership In Higher Education, Dr. Jewel Hale, Jr., Kristi Apostel

Tapestry: Journal of Research in Education

A crisis can highlight the critical need for resilient leadership within higher educational settings. Educational leaders encounter extraordinary difficulties, ranging from different learning options to prioritizing the well-being of both staff and students, necessitating flexible and innovative methods. By exploring how school leaders apply transformational techniques in actual educational environments, this article addresses the impact of the four I’s of transformational leadership, idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration, on building educator resiliency, sustaining school effectiveness, and promoting student achievement in higher education.

Fierce Leadership-Perspectives Of Black Women Educational Leaders: A Transcendental Phenomenological Study, Janice Taylor, Dianne Reed

Tapestry: Journal of Research in Education

The authors of this transcendental phenomenological study aimed to describe the lived experiences of Black women based on their perceptions, values, and beliefs about the complexities of leadership and the kind of leadership required to succeed in their respective roles, as educational leaders. This study was framed by the adaptive leadership theory. Adaptive leadership recognizes the need for leaders to stay flexible and resilient in fast-paced environments (Nelson & Squires, 2017). The three Black women leaders in this study were fierce adaptive leaders. The information acquired from this study is significant and highlights how Black women educational leaders developed the …

Research Literacy And Research Production Skills As Core Competencies In Leaders, Kk O'Byrne

Tapestry: Journal of Research in Education

No abstract provided.

Evaluating Sensory Sensitivities Among Children With Autism Spectrum Disorder In An Adaptive Gymnastics Program, Aicha Kaouss, Bradley Eppinger, Austin Ebbrecht, Kailash Ram, Kaitlin P. Hardy Md

Knowledge and Creativity Expo

Introduction: Children with autism spectrum disorder (ASD) participate in physical activity at lower rates than their neurotypical peers1. Sensory sensitivities, reported in approximately 75–95% of children with ASD, may contribute to this disparity2. Gymnastics environments involve bright lighting and loud noise, which can precipitate sensory overload. The impact of specific sensory features on participation in adaptive gymnastics remains underexplored.

Methods: A cross-sectional study recruited caregivers of children aged 3–12 years with an ASD diagnosis enrolled in the EVMS Adaptive Gymnastics Program. Caregivers completed the Sensory Experiences Questionnaire–Third Edition (SEQ-3)3 and supplemental survey items on Redcap which assessed environmental triggers and …

How Does Striving Against Adversity Impact Emotional Well-Being And Cardiovascular Risk In Children?, Brooks B. Gump, Stefanie Pilkay, Xiafei Wang, Sara Vasilenko, Nader H. Attallah-Yunes, Sarah Woolf-King, Stephen Maisto, Edith Chen, Craig K. Ewart

Population Health Research Brief Series

Working hard and persisting through challenges (i.e., striving) are often encouraged for children who face adversity.  But for children facing severe adversity, striving can come with hidden costs. This brief summarizes findings from a study using data from the Environmental Exposures and Child Health Outcomes (EECHO) cohort (N=283, 2013-2017) of children ages 9-11 in Syracuse, NY. The authors find that children facing adversity who strived harder reported lower depression and hostility. However, high-striving high-adversity children also experienced significantly higher blood pressure and enlarged heart chambers than their lower striving peers, both risk factors for future heart disease.

Bodies At Risk When Choice Is A Privilege: Women’S Reproductive Healthcare Accessibility And Health Outcomes Since The Dobbs (2022) Ruling, Dallas Bonnet

Undergraduate Theses

Existing literature has well-documented the disproportionate effects of abortion restrictions upon socioeconomically disadvantaged women and women of color. This thesis builds on that work by exploring the relationship between state-level abortion restrictions and women’s self-reported health, as well as state-level infant mortality rates and maternal mortality rates. This project breaks these relationships down into three separate studies: Study 1 investigates the effect that abortion restrictions have on women’s self perceptions of health. Study 2 assesses the impact of abortion restrictions on infant mortality rates. Study 3 inspects the impact of abortion restrictions on maternal mortality rates. The primary independent variable …

Depressive Symptoms, Campus Connectedness, And Campus Climate Related To Sexual Violence And Misconduct, Stephanie A. Navarro Silvera, Amanda S. Birnbaum, Eva S. Goldfarb, Ranju Mainali, Lisa D. Lieberman

Department of Public Health Scholarship and Creative Works

Depression, although a consequence of sexual violence, has not been studied in the context of college students’ views of campus sexual violence climate. Depression is one of the most prevalent and impairing mental health concerns among college students and has well-established links to sexual violence victimization; therefore, it serves as a theoretically and clinically meaningful focal outcome. Therefore, we assessed perceptions of institutional climate in the context of self-reported depression. Undergraduates (n = 716) reported perceptions and experiences of campus sexual violence and misconduct, connectedness, attitude, and depressive symptoms in an online survey. More than a third of participants reported …

Living In Liberal Areas Reduced Covid-19 Vaccine Hesitancy Among Conservatives, Brittany L. Kmush, Rachel E. Dinero

Population Health Research Brief Series

Political divisions shaped public health responses throughout the COVID-19 pandemic, with conservatives expressing higher vaccine hesitancy than liberals. But does where conservatives live matter? This brief summarizes findings from a study using survey data from 683 U.S. adults (ages 18-94) collected March-April 2023, combined with 2020 presidential election results by zip code. The authors found that liberals consistently had low vaccine hesitancy and high uptake regardless of where they lived, but conservatives living in lower Trump vote share communities reported lower vaccine hesitancy and higher vaccination and booster uptake than conservatives in high Trump vote share communities. This pattern was …

Development And Validation Of The Emergency Department Transitions Measure, Sara Beachy, Danielle M. Mccarthy, Julianna Lenoir, Alexzandra Gentsch, Richard W. Hass, Marissa Witmer, Paula Ostroff, Melissa Tupas, Lindsey Shughart, Hailey Shughart, Kristin L. Rising

Jefferson Center for Connected Care Faculty Papers

BACKGROUND: Transitions of care are high-risk periods for patient safety in the emergency department (ED), particularly for patients who are still in the diagnostic process and are discharged with diagnostic uncertainty. Care transitions must be improved for these patients, as one third of discharged ED patients have diagnostic uncertainty. Yet there are no validated measures that assess the quality of care transitions from the ED, limiting the ability to assess the impact of interventions. Thus, we developed and validated the ED Transitions (EDT) measure.

METHODS: This mixed methods study was conducted across a large healthcare system in three phases: item …

Decision-Making At The Edges Of Capacity: Brain Science And Caregiving, Dr. Julie Yonker

University Faculty Publications and Creative Works

Keynote address at the Disabilities Resources Symposium at City Hope Church in Grand Rapids on 3/14/2026. Attached is her powerpoint.

• Describe why our brains don’t like decisions
• Understand the impact of different types of decisions
• Value suggestions for more sustained decision making
• Consider a faith perspective

Quality Of Prenatal Care, Provider Preference, And Preeclampsia Among African American Women In Georgia, Lyteasha Bass

Walden Dissertations and Doctoral Studies

African American women experience disproportionately high rates of preeclampsia in the United States; however, the contributions of prenatal care provider type, health care access, and quality of care to this disparity were insufficiently defined. Guided by the quality health outcomes model, this quantitative case-control study used primary data to examine associations between these factors and the occurrence of preeclampsia among African American women age 18–40 who had given birth within the previous 5 years in Georgia. Descriptive statistics and binary and multinomial logistic regression analyses were conducted. Prenatal care quality was measured using the Quality of Prenatal Care Questionnaire (QPCQ), …

Social Network Determinants Of Cigarette Forgoing And Quit-Related Conversations In A 15-Day Ecological Momentary Assessment Study In Mexico And The Us, Lizeth Cruz-Jiménez, Kevin A. Carson, Jim Thrasher Ph.D., Ma, Ms, Katia Gallegos-Carrillo, Dèsirée Vidaña-Pérez, Diego F. Leal

Faculty Publications

Introduction

Methods

Associational Inference With Many Potential Covariates: Bayesian Information Criterion Elastic Net, Farideh Bagherzadeh Khiabani, I-Chan Huang, Jose Miguel Martinez Martinez, Shizue Izumi, Sedigheh Mirzaei, Tiange Zheng, Irina Dinu, Yutaka Yasui

COBRA Preprint Series

Background: An emerging feature in modern biomedical research is collecting and analyzing numerous variables. In the presence of many potential covariates, inference becomes challenging requiring both distinguishing a set of covariates truly associated with an outcome and estimating their corresponding regression coefficients consistently. Traditional statistical inference typically focuses on estimating coefficients assuming a pre-specified set of covariates. Further, advanced machine/statistical learning methods performing both selection and estimation predominantly focus on outcome prediction rather than association inference.

Methods: Motivated by our epidemiological research on long-term childhood cancer survivors, where we aimed to investigate associations between a large pool of longitudinal symptom …

Multi-Dimensional Research Appraisal: A Holistic Approach To Evidence-Informed Practice, John Damiao

Translational Science in Occupation

The field of occupational therapy (OT) and healthcare in general have made great strides in enhancing their scientific rigor through study methodologies that prioritize internal validity. However, concerns regarding reproducibility and replicability in research have cast doubt on traditional evidence-based models. This paper critically examines the limitations of an over-reliance on internal validity in evidence reviews and advocates for a multi-dimensional approach to evidence-based practice. By integrating methodological holism, contextual analysis, and a critical appraisal of external validity, this approach provides practitioners with a more nuanced and applicable framework for decision-making. The implications for research credibility and clinical confidence are …

Development And Validation Of A Life Participation Self-Assessment Tool For People Living With Obesity: The Life Participation Impact Questionnaire (Lpiq-O), Marie-Claude Touchette

Translational Science in Occupation

Purpose: Obesity is a chronic condition affecting over 40% of adults in the U.S. Given the well-documented impact of obesity on life participation, a comprehensive, population-specific assessment tool is needed. We aimed to establish the face and content validity of the Life Participation Impact Questionnaire for People with Obesity (LPIQ-O), an occupation-focused assessment tool measuring the impact of obesity on areas of life participation.

Method: This study included seven iterative phases: (a) literature review, (b) interviews, (c) synthesis of the literature review and interviews, (d) item development, (e) expert validation, (f) face validation, and (g) final expert review. Six participants …

Integration Of The Science Of Team Science (Scits) With Applied Healthcare Frameworks: Interprofessional Education Through A University-Based Head Injury Clinic, Part Ii: Mixed Methods, Emily Balog, Susan Paparella, Natalia Noce, Stephanie Hubbell, Kelly Pena

Translational Science in Occupation

Introduction: Effective healthcare delivery requires clinicians to function within high-performing, collaborative teams. To support this, interprofessional education (IPE) must provide opportunities that move beyond siloed training. This paper details the clinical application of a team science-informed educational intervention designed to prepare students for interprofessional practice (IPP) through a university-based head injury head injury clinic. Methods: The research team conducted a mixed methods case study with a convergent design to evaluate student outcomes. Eighteen graduate students from occupational therapy, physical therapy, and speech-language pathology participated in a 10-week clinic. Faculty delivered training in IPEC competencies, TeamSTEPPS® tools, and clinical processes before …

Pedaling Through Discomfort: A Feasibility Study Of Faculty-Led Spin Classes And Their Impact On Student Engagement, Resilience, And Faculty-Student Relationships, Gabriela Baza, Elizabeth Hathaway

Pursuit - The Journal of Undergraduate Research at The University of Tennessee

This study explored the feasibility and impact of faculty-led Spin classes on college students’ engagement, well-being, and connection with faculty. Offered twice weekly at 7 AM during Fall 2024, the classes aimed to promote physical activity, resilience, and faculty-student relationships. Twenty-six students attended at least one class, with a median attendance of 4.5 sessions. Post-semester surveys (88% response rate) assessed perceived exertion, interest, enjoyment, challenge, improvement, and instructor encouragement. Students reported high levels of engagement and positive challenge (RPE = 15.3; challenge = 6.4/7). Those attending 7 or more sessions reported significantly greater perceived improvement than those attending fewer sessions …

94th Annual Georgia Public Health Association Meeting And Conference Report, Angela H. Peden, Beverley Townsend, Patrina L. Bowles, Sarah L. Mosley

Journal of the Georgia Public Health Association

The 94th Annual Meeting and Conference of the Georgia Public Health Association (GPHA) was held in Jekyll Island, Georgia, at the Jekyll Island Convention Center, on May 1-3, 2024. The goal of the 2024 Georgia Public Health Association Annual Meeting and Conference was to assemble public health professionals, students, County Board of Health members, and stakeholders for networking and educational opportunities to support the mission and vision of GPHA.

The theme for the 2024 Georgia Public Health Association Annual Meeting and Conference was selected by the GPHA Executive Board during a meeting in the early fall of 2023: “Lighting the …

Rates And Predictors Of Intention To Get Preventive Screenings Among Individuals In Recovery From Substance Use Disorders, Afsha Hossain, Ban A. Majeed, Lia Pierson Bruner

Journal of the Georgia Public Health Association

Background: Individuals with substance use disorders (SUDs) are at greater risk for chronic disease but often face barriers to access and uptake of preventive screenings, so the aim of this study was to identify rates and predictors for intention to get preventive screenings among residents at two recovery centers.

Methods: We used a cross-sectional survey (N=95, response rate 51%) to determine previous screening rates and the intention to get recommended preventive screenings among residents of two long-term recovery programs in Athens, GA, using bivariate analysis with chi-square to look for associations with intention.

Results: Prior use of preventive health services …

Evaluating Strategies For Reducing Rates Of Adult Obesity In The United States Through Childhood Education And Exercise, Ameer M. Abdelkrim

Doctoral Dissertations and Projects

Obesity is a growing national public health crisis, impacting millions of adults and children in the U.S. Untreated obesity causes or aggravates diseases across multiple body systems. The societal impacts of obesity include an avoidable strain on the national healthcare system, with obesity and its comorbid conditions raising healthcare costs. Proactive policy and practices, with strict oversight, are essential for achieving a reduction in obesity rates. One proactive strategy that may be effective is early-age intervention, including enhanced physical activity and nutrition education for U.S. children. This study evaluates adolescent-intervention strategies for reducing rates of adult obesity. The employed methods …

Potency-Related Effects Of Smoked Cannabis On Simulated Driving Performance: A Randomized, Controlled Crossover Trial, Bruna Brands, Adam Zaweel, Madison Wright, Patricia Di Ciano, Christine M. Wickens, Justin Matheson, Andrew Fares, Omer S. M. Hasan, Marcos Sanches, Beth Sproule, Marilyn A. Huestis, Timothy L. Brown, Bernard Le Foll

Institute of Emerging Health Professions Faculty Papers

Given the increasing availability of high-potency Δ9-tetrahydrocannabinol (Δ9-THC) products, understanding potency-related effects of Δ9-THC on driving performance is an important public safety issue. This randomized, double-blind, placebo-controlled, within-subjects trial examined the effects of smoked cannabis with varying Δ9-THC concentrations on simulated driving. Adults aged 19–45 who regularly used cannabis and held valid driver’s licenses completed simulated driving tasks after smoking placebo, or cannabis containing low (6.25%/47 mg Δ9-THC), medium (12.5%/94 mg Δ9-THC), or high (22%/165 mg Δ9-THC) Δ9-THC levels. The primary outcome was mean speed (km/h); secondary measures included maximum speed, standard deviation of lateral position (SDLP), reaction time (RT), …

Domestic Violence In The Mountain West, 2026, Isabelle G. Graham, Olivia K. Cheche, Caitlin J. Saladino, William E. Brown Jr.

Criminal Justice

This fact sheet presents 2026 data on domestic violence in the five Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah. The World Population Review report, “Domestic Violence by State 2026,” reports data on the percentage of women and men in each state who report experiences of domestic violence in their lifetime.This fact sheet highlights state-level data on different forms of domestic violence reported across the Mountain West.

Anhedonia Underlies The Association Between Childhood Unpredictability And Adult Ptsd Symptoms: Evidence From Three Independent Longitudinal Cohorts, Christopher Hunt, Laura M. Glynn, Elysia Poggi Davis, Tallie Z. Baram, Caroline M. Nievergelt, Giovanni Castillo, Christian Cortes, Christine Y. Chang, Dewleen Baker, Victoria B. Risbrough

Psychology Faculty Articles and Research

Background

Unpredictability in the child’s environment has recently emerged as a significant and unique form of early life adversity (ELA). Cross-sectional studies have linked childhood unpredictability with increased post-traumatic stress disorder (PTSD) symptoms in adults; however, no prospective studies have tested the link between childhood unpredictability and PTSD risk in later life, nor what processes, such as increased anhedonia symptoms, might mediate such risk. Here, we leveraged three distinct prospective, longitudinal cohorts to test the hypothesis that unpredictability during childhood contributes to adult PTSD via worsening anhedonia symptoms.

Methods

Participants were male service members (n=314), adult females (n=170), and adolescents …

Face And Content Validity Of A Survey Tool To Measure Perceived Barriers And Facilitators To Diabetes Management In Rural Veterans: Perspectives Of Registered Dietitians, Jameson Tade, Mary Shotwell, Ronette Lategan-Potgieter, Marty R. Jacobson

Internet Journal of Allied Health Sciences and Practice

Purpose: Type 2 diabetes mellitus (T2DM) is a major health challenge in the United States, affecting over 36 million Americans exceeding $105 billion annually in treatment-related costs.^1,2 Type 2 diabetes affects some populations more than others, including rural and veteran populations.^1,3 Registered dietitians (RDs) are an integral part of the diabetes management team, but limited literature is available to identify perceived barriers to T2DM management in military veterans who preside in rural areas. The purpose of this study was to explore face and content validity of a survey tool distributed to Veterans Health Administration (VHA) dietitians in a …

Cognitive And Emotional Conflict Control Among Children Affected By Parental Hiv/Aids In China, Huihui Wang, Juan Liu, Danfeng Wen, Wan Zhao, Xiaoming Li Ph.D., Junfeng Zhao

Faculty Publications

Background: Children affected by parental HIV/AIDS constitute a particularly vulnerable population, often facing heightened risks in psychosocial adaptation due to family disruption, social stigma, and resource deprivation. However, the characteristics of their executive functions, particularly the core component of conflict monitoring, remain unclear.

Methods: The present study compared the performance of children affected by parental HIV/AIDS (n=32) to a control group (n=32) on a cognitive conflict and emotional conflict face-word Stroop task.

Results: The results of the cognitive Stroop task demonstrated that both groups showed better performance in congruent stimuli compared to incongruent stimuli (86.20% vs.67.30%; 568.43ms vs.586.04ms). In the …

Muscular Fitness Levels Of U.S. Children And Adolescents, Daniel J. Mcdonough, Yong Gao, Lynda B. Ransdell, Haichun Sun

International Journal of Physical Activity and Health

Purpose: To describe muscular fitness (MF) levels and percentile benchmarks among U.S. children and adolescents aged 6–15 years old across sociodemographic, physiological, and behavioral subgroups. Methods: Data were from the 2012 NHANES National Youth Fitness Survey (NNYFS). Four strength tests consisting of the plank, knee extension, modified pull-up, and handgrip, were analyzed by age, sex, race/ethnicity, income, BMI category, cardiorespiratory fitness (CRF), and physical activity (PA) among 1,234 participants (51% male) using SAS SURVEY procedures. Results: Mean ± SEM scores were 69.6 ± 1.8 s (plank), 56.6 ± 4.2 lb (left) and 59.2 ± 4.3 lb (right) knee extension, 5.5 …

Navigating Homelessness And Housing Accessibility: An Ethnography Of Guests At Operation Nightwatch, Chase Kawika Patton

Dissertations and Theses

In 2025, over 7,000 individuals in Portland, Oregon experiencing unsheltered homelessness are without access to shelter or transitional housing. In this resource gap Operation Nightwatch (ON) provides material support for people experiencing homelessness (PEH) in the University District neighborhood of downtown Portland. This study focused on the experiences of chronically homeless guests of Nightwatch as they navigated homelessness and housing access. The study relied on semi-structured interviews with staff and guests and on-site participant observation to determine the availability of support to access housing in a system governed by Coordinated Access and the Housing First model. Primary research took place …