Digital Commons Network^™

Location Of Firearm Suicides In The United States, 2003-2021, Camerin Rencken, Rosanna Smart, Eric Ruben, Ali Rowhani-Rahbar

Faculty Journal Articles and Book Chapters

Suicide is a leading cause of death in the US, with firearms accounting for more than half of those deaths. Current research about firearm suicide prevention largely focuses on promoting secure storage to reduce or delay access to lethal means at home. While such prevention measures are essential, their exclusive focus on the home environment may fail to address firearm suicides outside the home, which may vary by subpopulation and circumstance. However, there is little information on these factors. We sought to quantify and describe firearm suicides that occur outside the home to inform more comprehensive and effective prevention strategies …

Costs Of Non-Metastatic Prostate Cancer Treatment Among Privately Insured Men In The United States, Ashley J. Housten, Su-Hsin Chang, Hannah E. Rice, Allison J. L'Hotta, Eric H. Kim, Bettina F. Drake, Joanna L. Buss, Mary C. Politi

2020-Current year OA Pubs

BACKGROUND: Our objective was to quantify the cumulative total and out-of-pocket (OOP) costs for 3 non-metastatic prostate cancer treatment modalities: radiation, surgery, and conservative management at intervals of 1-, 3-, and 5-years post-diagnosis. We predicted these cumulative costs for a typical patient to improve cost transparency, facilitate conversations about potential costs, and to help advance non-metastatic prostate cancer cost evaluation.

METHODS: We used Merative™ MarketScan® Commercial Database data from 2007-2020. The cumulative total costs evaluated from the healthcare sector perspective were patient, clinician, and system/facility costs. We used descriptive statistics to summarize the sociodemographic characteristics of the cohort and a …

Disclosing Disabilities: Barriers For Medical School Applicants, Sarah Leah Solomon, Aitan E. Magence, Harry Haran, Fern R. Juster, Kristina H. Petersen

2020-Current year OA Pubs

This study investigated the availability of accommodation request procedures for medical school admissions interviews and the accessibility of Technical Standards (TS) for candidates with disabilities (CWD) across Liaison Committee on Medical Education (LCME)-accredited institutions in the United States and Canada. Utilizing a cross-sectional study methodology, surveys were distributed to Deans of Admissions and Disabilities Resource Professionals (DRP) at all LCME-accredited US and Canadian MD programs. Surveys gathered data about interview formats, interview accommodation procedures, and TS accessibility during the 2018-2019 academic year. We received responses from 71 institutions (41.3%), with 56.3% survey completion rate (n = 40). Among respondents, interview …

Social Anxiety, Negative Affect, And Hearing Difficulties In Adults, Katrina Kate S. Mcclannahan, Sarah Mcconkey, Julia M Levitan, Thomas L Rodebaugh, Jonathan E Peelle

2020-Current year OA Pubs

Subjective ratings of communication function reflect both auditory sensitivity and the situational, social, and emotional consequences of communication difficulties. Listeners interact with people and their environment differently, have various ways of handling stressful situations, and have diverse communication needs. Therefore, understanding the relationship between auditory and mental health factors is crucial for the holistic diagnosis and treatment of communication difficulty, particularly as mental health and communication function may have bidirectional effects. The goal of this study was to evaluate the degree to which social anxiety and negative affect (encompassing generalized anxiety, depression, and anger) contributed to subjective communication function (hearing …

Use Of Clinical Competency Examinations For Dental Hygiene Licensure, Jocelyn D. Weinhagen, Tara L. Newcomb, Brenda T. Bradshaw

Dental Hygiene Faculty Publications

Dental hygiene licensure with a clinical competency examination (CCE) using a live patient has been required by state licensing boards since 1929. Clinical competency examinations were initially used when dental training was poorly developed, non-standardized, and largely based on the apprenticeship model. Currently, Canada and the state of California have removed the requirement of passing a CCE for dental hygiene licensure, provided certain requirements have been met. Dentistry is the last health care profession to mandate that graduates pass a CCE. The vast majority of dental licensing boards continue to require that third party testing agencies validate the clinical skills …

Clinician Perspectives On Virtual Reality Use In Physical Therapy Practice In The United States, Danielle T. Felsberg, Jared T. Mcguirt, Scott E. Ross, Louisa D. Raisbeck, Charlend K. Howard, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

The primary goal of physical rehabilitation is to assess movement impairments and restore function to improve overall quality of life. Virtual reality (VR) may provide the optimal environment to promote these goals due to its motivating and modifiable nature which can be difficult to accomplish through traditional real-world therapeutic methods. Current research of VR for rehabilitation has demonstrated that VR interventions can produce clinically meaningful change in motor outcomes. Despite this, adoption and usage of VR by physical therapy professionals is unclear due to the limited research in this area. Thus, the purpose of this study was to identify the …

American Society Of Hematology/International Society On Thrombosis And Haemostasis 2024 Updated Guidelines For Treatment Of Venous Thromboembolism In Pediatric Patients, Paul Monagle, Muayad Azzam, Rachel Bercovitz, Marisol Betensky, Rukhmi Bhat, Tina Biss, Brian Branchford, Leonardo R. Brandão, Anthony K.C. Chan, E. Vincent S. Faustino, Julie Jaffray, Sophie Jones, Hassan Kawtharany, Bryce A. Kerlin, Nicole Kucine, Riten Kumar, Christoph Male, Marie-Claude Pelland-Marcotte, Leslie Raffini, Chittalsinh M. Raulji, Sarah E. Sartain, Clifford M. Takemoto, Cristina Tarango, C. Heleen Van Ommen, Maria C. Velez, Sara K. Vesely, John Wiernikowski, Suzan Williams, Hope P. Wilson, Gary Woods, Ayesha Zia, Reem A. Mustafa

Journal Articles: Pediatrics

BACKGROUND: The American Society of Hematology (ASH) guidelines on treatment of pediatric venous thromboembolism (VTE) were published in 2018. In the last 6 years, there has been a 10-fold increase in the number of children involved in VTE treatment trials.

OBJECTIVE: The ASH Committee on Quality and Guidelines agreed to update the pediatric guidelines in conjunction with the International Society on Thrombosis and Haemostasis (ISTH). These ASH/ISTH evidence-based guidelines are intended to support patients, clinicians, and other health care professionals in the management of pediatric patients with VTE.

METHODS: ASH/ISTH formed a multidisciplinary guideline panel to minimize potential bias from …

Selling Egg-Cellence: An Exploration Of Commercial Oocyte Donation And Genetic Determinism In 21st Century America, Abigail C. Oswald

Scripps Senior Theses

This thesis examines the impact of genetic determinism on commercial egg donation in the United States. Through critical analysis of social media advertisements, online forums, and interviews, it argues that reductionist, genetically deterministic thinking drives the commodification of oocytes. Fertility agencies exploit assumptions about heritable traits (health, ethnicity, intelligence) to market "desirable" donors, influencing intended parents' choices and compensation hierarchies. Then the research explores how these same ideas shape perceptions of familial closeness in donor-conceived individuals and their parents, revealing mixed feelings surrounding genetic ties. This study highlights the complex interplay of biology, technology, and social constructs in defining family …

From Curiosity To Controversy: American Perception Of Japanese Immigrants, 1853-1924, Chloe Elizabeth Curbelo

Theses and Dissertations

In the mid-nineteenth century, as the United States reached the Pacific through westward expansion, Asia emerged as a new stage for commerce and power. Japan, long isolated under the Tokugawa shogunate, became an object of American fascination when forced into relations. While early depictions cast Japan as an exotic yet uncivilized nation in need of Western guidance, Japan’s rapid modernization and the growing number of Japanese immigrants on the West Coast transformed curiosity into anxiety. My paper traces this evolution of perception from 1850 to 1924, arguing that shifting views of Japan and its people reflected America’s ethnocentric notions of …

Partisan Divides In Environmental Spending Attitudes: A Two-Level Hierarchical Analysis, 1973-2022, Jordan Lipner

Honors Undergraduate Theses

Public attitudes toward environmental spending have become increasingly divided along party lines, with sharp shifts over the past five decades. This thesis updates and expands on Johnson and Schwadel’s 2019 study by applying a two-level hierarchical linear model to General Social Survey data updated to include data from 2015-2022, capturing how political affiliation, education, race, and economic context interact with broader political and economic contexts to shape environmental attitudes over time.
The results show that political affiliation remains the strongest and most reactive predictor of environmental spending attitudes. Republican respondents are significantly more likely to oppose environmental spending, especially under …

The War On Knowledge And How Everyone Is A Part Of The Problem: Through The Lens Of Science Communication And The Trump Administration, Aidan D. Valcich

CEG 450 Cultural, Environmental, and Global Studies Capstone

Science communication as an emerging field of study has become increasingly important in the age of the internet and rapid information dissemination. The work of science communication focuses on the complexities of communicating sciences between experts and non-experts such as politicians and laymen. The importance is not only communicating the science but also why everyone, not just the experts, should care. In what has been called the War on Knowledge, there has been an increase in attacks against science and academia. A major example of this is in the United States during both of the presidential terms of Donald Trump. …

Multisociety Guidance For Infection Prevention And Control In Nursing Homes, Lona Mody, Sonali D. Advani, Muhammad Salman Ashraf, Allison H. Bartlett, Suzanne F. Bradley, Deborah P. Burdsall, Jennifer A. Hanrahan, Susan S. Huang, Robert L.P. Jump, Lindsay Nicolle, Mary-Claire Roghmann, Patricia Stone, Rekha K. Murthy

Department of Medicine Faculty Publications

This multisociety guidance was endorsed by SHEA, APIC, IDSA, PALTmed, and AGS. It provides recommendations for infection prevention and control (IPC) in the context of the complexity of nursing home care in the United States: increased medical acuity of residents, the spread of multidrug-resistant organisms, and the threat of emerging pathogens. Recommendations and implementation suggestions address IPC leadership, staffing, and resources, healthcare personnel and residents‘ adherence to precautions and effective hand hygiene, outbreak preparedness, training, occupational health, cleaning and disinfection in the care environment, and the involvement of IPC in the facility. The guidance also addresses the challenges of maintaining …

Informal Caregivers Connecting On The Web: Content Analysis Of Posts On Discussion Forums, Michelle L. Foster, Chinenye Egwuonwu, Erin Vernon, Mohammad Alarifi, M. Courtney Hughes

Faculty Articles, Papers, and Other Scholarship

Background: About 53 million adults in the United States offer informal care to family and friends with disease or disability. Such care has an estimated economic value of US $600 million. Most informal caregivers are not paid nor trained in caregiving, with many experiencing higher-than-average levels of stress and depression and lower levels of physical health. Some informal caregivers participate in web-based forums related to their caregiving role.

Objective: This study aimed to explore how informal caregivers use easy-to-access caregiving web-based forums, including the types of information they share and seek from others. It also aimed to gain insights into …

Aestheticizing And Engendering Disease: The Case Of Tuberculosis, Abigail Dollries

Dartmouth College Master’s Theses

This thesis examines how tuberculosis, known in the nineteenth century as “consumption,” was aestheticized in American cultural and medical discourse, particularly in industrial cities of the North between 1830 and 1850. It addresses the paradox at the heart of the disease’s representation: while tuberculosis was medically pathologized, it was simultaneously romanticized, especially when afflicting elite white women. The central problem explored is how this aestheticization of illness functioned to reinforce gender, class, and racial hierarchies by transforming suffering into a symbol of virtue, refinement, and social status. Using a cultural-historical methodology, this project analyzes a range of sources, including medical …

Dental Care Trajectories Among Formerly Incarcerated Older Adults In The United States, Alexander Testa, Luis Mijares, Mateus Renno Santos, Vahed Maroufy, Dylan B Jackson, Rafael Samper-Ternent, Rahma Mungia, Ana C Neumann

Faculty, Staff and Student Publications

A growing body of research has documented an association between prior incarceration and lower dental care use, yet the longitudinal impact of prior incarceration on dental care patterns over time among older adults remains unexplored. This study aims to investigate whether prior incarceration is associated with differing trajectories of dental care use among older adults in the United States. Data were drawn from the 2012-2020 waves of the Health and Retirement Study (HRS), a nationally representative longitudinal survey of older adults in the United States (n =  5,893). Group-based trajectory modeling was used to estimate dental care use patterns over …

Risk Of Post-Acute Symptoms Among Adults: A Comparison Study Of Severe Covid-19, Pneumonia, And Influenza, Caroline M Schaefer, Trudy Millard Krause, George L Delclos, Raymond S Greenberg

Faculty, Staff and Student Publications

Background: A retrospective cohort study was undertaken to assess the relationship between initial disease severity of COVID-19 and the risk of post-acute symptoms. The COVID-19 cohort was compared against influenza and pneumonia cohorts to assess whether risk of post-acute symptoms differed.

Methods: Administrative health claims data were obtained for commercially insured and Medicare Advantage covered adults (≥ 18 years) with symptomatic laboratory-confirmed COVID-19 diagnosed in 2020 (n=121,205), and similar cohorts of influenza (n=20,844) and pneumonia (n=29,052) patients diagnosed prior to the pandemic. Post-acute symptoms were assessed at four weeks, three and six months following initial diagnosis.

Results: Among the patients …

Protective Effects Of Psychiatric Medications Against Covid-19 Mortality Before Vaccines, Rodrigo Machado-Vieira, Trudy M Krause, Gregory Jones, Antonio L Teixeira, Lokesh R Shahani, Scott D Lane, Jair C Soares, Chau N Truong

Faculty, Staff and Student Publications

The coronavirus disease pandemic caused by the coronavirus SARS-CoV-2, which emerged in the United States in late 2019 to early 2020 and quickly escalated into a national public health crisis. Research has identified psychiatric conditions as possible risk factors associated with COVID-19 infection and symptom severity. This study aims to determine whether specific classes of psychiatric medications could reduce the likelihood of infection and alleviate the severity of the disease. The objective of this study is to investigate the relationship between neuropsychiatric medication usage and COVID-19 outcomes before the widespread utilization of COVID-19 vaccines. This cross-sectional study used Optum's de-identified …

Cardiovascular Risk Factors And Genetic Risk In Transthyretin V142i Carriers, Naman S Shetty, Mokshad Gaonkar, Akhil Pampana, Nirav Patel, Alanna C Morrison, Alexander P Reiner, April P Carson, Bing Yu, Bruce M Psaty, Charles Kooperberg, Diane Fatkin, Eric Boerwinkle, Jerome I Rotter, Kent D Taylor, Lifang Hou, Marguerite R Irvin, Michael E Hall, Mathew Maurer, Myriam Fornage, Nicole D Armstrong, Nicole Bart, Parag Goyal, Stephen S Rich, Ramachandran S Vasan, Peng Li, Garima Arora, Pankaj Arora

Faculty, Staff and Student Publications

Background: Nearly 3% to 4% of Black individuals in the United States carry the transthyretin V142I variant, which increases their risk of heart failure. However, the role of cardiovascular (CV) risk factors (RFs) in influencing the risk of clinical outcomes among V142I variant carriers is unknown.

Objectives: This study aimed to assess the impact of CV RFs on the risk of heart failure in V142I carriers.

Methods: This study included self-identified Black individuals without prevalent heart failure from 6 TOPMed (Trans-Omics for Precision Medicine) cohorts, the REGARDS (Reasons for Geographic And Racial Differences in Stroke) study, and the All of …

Heat Stress Prevention And Management In The Construction Industry: A Gap Analysis, Muinat Abolore Idris, Kristina D Mena, Christine Markham, William B Perkison

Faculty, Staff and Student Publications

Background: Despite decades of efforts to prevent heat stress, it remains a major health risk to workers in the construction industry. This health risk has been exacerbated by the rising ambient temperatures from climate change, as well as the increased susceptibility to heat stress in an aging workforce.

Objective: To develop a tailored occupational safety management framework for heat stress prevention in construction, advancing workers’ health, safety, and well-being.

Methods: We built on the findings of a systematic review and analyzed a large industrial company’s current heat stress prevention program through stakeholder engagement, evidence-based practices, and gap analysis. We reviewed …

What We Know About The Peer Workforce And Economic Evaluation For Peer Recovery Support Services: A Systematic Review, Sierra Castedo De Martell, J Michael Wilkerson, Nalini Ranjit, Lori Holleran Steiker, Sheryl A Mccurdy, H Shelton Brown

Faculty, Staff and Student Publications

Background: Peer recovery support services (PRSS) for substance use disorder (SUD) have expanded in the past 2 decades to be formally certified and reimbursed under Medicaid in almost every US state. This rapid expansion has been followed by a growth in research, but 2 persistent gaps remain: a lack of research on the peer workforce, and a lack of economic evaluation research. This systematic review examines the current literature on PRSS to summarize what is currently known about the SUD peer workforce and collect potential PRSS economic evaluation parameters, and clearly identify the current gaps in each category.

Methods: PRISMA …

Diversity In United States Dementia Prevention Trials: An Updated Systematic Review Of Eligibility Criteria And Recruitment Strategies, Najoua Lazaar, Sabine E Van Beek, Awaale F Rirash, Janne M Papma, Jaime Perales-Puchalt, Ashley R Shaw, Eric D Vidoni, Sanne Franzen

Faculty, Staff and Student Publications

Introduction: Given the elevated dementia risk in underrepresented demographic groups in the USA - particularly in Latino and Non-Latino Black individuals compared to Non-Latino White individuals - it is vital that these groups are well-represented in dementia prevention research. Eligibility criteria and recruitment strategies may play a key role in promoting participant diversity. The aim of this review was to examine eligibility criteria and recruitment strategies in US dementia prevention trials in light of participant diversity.

Methods: A systematic review was conducted using Medline (including PubMed), Embase, Cochrane Library, and CINAHL. We explored the percent White participants for trials using …

Use Of Digital Health Interventions For Cancer Prevention Among People Living With Disabilities In The United States: A Scoping Review, Chinenye Lynette Ejezie, Lea Sacca, Sylvia Ayieko, Sara Burgoa, Yasmine Zerrouki, Diana Lobaina, Goodness Okwaraji, Christine Markham

Faculty, Staff and Student Publications

BACKGROUND: The use of digital health strategies for cancer care increased dramatically in the United States over the past 4 years. However, a dearth of knowledge remains about the use of digital health for cancer prevention for some populations with heath disparities. Therefore, the purpose of the present scoping review was to identify digital health interventions for cancer prevention designed for people with disabilities.

METHODS: This scoping review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews and the Arksey and O'Malley methodological framework. The Embase, PubMed, Ovid MEDLINE, and CINAHL/EBSCO databases were …

Cannabis Use Among Cancer Survivors And The Impact On Cancer-Related Pain, Tiffanie A. Vargas

Theses and Dissertations

With a growing population of older adult cancer survivors—many of whom experience cancer-related pain—interest in medical cannabis as a pain management strategy has increased. This secondary analysis used data from the 2022 U.S. Behavioral Risk Factor Surveillance System (BRFSS) to examine cannabis use behaviors among cancer survivors and assess associations with cancer-related pain. The study had three aims: (1) to describe 30-day cannabis use (prevalence, intensity, and administration routes) by chronic health condition and cancer diagnosis, focusing on non-melanoma skin cancer, melanoma, and other cancers; (2) to compare demographics, health characteristics, and tobacco use by cannabis use status among cancer …

Shattering The Glass Ceiling: Comparative Narratives Of Women Leaders In Public Relations In Ghana And The United States Of America, Adriana Kukuwaa Adu

All Graduate Theses, Dissertations, and Other Capstone Projects

This study explores the lived experiences of women in public relations (PR) leadership roles in both Ghana and the United States, focusing on the cultural, institutional, and societal barriers that shape their professional journeys. Employing a qualitative research design, the study involved ten women in senior PR positions, five from each country, through in-depth, semi-structured interviews. Thematic analysis identified six key themes: institutional barriers and gendered expectations; double standards in leadership communication; the influence of stereotypes; mentorship and support; intra-gender competition; and leadership agency and optimism. Guided by Social Role Theory, Glass Ceiling Theory, Feminist Standpoint Theory, and Transformational Leadership …

Disposition Outcomes Following Prehospital Use Of Naloxone In A Large Metropolitan City In The United States, James R Langabeer, Christine Bakos-Block, A Sarah Cohen, Ishmam Alam, Bhanumathi Gopal, Marylou Cardenas-Turanzas, Arlo F Weltge, David Persse, Tiffany Champagne-Langabeer

Faculty, Staff and Student Publications

Objectives: During a drug overdose, research suggests individuals may not call 9-1-1 out of fear of criminal justice concerns. Of those that call, research is inconclusive about the disposition of the emergency transport. We evaluated transport outcomes for adults with opioid-related overdose in the Emergency Medical Services (EMS) of a large metropolitan city in the United States.

Methods: We reviewed the EMS incident report database from the patient care record system for years 2018 to 2022. We queried all records, searching for relevant terms, and two reviewers cross-checked the database to identify cases that did not result in death at …

Shifting Patterns In Primary Care Telehealth Utilization Among Medicare Beneficiaries And Providers, Yunxi Zhang, Lincy S Lal, Saurabh Chandra, John Michael Swint

Faculty, Staff and Student Publications

Introduction: The COVID-19 pandemic accelerated telehealth adoption, but disparities in its utilization persist. This study examines primary care patient sociodemographic characteristics, telehealth utilization patterns, and provider adoptions before and during the pandemic.

Methods: A retrospective cohort study analyzed data from Mississippi Medicare beneficiaries continuously enrolled in Parts A, B, and D who accessed primary care services from 2019 to 2021.

Results: Among 201 677 Medicare beneficiaries accessing primary care, 1364 used telehealth before the pandemic, compared to 73 994 during the pandemic. Telehealth utilization shifted during the pandemic to younger, female, White beneficiaries, and those enrolled in Medicare due to …

A Systematic Review And Narrative Synthesis Of Factors Affecting Pre-Exposure Prophylaxis Willingness Among Black Women For Hiv Prevention, Alexis Sims Haynes, Christine Markham, Vanessa Schick, Robert Suchting, Nivedhitha Parthasarathy, Sumaita Choudhury, Mandy J Hill

Faculty, Staff and Student Publications

Pre-exposure prophylaxis (PrEP) can significantly reduce human immunodeficiency virus (HIV) transmission among Black women in the United States (U.S.), a group disproportionately affected by HIV. However, PrEP uptake in this HIV-vulnerable population is low. This review analyzes the factors influencing Black women's PrEP willingness using the Behavioral Model for Vulnerable Populations (BMVP). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Population, Intervention, Comparison, Outcome, Study Design (PICOS) framework, we conducted a systematic literature search and selected 24 peer-reviewed studies on PrEP willingness. Narrative synthesis revealed a heterogeneous landscape of the determinants affecting PrEP willingness …

Factors Affecting The Quality Of Life Of Residents In The United States: Lessons From Virginia, Daniel K. Pryce

Sociology & Criminal Justice Faculty Publications

Evaluating community members' views about their quality of life is important for improving quality of well-being in society, as most societies are interested in the collective well-being of the people. Moreover, quality-of-life research helps public officials to understand how well they are meeting the needs of the electorate. Using the theoretical framework of Maslow's Developmental Perspective, which argues that the higher the need satisfaction of the majority in a given society the greater the quality of life of that society, I explore the effects of multiple variables on quality of life in the Hampton Roads region of Southeast Virginia (this …

Trends In Contacts Made By Immigrants To The National Domestic Violence Hotline, Before And During The Covid-19 Pandemic, Sarah Treves-Kagan, Vi D Le, Liris S Berra, Colleen M Ray, Yanet Ruvalcaba, Leila Wood, Denise V D'Angelo, Tatiana M Vera, Lianne Fuino Estefan

Faculty, Staff and Student Publications

Objectives: Immigrants in the United States are more likely than nonimmigrants to experience risk factors for intimate partner violence (IPV) and problems in getting support. The COVID-19 pandemic and recent incidents of xenophobia and anti-immigrant sentiment may have exacerbated exposure to IPV risk factors. We examined immigrant experiences of IPV before and during the COVID-19 pandemic.

Methods: This study identified changes in characteristics of abuse, services used, referrals, and barriers to services among those who contacted the National Domestic Violence Hotline (NDVH) and identified as immigrants, reported immigration status as a concern, needed immigration support, and/or identified immigration status as …

Exploring Gaps In Hiv Prevention: Hiv Pre-Exposure Prophylaxis Awareness, Attitudes, Utilization, Coverage, Hiv Testing And Risk Perception Among Sub-Saharan African College Students In The United States, Ikenna Obasi Odii

All ETDs from UAB

This dissertation focuses on increasing HIV awareness and contributing to efforts at reducing new HIV infections among Sub-Saharan African (SSA) college students. It begins with an introductory chapter one and ends in the concluding chapter five. Chapter two presents a systematic review identifying key gaps in HIV Pre-Exposure Prophylaxis (PrEP) knowledge, attitudes, and utilization among Black college students in the United States (U.S). The review synthesizes findings from four studies, revealing that a third of participants demonstrated adequate PrEP knowledge, while PrEP utilization remained under-utilized at three percent. Key barriers to PrEP uptake included fear, low self-perceived HIV risk, infrequent …