Digital Commons Network^™

Exploring Attitudes Toward Pre-Exposure Prophylaxis For Hiv Prevention Prior To Implementation Among Female Sex Workers In Malaysia: Results From A Qualitative Study, Shaylen Foley, Danya E. Keene, Roman Shrestha, Shan-Estelle Brown, Kamal Gautam, Ryan A. Sutherland, Francesca Maviglia, Rumana Saifi, Jeffrey A. Wickersham

Faculty Publications

No abstract provided.

Covid-19 Vaccine Effectiveness Among People Living With And Without Hiv In South Carolina, Usa: Protocol Of A Population-Based Cohort Study, Xueying Yang, Jiajia Zhang Ph.D., Bankole Olatosi, Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Introduction Despite the effectiveness of COVID-19 vaccines in preventing severe COVID-19 outcomes, a small percentage of fully vaccinated persons will develop symptomatic or asymptomatic infections with SARSCoV-2, which is referred to as ‘breakthrough COVID-19’. People living with HIV (PLWH) appear to have an elevated risk of severe COVID-19 outcomes, yet the effectiveness of the COVID-19 vaccine in this population remains unclear due to the limited research efforts in this population in the real world. This study aims to characterise and compare the breakthrough COVID-19 (eg, prevalence and disease severity) between PLWH and non-PLWH and then examine whether HIV markers play …

The Prevalence Of Gram-Negative Bacteria With Difficult-To-Treat Resistance And Utilization Of Novel Β-Lactam Antibiotics In The Southeastern United States, Y. Vivian Tsai, P. Brandon Bookstaver Pharm.D., Joseph Kohn, Julie Ann Justo, Darrell Childress, Stefanie Stramel, Douglas Slain, Patrick Tu, Mary Joyce B. Wingler, Bruce M. Jones, Daniel T. Anderson, Megan M. Seddon, David A. Cretella, Joshua Eudy, Hana Winders, Kayla Antosz Pharm.D., Pamela Bailey, Majdi N. Al-Hasan

Faculty Publications

Objective:

To evaluate temporal trends in the prevalence of gram-negative bacteria (GNB) with difficult-to-treat resistance (DTR) in the southeastern United States. Secondary objective was to examine the use of novel β-lactams for GNB with DTR by both antimicrobial use (AU) and a novel metric of adjusted AU by microbiological burden (am-AU). Design:

Retrospective, multicenter, cohort. Setting:

Ten hospitals in the southeastern United States. Methods:

GNB with DTR including Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter spp. from 2015 to 2020 were tracked at each institution. Cumulative AU of novel β-lactams including ceftolozane/tazobactam, ceftazidime/avibactam, meropenem/vaborbactam, imipenem/cilastatin/relebactam, and cefiderocol in days of therapy (DOT) …

Planetary Protection Knowledge Gap Closure Enabling Crewed Missions To Mars, James A. Spry, Bette Siegel, Corien Bakermans, David W. Beaty, Mary Sue Bell, James N. Benardini, Rosalba Bonaccorsi, Sarah L. Castro-Wallace, David A. Coil, Athena Coustenis, Peter T. Doran, Lori Fenton, David P. Fidler, Brian Glass, Stephen J. Hoffman, Fathi Karouia, Joel S. Levine, Mark L. Lupisella, Javier Martin-Torres, Rakesh Mogul, Karen Olsson-Francis, Sandra Ortega-Ugalde, Manish R. Patel, David A. Pearce, Margaret S. Race, Aaron B. Regberg, Petra Rettberg, John D. Rummel, Kevin Y. Sato, Andrew C. Schuerger, Elliot Sefton-Nash, Matthew Sharkey, Nitin K. Singh

Faculty Publications

As focus for exploration of Mars transitions from current robotic explorers to development of crewed missions, it remains important to protect the integrity of scientific investigations at Mars, as well as protect the Earth's biosphere from any potential harmful effects from returned martian material. This is the discipline of planetary protection, and the Committee on Space Research (COSPAR) maintains the consensus international policy and guidelines on how this is implemented. Based on National Aeronautics and Space Administration (NASA) and European Space Agency (ESA) studies that began in 2001, COSPAR adopted principles and guidelines for human missions to Mars in 2008. …

Waning Effectiveness Of Mrna Covid-19 Vaccines Against Inpatient And Emergency Department Encounters, Theodoros V. Giannouchos, Nicole L. Hair Ph.D., Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

In the United States, most real-world estimates of COVID-19 vaccine effectiveness are based on data drawn from large health systems or sentinel populations. More data is needed to understand how the benefits of vaccination may vary across US populations with disparate risk profiles and policy contexts. We aimed to provide estimates of mRNA COVID-19 vaccine effectiveness against moderate and severe outcomes of COVID-19 based on state population-level data sources. Using statewide integrated administrative and clinical data and a test-negative case-control study design, we assessed mRNA COVID-19 vaccine effectiveness against SARS-CoV-2-related hospitalizations and emergency department visits among adults in South Carolina. …

Sexual Orientation And Gender Identity Measures And Viral Suppression For People Living With Hiv: A Protocol For A Population-Based Cohort Study, Xueying Yang, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Introduction The measure of sexual orientation and gender identity (SOGI) data in electronic health records (EHR) has been critical for addressing health disparities and inequalities, especially for HIV care. Given that gender and sexual minorities (eg, transgender, men who have sex with men and intersex) are key groups in people living with HIV (PLWH), SOGI data can facilitate a more accurate understanding about the HIV outcomes (eg, viral suppression) among this key group and then lead to tailored therapeutic services. The two-step SOGI collection method as an emerging gender measurement can be used to measure SOGI status in medical settings. …

Simultaneous Detection And Quantification Of Multiple Pathogen Targets In Wastewater, Gouthami Rao, Drew Capone, Kevin Zhu, Abigail Knoble, Yarrow Linden, Ryan Clark, Amanda Lai, Juhee Kim, Ching Hua Huang, Aaron Bivins, Joe Brown

Faculty Publications

Wastewater-based epidemiology has emerged as a critical tool for public health surveillance, building on decades of environmental surveillance work for pathogens such as poliovirus. Work to date has been limited to monitoring a single pathogen or small numbers of pathogens in targeted studies; however, few studies consider simultaneous quantitative analysis of a wide variety of pathogens, which could greatly increase the utility of wastewater surveillance. We developed a novel quantitative multi-pathogen surveillance approach (35 pathogen targets including bacteria, viruses, protozoa, and helminths) using TaqMan Array Cards (TAC) and applied the method on concentrated wastewater samples collected at four wastewater treatment …

Regional Geographies And Public Health Lessons Of The Covid-19 Pandemic In The Arctic, Sweta Tiwari, Andrey N. Petrov, Nikolay Golosov, Michele Devlin, Mark Welford, John Degroote, Tatiana Degai, Stanislav Ksenofontov

Faculty Publications

Objectives: This study examines the COVID-19 pandemic’s spatiotemporal dynamics in 52 sub-regions in eight Arctic states. This study further investigates the potential impact of early vaccination coverage on subsequent COVID-19 outcomes within these regions, potentially revealing public health insights of global significance. Methods: We assessed the outcomes of the COVID-19 pandemic in Arctic sub-regions using three key epidemiological variables: confirmed cases, confirmed deaths, and case fatality ratio (CFR), along with vaccination rates to evaluate the effectiveness of the early vaccination campaign on the later dynamics of COVID-19 outcomes in these regions. Results: From February 2020 to February 2023, the Arctic …

A Baker’S Dozen Of Top Antimicrobial Stewardship Intervention Publications In 2022, Reagan K. Barfield, Matthew L. Brown, Benjamin Albrecht, Katie E. Barber, Jeannette Bouchard, Amy L. Carr, Elias B. Chahine, David Cluck, Elizabeth W. Covington, Connor R. Deri, Spencer H. Durham, Carmen Faulkner-Fennell, Lauren K. Freeman, Timothy P. Gauthier, Geneen M. Gibson, Sarah B. Green, Athena L.V. Hobbs, Bruce M. Jones, P. Brandon Bookstaver Pharm.D., Et. Al.

Faculty Publications

Keeping abreast of the antimicrobial stewardship–related articles published each year is challenging. The Southeastern Research Group Endeavor identified antimicrobial stewardship–related, peer-reviewed literature that detailed an actionable intervention during 2022. The top 13 publications were selected using a modified Delphi technique. These manuscripts were reviewed to highlight actionable interventions used by antimicrobial stewardship programs to capture potentially effective strategies for local implementation.

The Lavatory Lens: Tracking The Global Movement Of Pathogens Via Aircraft Wastewater, Aaron Bivins, Robert Morfino, Andrew Franklin, Stuart Simpson, Warish Ahmed

Faculty Publications

Modern commercial air travel connects disparate human populations. The global airline industry transported as many as 4.5 billion passengers annually in the years leading up to the COVID-19 pandemic. While such connections are convenient for commerce and tourism, air travel networks can also be efficient distributors of infectious diseases. During the COVID-19 pandemic, public health agencies used multi-layered control strategies to manage the risk of COVID-19 transmission associated with air travel. Simultaneously, the surveillance of aircraft wastewater was further developed as a promising new method to screen for COVID-19, including newly emerging lineages, among international travelers. Herein, we review the …

Th2 And Th17-Associated Immunopathology Following Sars-Cov-2 Breakthrough Infection In Spike-Vaccinated Ace2-Humanized Mice, Tianyi Zhang, Nicholas Magazine, Michael C. Mcgee, Mariano Carossino, Gianluca Veggiani, Konstantin G. Kousoulas, Avery August, Weishan Huang

Faculty Publications

Vaccines have demonstrated remarkable effectiveness in protecting against COVID-19; however, concerns regarding vaccine-associated enhanced respiratory diseases (VAERD) following breakthrough infections have emerged. Spike protein subunit vaccines for SARS-CoV-2 induce VAERD in hamsters, where aluminum adjuvants promote a Th2-biased immune response, leading to increased type 2 pulmonary inflammation in animals with breakthrough infections. To gain a deeper understanding of the potential risks and the underlying mechanisms of VAERD, we immunized ACE2-humanized mice with SARS-CoV-2 Spike protein adjuvanted with aluminum and CpG-ODN. Subsequently, we exposed them to increasing doses of SARS-CoV-2 to establish a breakthrough infection. The vaccine elicited robust neutralizing antibody …

Use Of Machine Learning Approaches To Predict Transition Of Retention In Care Among People Living With Hiv In South Carolina: A Real-World Data Study, Ruilie Cai, Xueying Yang Ph.D., Yunqing Ma, Hao H. Zhang, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Maintaining retention in care (RIC) for people living with HIV (PLWH) helps achieve viral suppression and reduce onward transmission. This study aims to identify the best machine learning model that predicts the RIC transition over time. Extracting from the enhanced HIV/AIDS reporting system, this study included 9765 PLWH from 2005 to 2020 in South Carolina. Transition of RIC was defined as the change of RIC status in each two–year time window. We applied seven classifiers, such as Random Forest, Support Vector Machine, eXtreme Gradient Boosting and Long–short–term memory, for each lagged response to predict the subsequent year's RIC transition. Classification …

Medicaid Managed Care Restrictions On Medications For The Treatment Of Opioid Use Disorder, Maureen T. Stewart, Christina M. Andrews Ph.D., Sage R. Feltus, Dominic Hodgkin, Constance M. Horgan, Cindy Parks Thomas, Thuong Nong

Faculty Publications

Objective: To examine whether Medicaid managed care plan (MCP) utilization management policies for buprenorphine–naloxone and injectable naltrexone are related to key state Medicaid program policy decisions. Data Sources and Study Setting: We abstracted data on state Medicaid regulatory and policy information from publicly available sources and publicly available insurance benefit documentation from all 241 Medicaid MCPs operating in 2021. Study Design: In this cross-sectional study, we used bivariate and multivariate analyses to examine whether Medicaid MCP prior authorization and quantity limits on receipt of buprenorphine and injectable naltrexone were associated with key state Medicaid choices to leverage federal funds to …

Human Mobility And The Infectious Disease Transmission: A Systematic Review, M. Naser Lessani, Zhenlong Li, Fengrui Jing, Shan Qiao Ph.D., Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Recent decades have witnessed several infectious disease outbreaks, including the coronavirus disease (COVID-19) pandemic, which had catastrophic impacts on societies around the globe. At the same time, the twenty-first century has experienced an unprecedented era of technological development and demographic changes: exploding population growth, increased airline flights, and increased rural-to-urban migration, with an estimated 281 million international migrants worldwide in 2020, despite COVID-19 movement restrictions. In this review, we synthesized 195 research articles that examined the association between human movement and infectious disease outbreaks to understand the extent to which human mobility has increased the risk of infectious disease outbreaks. …

The Intellectual Structure Of Audit Committee Research: A Bibliometric Analysis (1969 – 2020), Joel Behrend, Marc Eulerich, David A. Wood

Faculty Publications

The audit committee is a widely recognized mechanism of effective corporate governance. We advance prior literature reviews by using bibliometric analysis techniques that comprehensively process large bodies of bibliometric information. We base inferences on citation patterns of 1,173 articles to identify concepts that “shine through” within the scientific understanding of audit committees. Using content analysis, we then analyze these concepts and explore existing interrelationships. We document a declining influence of audit committee research, as well as a widening gap between the quantitative and qualitative research camps. While the former is mostly derivative in nature, the latter produces innovative insights on …

How Individuals’ Opinions Influence Society’S Resistance To Epidemics: An Agent-Based Model Approach, Geonsik Yu, Michael J. Garee, Mario Ventresca, Yuehwern Yih

Faculty Publications

Background: Protecting public health from infectious diseases often relies on the cooperation of citizens, especially when self-care interventions are the only viable tools for disease mitigation. Accordingly, social aspects related to public opinion have been studied in the context of the recent COVID-19 pandemic. However, a comprehensive understanding of the effects of opinion-related factors on disease spread still requires further exploration. Methods: We propose an agent-based simulation framework incorporating opinion dynamics within an epidemic model based on the assumption that mass media channels play a leading role in opinion dynamics. The model simulates how opinions about preventive interventions change over …

A Survey On Mosquito Control Knowledge And Insecticide Use In New Orleans, La, 2020–2021, Erin R. Cloherty, Janet C. Mcallister, James A. Ottea, Kristen Healy, Claudia Riegel

Faculty Publications

Mosquitoes are a known public nuisance and can vector various diseases. Historically, New Orleans, LA, has long been acquainted with the burden of mosquito-borne diseases, such as malaria and yellow fever in the 20th century and West Nile virus in the 21st century. Government mosquito control awareness campaigns have been around for decades as has the use of organophosphate and pyrethroid insecticides by mosquito abatement districts. However, few data are available on public perception of mosquito control and public usage of insecticides to kill mosquitoes in New Orleans. We conducted a survey from August 2020 to July 2021 to evaluate …

Understanding The Implications Of Underreporting, Vaccine Efficiency And Social Behavior On The Post-Pandemic Spread Using Physics Informed Neural Networks: A Case Study Of China, Samiran Ghosh, Alonso Ogueda-Oliva, Aditi Ghosh, Malay Banerjee

Faculty Publications

In late 2019, the emergence of COVID-19 in Wuhan, China, led to the implementation of stringent measures forming the zero-COVID policy aimed at eliminating transmission. Zero COVID policy basically aimed at completely eliminating the transmission of COVID-19. However, the relaxation of this policy in late 2022 reportedly resulted in a rapid surge of COVID-19 cases. The aim of this work is to investigate the factors contributing to this outbreak using a new SEIR-type epidemic model with time-dependent level of immunity. Our model incorporates a time-dependent level of immunity considering vaccine doses administered and time-post-vaccination dependent vaccine efficacy. We find that …

A Membrane Protein Of The Rice Pathogen Burkholderia Glumae Required For Oxalic Acid Secretion And Quorum Sensing, Asif Iqbal, George Nwokocha, Vijay Tiwari, Inderjit K. Barphagha, Anne Grove, Jong Hyun Ham, William T. Doerrler

Faculty Publications

Bacterial panicle blight is caused by Burkholderia glumae and results in damage to rice crops worldwide. Virulence of B. glumae requires quorum sensing (QS)-dependent synthesis and export of toxoflavin, responsible for much of the damage to rice. The DedA family is a conserved membrane protein family found in all bacterial species. B. glumae possesses a member of the DedA family, named DbcA, which we previously showed is required for toxoflavin secretion and virulence in a rice model of infection. B. glumae secretes oxalic acid as a “common good” in a QS-dependent manner to combat toxic alkalinization of the growth medium …

Technology Specificity And Equitable Access To Pharmaceuticals, Ana Santos Rutschman

Faculty Publications

Current models of production of pharmaceuticals, particularly those dependent on intellectual property (and adjacent) protections, often contribute to the highly asymmetrical and inequitable distribution of resulting outputs. These problems are especially acute when emerging pathogens cause transnational public health crises in which there is concurrent demand for the same medicines in both lower- and higher-income countries, with populations in the Global South getting very limited timely access, if any, to preventatives and life-saving medicines—even when an outbreak disproportionately affects populations in these very countries.

This essay examines an under-theorized and under-explored way to help correct this historical and persisting deficit …

Influencing Air Force Logisticians' Information Seeking During The Covid-19 Pandemic: The Role Of Organizational Meetings In An Expanded Prism Framework, Matthew D. Roberts, Christopher T. Price, Seong-Jong Joo

Faculty Publications

Purpose: This research aims to understand how organizational workplace meetings surrounding the COVID-19 pandemic impacted logistics Airmen across the United States Air Force and how these meetings impacted their risk seeking behavior on social media.

Design/methodology/approach: This survey research tested an extended Planned Risk Information Risk Seeking Model (PRISM) with organizational meetings as an antecedent to determine if current meetings influenced an Airman's perceived behavioral control, attitude toward seeking, subjective norms, knowledge sufficiency and intention to seek information regarding COVID-19.

Findings: Results of the CFA showed that the expanded PRISM model had good model fit. Additionally, using …

Structured Ethical Review For Wastewater-Based Testing In Support Of Public Health, Devin A. Bowes, Amanda Darling, Erin M. Driver, Devrim Kaya, Rasha Maal-Bared, Lisa M. Lee, Kenneth Goodman, Sangeet Adhikari, Srijan Aggarwal, Aaron Bivins, Zuzana Bohrerova, Alasdair Cohen, Claire Duvallet, Rasha A. Elnimeiry, Justin M. Hutchison, Vikram Kapoor, Ishi Keenum, Fangqiong Ling, Deborah Sills, Ananda Tiwari, Peter Vikesland, Ryan Ziels, Cresten Mansfeldt

Faculty Publications

Wastewater-based testing (WBT) for SARS-CoV-2 has rapidly expanded over the past three years due to its ability to provide a comprehensive measurement of disease prevalence independent of clinical testing. The development and simultaneous application of WBT measured biomarkers for research activities and for the pursuit of public health goals, both areas with well-established ethical frameworks. Currently, WBT practitioners do not employ a standardized ethical review process, introducing the potential for adverse outcomes for WBT professionals and community members. To address this deficiency, an interdisciplinary workshop developed a framework for a structured ethical review of WBT. The workshop employed a consensus …

Increasing Equity In The Transnational Allocation Of Vaccines Against Emerging Pathogens: A Multi-Modal Approach, Ana Santos Rutschman

Faculty Publications

This article proposes the adoption of a multi-modal system for allocating vaccine doses during large transnational outbreaks of infectious diseases. The chosen allocative criteria (public health need; country-income level; qualification through funding; and, subsidiarily, a modified lottery system) are adapted from a current embodiment of allocative multi-modality outside the context of public health: the New York City Marathon

Developing An Ethical Framework-Guided Instrument For Assessing Bias In Ehr-Based Big Data Studies: A Research Protocol, Shan Qiao Ph.D., George Khushf, Xiaoming Li, Jiajia Zhang Ph.D., Bankole Olatosi Ph.D.

Faculty Publications

Introduction The emergence of Big Data health research has exponentially advanced the fields of medicine and public health but has also faced many ethical challenges. One of most worrying but still under-researched aspects of the ethical issues is the risk of potential biases in data sets (eg, electronic health records (EHR) data) as well as in the data curation and acquisition cycles. This study aims to develop, refine and pilot test an ethical framework-guided instrument for assessing bias in Big Data research using EHR data sets.

Methods and analysis Ethical analysis and instrument development (ie, the EHR bias assessment guideline) …

The Association Between Covid-19 Preventive Behaviors And Mental Health Conditions, Elizabeth Wachira, Bhakti Chavan, Carolyn Nganga-Good, Caroline Kingori

Faculty Publications

Our findings highlight that individuals with mental health conditions reported more psychological distress. Specifically, feeling depressed, anxious, lonely, and hopeless were triggered and exacerbated as a result of the pandemic and may have long-term effects on general well-being and productivity. Therefore, our findings have important implications on the need to include mental health promotion as part of pandemic response efforts. This includes developing policies and allocating funding so as to ensure sustainable mental health interventions and support, public and provider education on the importance of screening for mental health issues.

Whose Social Capital?: Citation And Co-Citation Patterns Of A Fragmented Concept, Jimi Adams, Kate Vinita Fitch

Faculty Publications

Despite its wide use across the social sciences, social capital research has been regularly criticized as having fuzzy conceptualization, resulting in multiple (potentially conflicting) operationalizations. Our analyses employ bibliometric analytic tools to demonstrate the disconnected structure of social capital research. The resulting visualization illustrates one potential source of the confusion surrounding social capital—that there are many, potentially nonoverlapping versions of the idea rather than one unified social capital concept.

Influence Of Membrane Pore-Size On The Recovery Of Endogenous Viruses From Wastewater Using An Adsorption-Extraction Method, Warish Ahmed, Wendy J.M. Smith, Kwanrawee Sirikanchana, Masaaki Kitajima, Aaron Bivins, Stuart L. Simpson

Faculty Publications

The ongoing COVID-19 pandemic has emphasized the significance of wastewater surveillance in monitoring and tracking the spread of infectious diseases, including SARS-CoV-2. The wastewater surveillance approach detects genetic fragments from viruses in wastewater, which could provide an early warning of outbreaks in communities. In this study, we determined the concentrations of four types of endogenous viruses, including non-enveloped DNA (crAssphage and human adenovirus 40/41), non-enveloped RNA (enterovirus), and enveloped RNA (SARS-CoV-2) viruses, from wastewater samples using the adsorption-extraction (AE) method with electronegative HA membranes of different pore sizes (0.22, 0.45, and 0.80 µm). Our findings showed that the membrane with …

Three-Dimensional Scaffolds For Bone Tissue Engineering, Harish Chinnasami, Mohan Kumar Dey, Ram Devireddy

Faculty Publications

Immobilization using external or internal splints is a standard and effective procedure to treat minor skeletal fractures. In the case of major skeletal defects caused by extreme trauma, infectious diseases or tumors, the surgical implantation of a bone graft from external sources is required for a complete cure. Practical disadvantages, such as the risk of immune rejection and infection at the implant site, are high in xenografts and allografts. Currently, an autograft from the iliac crest of a patient is considered the “gold standard” method for treating large-scale skeletal defects. However, this method is not an ideal solution due to …

Toward One Health: A Spatial Indicator System To Model The Facilitation Of The Spread Of Zoonotic Diseases, Daniel Jato-Espino, Fernando Mayor-Vitoria, Vanessa Moscardó, Fabio Capra-Ribeiro, Leticia Bartolome Del Pino

Faculty Publications

Recurrent outbreaks of zoonotic infectious diseases highlight the importance of considering the interconnections between human, animal, and environmental health in disease prevention and control. This has given rise to the concept of One Health, which recognizes the interconnectedness of between human and animal health within their ecosystems. As a contribution to the One Health approach, this study aims to develop an indicator system to model the facilitation of the spread of zoonotic diseases. Initially, a literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement to identify relevant indicators related to One Health. The …

Exploring The Experiences Of Pregnant Women In The U.S. During The First Year Of The Covid-19 Pandemic, Courtney E. Williams, Dana Berkowitz, Heather M. Rackin

Faculty Publications

In this paper, we integrate the stress process model with symbolic interactionism to frame our analysis of interviews with 35 women who were pregnant and/or gave birth during the first year of the Covid-19 pandemic. We detail three stressors, highlight their variation, and discuss how they coped with these stressors. Women reported having to navigate contradictory information about the public health crisis, but Black participants simultaneously endured added strain from a heightened awareness of racialized violence. To cope with an overabundance of precarious and contradictory messages, some women sought out information (i.e., information gatherers), others eschewed information (i.e., information avoiders), …