Digital Commons Network^™

Impact Of Online Interactive Decision Tools On Women’S Decision-Making Regarding Breast Cancer Screening: Systematic Review And Meta-Analysis, Patricia Villain, Laura Downham, Alice Le Bonniec, Charlotte Bauquier, Olena Mandrik, Tom Nadarzynski, Lorie Donelle Phd, Rn, Fcan, Raúl Murillo, Eleni L. Tolma, Sonali Johnson, Patricia Soler-Michel, Robert Smith

Publications

Background: The online nature of decision aids (DAs) and related e-tools supporting women’s decision-making regarding breast cancer screening (BCS) through mammography may facilitate broader access, making them a valuable addition to BCS programs. Objective: This systematic review and meta-analysis aims to evaluate the scientific evidence on the impacts of these e-tools and to provide a comprehensive assessment of the factors associated with their increased utility and efficacy. Methods: We followed the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and conducted a search of MEDLINE, PsycINFO, Embase, CINAHL, and Web of Science databases from August 2010 to …

Development And Validation Of A Revised Multidimensional Digital Health Literacy Scale: Secondary Analysis Using Cross-Sectional Data From The 2022 Getcheckedonline Community Survey In British Columbia, Canada, Ihoghosa Iyamu, Pierce Gorun, Hsiu Ju Chang, Rodrigo Sierra-Rosales, Devon Haag, Heather Pedersen, Sofia Bartlett, Nathan Lachowsky, Geoffrey Mckee, Catherine Worthington, Troy Grennan, Lorie Donelle Phd, Rn, Fcan, Daniel Grace, Mark Gilbert

Publications

Background: Digital technologies are reshaping health care, making digital health literacy (DHL) a critical competency for navigating online health information. Although widely conceived and measured as a unidimensional measure of DHL, the literature increasingly supports a multidimensional framing of the eHealth Literacy Scale (eHEALS). Studies propose alternative factor structures that can better inform population-level interventions, but these studies have not accounted for the ordinal nature of eHEALS response data. Objective: This study aimed to identify and validate an alternate multidimensional structure of eHEALS accounting for its ordinal response scale. Methods: Data were drawn from the 2022 GetCheckedOnline community survey of …

Harnessing Team Science In Dementia Research: Insights From The Alzheimer’S Disease Research Group In South Carolina, Sayema Akter, Eric Mishio Bawa, Nicholas Riccardi, Daniel A. Amoatika, Margaret C. Miller Ms, Ph.D., Otis L. Owens Mph, Ph.D., Caps, Lorie Donelle Phd, Rn, Fcan, E Angela Murphy, Daping Fan, Melissa Moss, Mihyun Lim Waugh, Sue E. Levkoff Scd, Msw, Sm, Freda Allyson Hucek, Jean Neils-Strunjas Ph.D, Ccc-Slp, Swann Arp Adams Ph.D., Ms, Face, Roger Newman-Norlund, Sarah Newman-Norlund Ph.D., James Hardin Ph.D., John Absher, Bankole A. Olatosi Ph.D., Xiaoming Li Ph.D., Lumi Bakos Ph.D., Quentin Mccollum, Chris Rorden, Leonardo Bonilha, Daniela B. Friedman

Publications

Alzheimer's disease and related dementias (ADRD) are complex and rapidly growing public health challenges that require integrative, collaborative approaches. To meet this need, the Alzheimer's Disease Research Center (ADRC) of South Carolina, a state-funded partnership across multiple institutions, has embraced a team science model that brings together expertise from four key disciplines: neuroimaging-neurology, health sciences, molecular biology, and engineering. This paper highlights the work at the University of South Carolina (USC) and how each discipline contributes uniquely yet collaboratively within a recurring loop model framework. Extending from USC's Cancer Prevention and Control Program, the framework guides scientific growth through four …

Ready Or Not, The Deadline Is Coming! Getting Onboard With Accessible Course Content, Karen Edwards, Lena Pinkston

Faculty Publications

People with disabilities often have less engagement with and access to online resources (Lissitsa & Madar, 2018). Accordingly, the Department of Justice’s (DOJ) Final Rule (89 FR 31320, 2024) for Title II of the Americans with Disabilities Act of 1990 (ADA) requires many public educational institutions and others to comply with the Web Content Accessibility (WCAG) Guidelines Version 2.1 AA by April 24, 2026. Compliance officers and technology specialists across the country have been working to make sure institutional websites and apps meet the Guidelines. Despite spirited debate during the rulemaking process, the updated rule also requires instructional content within …

Integrating School Mental Health Services: How Therapeutic Alliance May Improve Outcomes In A Mental Health Literacy Intervention, Alena Quinn

Theses and Dissertations

The youth mental health crisis continues to face persistent barriers of stigma, workforce shortages, and fragmented service delivery systems. Schools play a pivotal role in addressing these challenges, as youth are six times more likely to access mental health services in schools than in community settings. Frameworks such as the Comprehensive School Mental Health Systems (CSMHS) and the Interconnected Systems Framework (ISF) have improved access and quality of school-based mental health services through integration and partnership efforts. However, stigma remains a persistent barrier for seeking help and perpetuating untreated mental health difficulties. Research has found that mental health literacy (MHL) …

Iq Trends In Preschoolers With Autism And Co-Occurring Developmental Delay Are Associated With Autism Severity Not Anxiety, Chandler Elizabeth Knott

Theses and Dissertations

Intellectual functioning constitutes a significant source of heterogeneity in individuals with autism spectrum disorder (ASD); however, little is known about how intellectual functioning manifests over development in preschool children with non-syndromic ASD (nsASD) and co-occurring global developmental delay (GDD) or how this relates to functionally impairing co-occurring conditions, such as anxiety. Study participants included 57 children with nsASD and co-occurring global developmental delay (ASD+GDD), 24 categorized with mild GDD, and 33 categorized with moderate GDD. Drawing on dynamic systems theory, the present study explored developmental trends within the context of multiple complex systems, including intelligence, social-emotional, and behavioral functioning. Moderated …

The Effects Of Schema Therapy On Shame In Victims Of Intimate Partner Violence, Annette Ibarra Skeen

Theses and Dissertations

Intimate partner violence (IPV) is prevalent in the United States and worldwide. Despite the deleterious effects of IPV on personal and societal wellness, there is limited research on effective interventions for IPV victims. Among the detrimental effects of IPV on mental health, shame is a common emotion experienced by IPV victims. Shame can contribute to an array of mental health concerns, such as depression, anxiety, low self-esteem, PTSD, substance abuse, and suicidality. Using a multiple baseline, singe case design, the aim of the current study was to evaluate the effects of Schema Therapy (ST) on shame on IPV victims. Based …

Involvement Of Integrated Stress Response In Primary And Secondary Dystonia, Tricia Aleena Dulice Simon

Theses and Dissertations

ABSTRACT Dystonia is the third most common movement disorder in the United States of America , the first two being essential tremor and Parkinson’s disease. Gaining mechanistic knowledge about pathobiology of dystonia is essential for development of effective therapies. As the only therapies currently available are invasive procedures such as deep brain stimulation (DBS) or frequent botulinum toxin injections, it is critical to understand the underlying molecular mechanisms leading to dystonia. A maladaptive integrated stress response (ISR) involving dysregulation of the eukaryotic translation initiation factor  (eIF2) mediated signaling is observed in DYT-PRKRA patient cells. Mutations in PRKRA gene, which …

Harnessing Big Heterogeneous Data To Evaluate The Potential Impact Of Hiv Responses Among Key Populations In Sub-Saharan Africa: Protocol For The Boloka Data Repository Initiative, Refilwe Nancy Phaswana Mafuya, Edith Phalane, Amrita Rao, Kalai Willis, Katherine Rucinski, K. Alida Voet, Amal Abdulrahman, Claris Siyamayambo, Betty Sebati, Mohlago Seloka, Musa Jaiteh, Lerato Lucia Olifant, Katharine Journeay, Haley Sisel, Xiaoming Li Ph.D., Bankole Olatosi Ph.D., Neset Hikmet, Prashant Duhoon, Francois Wolmarans, Yegnanew A. Shiferaw, Lifutso Motsieloa, Mashudu Rampilo, Stefan Baral

Faculty Publications

Background: In South Africa, there is no centralized HIV surveillance system where key populations (KPs) data, including gay men and other men who have sex with men, female sex workers, transgender persons, people who use drugs, and incarcerated persons, are stored in South Africa despite being on higher risk of HIV acquisition and transmission than the general population. Data on KPs are being collected on a smaller scale by numerous stakeholders and managed in silos. There exists an opportunity to harness a variety of data, such as empirical, contextual, observational, and programmatic data, for evaluating the potential impact of HIV …

Caregiving Burdens Of Task Time And Task Difficulty Among Paid And Unpaid Caregivers Of Persons Living With Dementia, Matthew Lee Smith, Jodi L. Southerland, Malinee Neelamegam, Gang Han, Shinduk Lee, Chung Lin Kew, Juanita Dawne R. Bacsu, Elyse Couch, Steffi M. Kim, Monique J. Brown Ph.D., Mph, Ayse Malatyali, Lucas Wilson, Zahra Rahemi, Jeremy Holloway, Marcia G. Ory

Faculty Publications

Background: Demands of caregivers of persons living with dementia (PLWD) are often influenced by the context of their caregiving situation. This study examines common and unique factors associated with caregiving burden in terms of task time and task difficulty among paid and unpaid caregivers of PLWD. Methods: Cross-sectional baseline survey data were analyzed from 107 paid and unpaid caregivers of PLWD participating in a larger NIH-funded study assessing the feasibility of using a novel in-situ sensor system. Oberst Caregiving Burden Scale constructs of task time and task difficulty served as dependent variables. Two least squares regression models were fitted, controlling …

Investing In The Development Of The Next Generation Of Mch Leaders, Karen A. Mcdonnell, Jamal Percy, Lisa Anders, Monique J. Brown Ph.D., Mph, Alice R. Richman, Julianna Deardorff, Monica S. Ruiz, Jihong Liu Sc.D., Kelli Russell, Audrey Snyder, Cassondra Marshall

Faculty Publications

The public health landscape is constantly evolving to address the strengths and needs of the community. Training for the public health workforce is leading the way, establishing an ecosystem approach that integrates individuals within social, political, and environmental contexts to promote health equity within a framework of social justice. One area of public health that is innovatively preparing the next generation of leaders is maternal and child health (MCH). In the United States, key indicators of health disparities within MCH remain stagnant, highlighting the need for training programs that develop future MCH professionals from diverse backgrounds. These professionals will deliver …

Healthcare Providers’ Perspective On Hiv Testing And Hypothetical Mhealth-Connected Linkage To Care Among Men Who Have Sex With Men (Msm) In South Carolina, Tony Brown, Prince Nii Ossah Addo, Monique J. Brown Ph.D., Mph, Xiaoming Li, Oluwafemi Adeagbo

Faculty Publications

Background: HIV continues to be an important public health concern in South Carolina (SC). However, an examination of providers’ willingness to use mHealth technologies to address ongoing barriers to HIV care and prevention strategies, particularly among men who have sex with men (MSM) is currently lacking in SC. We therefore explored HIV care providers’ perceptions of HIV testing and treatment uptake among MSM, and providers’ willingness to use mHealth technology to address barriers to HIV testing and treatment in SC. Methods: Between August and December 2021, we conducted semistructured virtual interviews with 10 HIV care providers recruited purposively based on …

Knowledge And Ontology Enhanced Approach To Natural Language Understanding (Koe-Nlu) In Computational Social Media And Healthcare, Naga Usha Gayathri Lokala

Theses and Dissertations

Natural Language Understanding (NLU) faces both opportunities and challenges as the amount of social media and healthcare data grows. This is particularly evident in context-sensitive applications such as evaluating cognitive health, identifying mental health symptoms, and monitoring drug abuse. Even though traditional NLU models work well for processing language in a wide range of areas, they often lack the ability to understand language in a specific domain, reason in context, and incorporate structured external knowledge. This dissertation talks about the Knowledge and Ontology Enhanced Approach to Natural Language Understanding (KOE-NLU), a new framework that is meant to make NLU systems …

Invention Beyond The Author, Jonathan Brent Butler

Theses and Dissertations

The following dissertation examines how what Michel Foucault calls the “author function” affects contemporary students of writing and examines some historical alternatives to this way of conceptualizing the writing process and the writer’s role in it. Chapter 1: Author (Dys)function describes the author function and its discontents, the problems of the Romantic conception of “genius,” and summarizes the following chapters. Chapter 2: Early Writing Instruction focuses on classical approaches to rhetorical instruction that emphasize habit and aim at the cultivation of a particular subjectivity characterized by the capacity to respond to shifting rhetorical situations; this chapter draws on the work …

Origen Of Alexandria On Cancticles: Exegeses And Homilies As Forming Christian Identity, Annaline Bethany Cely

Theses and Dissertations

This dissertation focuses on how Origen of Alexandria, through both homilies and exegetical commentary practice, presents Canticles as a piece of literature fittingly understood as Scripture. For Origen, Scripture is the source text by which Christians can engage with God and mold their lives upon Christ. This dissertation mimics Origen's own methodology by performing a line-by-line reading of his work, which allows the reader immediate access to Origen's work while also acting as a commentary of Origen's commentary. As of Fall 2025, there are no commentaries in English on any Church Father (only translations) which is concerning as the reading …

Influence, Confidence, And Interest In Mathematics: The Route To Increasing Female Participation In Stem, Lisa Galbreath Neaton Black

Theses and Dissertations

Women are underrepresented in STEM professions despite initiatives to encourage young women to pursue these financially rewarding careers. Studies show this divide is not due to inability or lack of female participation in higher education, as women tend to outscore their male counterparts on standardized tests and make up approximately 59% of the postsecondary student population. Rather, the disconnect in the high school-to-college STEM pipeline for young women seems to center on mathematics. In response, this action research study focused on addressing societal influence and mathematical confidence and interest using a constructivist approach in an honors Algebra 2 class.Hands-on activities, …

Factors Influencing Adherence To Surveillance Guidelines In Individuals With Tuberous Sclerosis Complex, Kashish Khanna

Theses and Dissertations

Tuberous Sclerosis Complex (TSC) is a genetic condition that is caused by pathogenic changes in either the TSC1 or TSC2 gene and is characterized by multiple benign tumors, otherwise known as hamartomas, in various organs such as the brain, skin, lungs, and kidneys. Because of the many different clinical manifestations of TSC, extensive surveillance guidelines are recommended for individuals with TSC. Past studies have shown that there has been a gap in knowledge of these surveillance guidelines. These studies also suggest projects that measure adherence to surveillance guidelines and address specific challenges hindering surveillance guideline adherence. This study aims to …

“Digital Shame Shift”: From Telling The Pain To Recording The Truth — Black Maternal Health And Digital Counter-Narrative Storytelling On Tiktok, Odera Covenant Ezenna

Theses and Dissertations

This dissertation explores how digital storytelling on TikTok is used to challenge medical racism, with a particular focus on Black maternal health. Guided by Critical Race Theory (CRT) and Critical Technocultural Discourse Analysis (CTDA), the study examines how TikTok users—ranging from Black mothers to healthcare professionals—create and circulate counter-narratives through two prominent campaigns: #BlackMaternalHealthWeek and #BlackMamasMatter. These digital stories serve as acts of resistance, disrupting dominant medical discourse and amplifying the lived experiences of Black birthing individuals. The research analyzes over 2900 TikTok videos posted between 2021 and 2024, identifying key themes, storytelling strategies, and rhetorical shifts over time. The …

Emotions And Cognition, Krystal D. Becks

Theses and Dissertations

Background: Cognitive functioning is linked to emotional processes, with this relationship shaped by various biological (e.g., age, sex, diseases, and genetics), psychological (e.g., emotional well-being, coping strategies, mental health), and sociological (e.g., income and education) factors. Understanding these interactions is critical for advancing research on cognitive-emotional health across diverse populations. Purpose: To examine the relationship between positive and negative emotions and cognitive functioning among healthy adults. Methods: This was a cross-sectional analysis of data from the Aging Brain Cohort (ABC) study (n=434). The independent variables were subsets from the NIH toolbox emotional battery. The dependent variables were from the NIH …

Intimate Partner Violence Victims' Experiences With Civil Legal Interventions, Jessica Brooke Pomerantz

Theses and Dissertations

The court system has become a central part of the societal response to intimate partner violence (IPV) and is a frequently used as a source of help for victims (Cattaneo et al., 2013). Despite the importance of a justice system response to IPV, it is not always accessible or helpful to victims. Past research has demonstrated barriers to IPV victims seeking legal intervention including mistrust of the court system generally, extensive and confusing legal processes and procedures, and failure of the courts to assess more invisible forms of abuse (Calton et al., 2017; Cerulli et al., 2015; Cuomo & Dolci, …

Self-Regulation In Children With Fragile X Syndrome: Biobehavioral Underpinnings, Familial Predictors, And Outcomes, Erin Evelyn Hunt

Theses and Dissertations

Self-regulation is a multifaceted construct that occurs on biological, cognitive, emotional, and behavioral levels. Self-regulatory abilities typically emerge in the first years of life and continuously develop through early adulthood. There is considerable interindividual variability in developmental trajectories of self-regulation which are associated with numerous adaptive and maladaptive outcomes. Factors influencing the development of self-regulation include interacting genetic and social environmental factors. Given the high heritability of self-regulation, within-family associations are common.

Individuals with Fragile X syndrome (FXS), an inherited, single-gene neurodevelopmental disorder, have heightened vulnerability for self-regulation deficits that are evident in early infancy; however, the developmental trajectories and …

Cerebellar Contributions To Speech And Clinical Outcomes In Stroke: A Multimodal Investigation Of Structural Integrity Across Chronic And Acute Cohorts, Makayla Joy Gibson

Theses and Dissertations

This dissertation investigates the critical role of the cerebellum in speech production, with a focus on chronic post-stroke apraxia of speech (AOS), lesion-related cerebellar degeneration, and age-related changes in cerebellar structure among healthy individuals. While speech deficits have traditionally been attributed to cortical lesions, mounting evidence suggests that the cerebellum contributes significantly to speech-motor planning, execution, and error correction. Using multimodal neuroimaging, lesion-symptom mapping, and standardized speech assessments, this research examines cerebellar gray matter volume (GMV) across three complementary studies.

Aim 1 evaluates the association between cerebellar GMV and AOS severity in individuals with chronic left hemisphere stroke. Findings support …

Examining Effects Of A Cultural And Family Resilience Program On Improving Physical Activity And Eating Behaviors Among Overweight Black Adolescents, Mary Quattlebaum

Theses and Dissertations

Black adolescents have higher rates of physical inactivity, lower quality dietary intake, and fewer family meals compared to their White peers. These health inequities place Black adolescents at greater risk for overweight and obesity, as well as long-term health consequences, including chronic disease and early mortality. However, few health promotion programs have been successful in improving health behaviors among Black adolescents and families. Elevated rates of chronic stress, namely racial stress, among Black families may be a prominent obstacle for engagement in and effectiveness of health promotion initiatives. Limited family-based health promotion programs with Black families have incorporated cultural and …

A Math Teacher’S Reflexive Journey Into The Opportunity Gap, Richard A. Ball Iii

Theses and Dissertations

This multiple case study sought to determine what educational factors, if any, impacted Black students in a public school located in the South-eastern United States, to enroll in a lower-level math course. The study also aimed to view the mathematical identities of these students and have myself reflect on my practice both locally and globally. This, however, is a result of the Problem of Practice, the opportunity gap. H. Richard Milner’s (2012) opportunity gap framework served as the theoretical framework for this study and for which all findings were situated. The data was analyzed using deductive coding, with the elements …

Digital Twins For Flexible Manufacturing, Drew Brandon Sander

Theses and Dissertations

With the establishment of Digital Twins as an enabling technology for Industry 4.0, it is time to transition from the previous foundations to works that implement and highlight the capabilities Digital Twins present. The Industry 4.0 paradigm has recentered the focus on customizability, leading to reemerging goals of flexibility within manufacturing. Empowered through new cyber-physical systems, new enabling technologies are driving the revolution. To identify how Digital Twins as an enabling technology contribute to flexibility within manufacturing, a comprehensive investigation is conducted along with a detailed case study. A systematic literature review is conducted to analyze quality Digital Twin implementations …

Utilizing Evisits To Increase Access To Genetic Services For The Hearing Loss Population: A Tailored Service Delivery Model, Ansley Roberts

Theses and Dissertations

Purpose: Patients referred for genetics services have specific barriers decreasing accessibility, such as communication difficulties, long wait times, and misconceptions about the utility of genetic testing. We assessed a new tailored service delivery model used by the Greenwood Genetic Center to evaluate patients referred for hearing loss to determine if this model increases access to genetics services for individuals with hearing loss. Methods: Data points such as wait times, testing plan, and diagnostic yield were compiled from patient medical records. Comparison and analysis of data was completed by visit type, in-person, virtual, and electronic visits (eVisits), between October 2023 – …

Safe Data-Enabled Control Of Human-In-The-Loop Robotic Manipulator Systems, Ritirupa Dey, Avimanyu Sahoo, Vignesh Narayanan

Publications

Safe control of human-in-the-loop (HIL) robotic manipulators is critical for applications such as assistive robotics, teleoperation in hazardous environments, and collaborative manufacturing. However, this remains challenging due to the lack of a unified framework that simultaneously addresses safety constraints, external disturbances, unmodeled dynamics, and dynamic role switching in the HIL setting. In this paper, we propose a novel NN-driven HIL control framework in which human–robot dyadic interaction occurs through the haptic channel. Using Lyapunov stability analysis, we theoretically show that the proposed NN-based controller ensures accurate joint trajectory tracking, compensates for system uncertainties, and adapts to human inputs modeled as …

Treating Chronic Low Back Pain And Plantar Fasciitis With Myokinesthetic System: A Case Study, Sadie Buboltz-Dubs, Russell Baker

Clinical Practice in Athletic Training

The purpose of this case study was to report the effects of the MyoKinesthetic (MYK) System on the pain and function of a collegiate softball player previously diagnosed with chronic non-specific low back pain and foot pain. The patient had been experiencing bilateral foot pain since childhood and conservative treatment options had failed to resolve her pain long term. Additionally, the patient had been experiencing persistent back tightness and soreness. Upon arrival at the university, the patient was evaluated using the MYK postural analysis to identify if a primary nerve root dysfunction could be the cause of her pain. The …

A Review Of Automated External Defibrillator Considerations In Athletic Training, Bryana M. Mammana, Susan W. Yeargin, Zachary K. Winkelmann

Clinical Practice in Athletic Training

N/a

College Student-Athlete Perceptions Of Characterizations And Interpersonal Trust In Their Athletic Trainer: A Point-Of-Care Research Study, Ryan N. Moran, Deidre Leaver-Dunn, Jeff Allen, Jessica Wallace

Clinical Practice in Athletic Training

Patient-centered care is essential in athletic training with limited research examining the relationship between patient and clinician. Previous theory has identified constructs of quality athletic trainers (ATs); however, it remains unknown how current athletes perceive these theorized constructs in the ATs providing them medical care. The purpose of this study was to determine the perceptions of characterizations of a quality athletic trainer and interpersonal trust between the student-athlete and AT in the collegiate setting and establish reliability of these surveys. A second aim was to explore differences between sex, previous exposure to an AT, and having had access to an …