Digital Commons Network^™

Implementing The Lung Donor (Lundon) Acceptability Score In U.S. Donor Management And Transplant Decision-Making: A Multi-Aim, Mixed-Methods Protocol, Nikki E. Rossetti, Su-Hsin Chang, Yan Yan, Graham Jaensch-Frie, Charles R. Liu, Nahom Y. Seyoum, Meghna Katta, Arvind Kumar, Zhizhou Yang, Christian Oncken, Christy Hamilton, Kyle Stumbaugh, Brendan Heiden, Sarah Peskoe, Varun Puri, Et Al.

2020-Current year OA Pubs

BACKGROUND: Despite advances in transplantation science, a persistent shortage of donor lungs continues to limit access to life-saving lung transplants. The Lung Donor (LUNDON) Acceptability Score is a validated tool that predicts donor lung utilization and post-transplant recipient outcomes, but integration into practice remains limited. This study will evaluate determinants of LUNDON score adoption, its impact on clinical decision-making, and develop tools to support its implementation.

METHODS: This is a multi-aim mixed-methods pre-implementation study that will be conducted across U.S. Organ Procurement Organizations (OPOs) and lung transplant centers. Aim 1 will identify barriers and facilitators of LUNDON score adoption through …

Elite Perceptions Of The Us’ Commitment To Nato After Russia’S Invasion Of Ukraine: “The Direction Of Travel Is Clear”, Jason W. Davidson

Political Science & International Affairs Articles

This article seeks to explore elite perceptions of the US’ commitment to NATO in the leadup to the 2024 election. It presents findings from ninety-two interviews from 2023 and 2024 with policymakers and analysts from six leading NATO allies. Analysis of the interviews demonstrates that only roughly half of interviewees were concerned with the US’ future commitment to NATO. The bulk of the article seeks to make sense of the variety of responses by categorizing them according to five different worldviews. A domestic political worldview provides an explanation for why some elites were concerned with the prospect of Donald Trump’s …

[Introduction To] Shakers At The Center : Manifesting Spirits & Spectacles In Nineteenth-Century America, Douglas L. Winiarski

Bookshelf

Edited by Douglas WIniarski.

"Exploring the theological, social, and cultural dimensions of one of America’s most ambitious prophetic movements

The Shakers’ Era of Manifestations ranks among the most astounding events in American religious history. During the 1840s, members of the United Society of Believers in Christ’s Second Appearing embarked on an audacious project of receiving visions, revelations, and other manifestations from the spirit world and convincing both themselves and the world’s people of their reality. Gifted Shakers known as “instruments” surrendered their bodies to possessing spirits and celestial beings who, in turn, provided the Believers with an unimaginable number of …

Organ Chips And Translational Research: Identifying And Examining New Ethical Issues, Melanie Jeske

Center for Medical Ethics and Health Policy Staff Publications

Organ chips, also known as organ-on-a-chip devices, tissue chips, or microphysiological systems, have emerged over the last decade as a promising translational technology amidst growing concern about the translational crisis between laboratory research and patient bedside. Pointing to high rates of failure between nonhuman animal models and safety and efficacy in humans, organ chips and similar new approach methods have attracted substantial public and private investment. As human-cell-based alternatives to animal models, organ chips promise more predictive, efficient, and ethical platforms for pharmaceutical and toxicity testing. Engineered cultivation systems that enable cells to assemble into tissue-like structures (e.g. kidney, brain, …

Anything But Endo: Diagnostic Buck-Passing In Endometriosis Diagnosis, Rita Dexter, Megan Kitts, Heather Welty, Melanie Jeske

Center for Medical Ethics and Health Policy Staff Publications

People living with endometriosis, a disease in which tissue similar to the lining of the uterus grows elsewhere in the body, often experience prolonged diagnostic journeys because of symptom variability, normalisation of period pain and other symptoms, and lack of awareness of the condition. In this article, we analyse the endometriosis diagnostic journey through the lens of epistemic injustice. Drawing on in-depth interviews with 52 people living with endometriosis in the United States, we introduce the concept of diagnostic buck-passing to characterise the phenomenon wherein individuals who seek treatment for their symptoms end up stuck in a cycle of seeing …

Differences Between Government, Consortium, And Private Database Stewards Impacting The Genomic Data Market: A Survey Of U.S. Academic Genetic Researchers., Amanda K Greene, J Denard Thomas, Kaitlyn Jaffe, Luyun Chen, Kerry A Ryan, Brian J Zikmund-Fisher, J Scott Roberts, Amy L Mcguire, Katherine Hendy, Kayte Spector-Bagdady

Center for Medical Ethics and Health Policy Staff Publications

Background: Despite major shifts in U.S. federal government data sharing requirements, their impact, and relation to researcher choice of database, are underexplored. This study surveyed genetic researchers regarding trends, priorities, perceptions of quality, impact on research outcomes, and genomic data sharing and use across government, consortium, and private databases.

Methods: As part of an exploratory sequential mixed methods project, we surveyed 294 U.S.-based genomic academic researchers.

Results: Genetic researchers generally have a choice between databases, which allows them to prioritize data quality. This might explain recent trends toward the use of government and consortium databases away from private ones. Respondents …

Facebooking Under Crisis: A Comparative Study Of Online French And American Mutual Aid Organizing During The Covid-19 Pandemic, Clare Reimers-Hejnal

Scripps Senior Theses

This thesis studies the political discussions, practices, and projects that emerged through mutual aid Facebook groups based in France and the United States during the COVID-19 pandemic. Of particular interest is how these online spaces and the Facebook users that comprised them understood their mutual aid organizing in relationship to specific themes, including but not limited to: the COVID-19 pandemic as a "crisis", the role of government presence or absence in the wellbeing of the public, and the concept of collective yet differentiated struggle. Chapter 1 looks at four Facebook pages based in the greater Paris area: Entraide Danube, Clichy …

Implementing Climate Remedies, Camila Bustos

Elisabeth Haub School of Law Faculty Publications

Climate change litigation has emerged as a powerful tool for addressing the climate crisis, particularly in the face of executive and legislative inaction. Across jurisdictions, courts have issued landmark decisions mandating stronger mitigation targets and recognizing rights-based claims against governments and corporations. While recent scholarship has examined the trends, legal theories, and broader effects of this relatively new phenomenon, it has primarily focused on bringing and winning legal challenges. Less attention has been paid to a crucial phase: the implementation and enforcement of judicial rulings. A deeper understanding of how climate remedies are implemented can provide valuable insights for climate …

The Future Of U.S. Higher Education: Equity Implications Of Shifting Immigration Policies, Research Institute For Social Equity Rise

Research Institute for Social Equity

This report examines the impact of U.S. immigration policies on higher education and international students from 2000 to 2025. It traces five major policy eras, from the post- 9/11 security overhaul and Obama-era expansion to the restrictive turns of 2017–2020 and 2025, and analyzes how shifting regulations have influenced enrollment patterns, economic contributions, and student well-being. Despite hosting more than 1.1 million international students in 2023–2024, the U.S. share of the global student market has fallen from 20% to 16%, underscoring how policy volatility and restrictive measures weaken national competitiveness. Drawing on federal data, scholarly research, and institutional reports, this …

The Prevalence Of Diabetic Retinopathy In American Indians Or Alaska Natives And Non-Indigenous Americans: A Systematic Review And Meta-Analysis., Caberry W. Yu, Keean Nanji, Anubhav Garg, Michele Zaman, Jane Jomy, Abdullah El-Sayes, Catherine Sun, Shreyas Bhat, Mark Phillips, Dena Zeraatkar, Jinhui Ma, Enrico Borrelli, Sunir J Garg, David H. Steel, Tien Yin Wong, Sobha Sivaprasad, Charles C. Wykoff, Varun Chaudhary

Wills Eye Hospital Papers

TOPIC: To estimate the prevalence of diabetic retinopathy (DR) in adult American Indian or Alaska Native (AIAN) and non-AIAN patients with diabetes.

CLINICAL RELEVANCE: Although diabetes mellitus is more prevalent among AIAN patients compared with non-AIAN patients, the evidence is inconsistent regarding whether AIAN patients have a higher prevalence or severity of DR.

METHODS: We searched Ovid MEDLINE, EMBASE, and Web of Science databases from inception through February 23, 2025. We included primary studies evaluating the prevalence of DR in Americans with diabetes. The prevalence of (1) DR, (2) diabetic macular edema (DME), (3) proliferative diabetic retinopathy (PDR), (4) vision-threatening …

Sustainable Community-Wide Model To Enhance Cancer Data Usage And Utility, Emily S Boja, Mousumi Ghosh, Ying Huang, Tung-Shing Mamie Lih, Rawan Shraim, Gregory Wheeler, Diana Thomas, Rakesh Khanna, Stephanie Sandor, Jinghui Zhang, Sapna Oberoi, Nicolas J Llosa, Aditya Suru, Fernanda Silva Michels, Eric Durbin, Anna Fernandez, Lucy Han, James Galbraith, Yin Lu, Brian Furner, James H Tanis, Michael Watkins, David Higgins, Gavriel Matt, Xin Zhou, Yang Li, Marcin Cieslik, Jamie Estill, Michael Sierk, Yanling Sun, Weiping Ma, Joseph Flores-Toro, Freddie Pruitt, Subhashini Jagu, Elmer A Fernández, Daniela Orschanski, Stephanie J Spielman, Jaclyn Taroni, Trinh Nguyen, Brian Capaldo, Erin Beck, Tanja Davidsen, Johanna Goderre Jones, Minghong Ward, Anne Sturcke, Jennifer M Torres Del Valle, Sean Hanlon, Danielle Daee, Brandon Wright, Nathaniel Boyd, Heather Basehore, Liang Liu, Ying Hu, Daoud Meerzaman, Huiqing Li, Ying Wu, Gregory H Reaman, Erin Rudzinski, Jack F Shern, Brigitte Widemann, Warren Kibbe, Jaime Guidry Auvil

Children’s Nutrition Research Center Staff Publications

Despite vast investments in data collection, generation, and sharing from childhood cancer studies, for example, Gabriella Miller Kids First Research Program, Childhood Cancer Data Initiative, and other efforts, secondary use of data remains a challenge especially for rare diseases. The National Cancer Institute (NCI) Office of Data Sharing (ODS) aimed to promote FAIR (Findable, Accessible, Interoperable, Reusable) data sharing practices to enhance data utility, accelerate discovery, and foster interdisciplinary collaboration. NCI ODS launched its inaugural Data Jamboree focusing on childhood cancer alongside its third Annual Symposium in September 2025. Over 120 participants with diverse backgrounds coalesced into 23 multidisciplinary teams …

A Mixed-Methods Cross-Cultural Analysis Of Trust, Parenting, And Well-Being Of Emerging Adults In The United States And Romania, Matthew Bucaloiu

Honors Theses

Trust is linked to emerging adults’ higher well-being. To our knowledge, few studies explore U.S. and Romanian emerging adults’ trust in others and their parents and their relationships to dimensions of parenting and well-being. This mixed-methods project examines cross-cultural differences and similarities in the relationships between trust, parenting dimensions, and well-being in two countries. With self-report quantitative data from 152 U.S. and 233 Romanian emerging adults, Study 1 found positive correlations between general trust dimensions, trust in mothers and fathers, parental care, and well-being, while psychological control was negatively correlated with trust and well-being. Multiple regression analyses revealed that for …

Adolescent Girls’ Experiences Of Digital Dating Abuse Through Social Media: A Scoping Review, Kiara E. Rodriguez

Social Work Theses

Teen dating violence (TDV) is a prevalent adverse childhood experience with lasting psychological and behavioral consequences. As adolescents increasingly engage with social media, with 95% of teens aged 13-17 reporting using it, digital spaces have become a significant context in which dating abuse can occur. Digital dating abuse (DDA) refers to patterns of abusive behaviors that are directed toward a dating partner through digital technologies, including social media and mobile phones. Despite the growing role of social media in adolescent relationships, research on how adolescent girls experience DDA in these contexts remains limited. The central question for this scoping review …

The Mediating Effect Of Socioeconomic Status And Persistent Poverty On Racial And Ethnic Disparities In Pediatric Cancer Mortality In The United States, Josiane Kabayundo, Apu Das, Cheng Zheng, Emma Hymel, Krishtee Napit, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

BACKGROUND: Socioeconomic (SE) factors have been shown to mediate racial and ethnic disparities in adult cancer mortality. However, evidence in pediatric cancer is limited, especially at finer geographic levels.

OBJECTIVE: Evaluate the mediating effect of socioeconomic status (SES) and persistent poverty in racial and ethnic disparities in childhood cancer mortality using census tract-level data.

METHODS: Data were obtained from the 2006-2020 SEER Incidence Data with Census Tract Attributes Database and included children 0-19 years. Neighborhood-level SES was measured using a composite variable with five categories. Census tracts were classified as persistently poor if 20% or more of the population lived …

Oral Health Access Among Ethnic Minority Older Adults In The United States, Jasleen K. Sodhi

Honors Undergraduate Theses

Oral healthcare is a critical yet often overlooked component of overall health among U.S. adults. Ethnic minorities for older adults face heightened risks of poor oral health and related health conditions, while experiencing disparities in access to care. This study aimed to systematically examine and synthesize existing literature to assess the extent to which oral health disparities exist among ethnic minority older adults in the U.S. and explore the roles of socioeconomic factors on these disparities. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework, we conducted a systematic review of peer-reviewed articles published in English …

An Analysis Of How Adverse Weather Conditions Impact Concessions Revenue At Live College Sporting Events, Luke V. Eiermann

Honors Undergraduate Theses

Previous literature finds that weather affects consumer behavior, though these findings are conflicting among sports fans. While there have been some studies into weather’s effects on attendance, there has not yet been research into its effects on concessions revenue. This is a topic of interest as adverse weather is increasingly prevalent in consumers’ lives, and learning more about their behavior in response to adverse weather is becoming more important. I performed a fixed effects panel data regression, using weather data sourced from the NOAA and sports and population data sourced from various locations. I did not find significant results for …

Nuclear Deterrence In The Age Of Hybrid Warfare, Chick Edmond

Political Science & Geography Faculty Publications

The main mechanism through which strategic stability can be preserved amongst nuclear armed states has traditionally been viewed as nuclear deterrence. Deterrence works on the premise that catastrophic consequences will cause rational restraint due to the fear of nuclear conflict. The proliferation of hybrid warfare (the coordinated use of conventional, cyber, informational, economic, and proxy instruments below the threshold of open war) has changed the strategic environment within which deterrence now operates. This research paper assesses whether nuclear deterrence is still effective in preventing escalation in an era marked by continuous grey zone competition amongst major powers. The paper also …

The 2025 American Society Of Pediatric Otolaryngology Workforce And Compensation Survey: Current State And Future Directions, Lyndy J. Wilcox, Cristina M. Baldassari, Amy C. Brenski, Emily Boss, John Carter, David H. Chi, William O. Collins, Charles A. Elmaraghy, Andrew J. Tompkins, Craig S. Derkay, The Aspo 2025 Workforce And Compensation Committee

Department of Otolaryngology (ENT) Faculty Publications

Objective

To provide an updated comprehensive assessment of the Pediatric Otolaryngology workforce in the United States inclusive of compensation, productivity, practice patterns, and on-call burden.

Study Design

Cross-sectional electronic survey.

Methods

A structured electronic survey was developed by members of the American Society of Pediatric Otolaryngology (ASPO) Workforce and Compensation Committee. The survey evaluated six domains: demographics, compensation, workforce dynamics, productivity, on-call burden, and future priorities, and was distributed to all 480 presumedly actively-practicing, domestic ASPO members.

Results

The survey response rate was 68% (327/480). Ninety-one percent of respondents held an academic appointment with relatively equal percentages of each rank …

Relationship Between Number Of Assigned Patients And Rn Time To Administer Medications During The Peak-Time Medication Pass, Chase S Eck, Melissa K Knox, Paras D Mehta, Christine Yang, Laura A Petersen

Faculty, Staff and Students Publications

Background: Inpatient nurse staffing affects patient outcomes. Less is known about the mechanism of this relationship and how lower overall staffing in a unit affects individual RN activities at the bedside.

Objectives: Estimate the relationship between the number of patients assigned to an RN and time spent on medication administration at the peak-time medication pass (PTM), a common nursing task.

Research design: Estimate the association using multivariable linear regression to adjust for patient severity and staff and unit fixed effects.

Subjects: All 9272 RNs administering medications during the PTM on 243 inpatient units in 113 VHA hospitals in 2019.

Measures: …

1981, Carliss N. Chatman

Faculty Journal Articles and Book Chapters

42 U.S.C. § 1981 should have solved a pervasive problem in American capitalism—when white economic interests do not converge with the contract rights of Black people, they are excluded from the market in a way that causes systemic harm. This Article proposes that the failure to enforce 1981 in the past may render it more harmful than beneficial in the present climate of retrenchment. The realities of racism combine with the lack of economic interest convergence to make combatting contract inequality on a contract-by-contract basis legally precarious, nearly impossible to properly evaluate, and difficult to economically incentivize. This is in …

Food Delivery Services For Enhancing Participation In The Special Supplemental Nutrition Program For Women, Infants, And Children (Wic) In The United States: Bridging The Wic-Eligible Access Gap, Jingjing Gao, Muinat Abolore Idris, Lilian O Ademu, Bryan Colby Griffin, Yue Zhang, Yun Hang, Gabriela A Gallegos

Faculty, Staff and Student Publications

Background: Diet-related health disparities among U.S. children persist despite the availability of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) benefits to eligible women, infants, and children. Participation remains suboptimal: only 51.2% of eligible individuals were enrolled in 2021. Transportation and food-environment constraints pose salient barriers, especially for caregivers of infants in food deserts. Emerging online ordering and delivery options may reduce access frictions, but grocery delivery coverage is limited, and fees are often not covered by benefits.

Methods: We linked USDA Food and Nutrition Service state-level WIC participation data (November 2024 vs. September 2025) with demographic, …

Evaluating Differences In Nonsyndromic Orofacial Clefts By Infant Sex: National Birth Defects Prevention Study, 1997-2011, Victoria A Salinas, Natalie P Archer, Layla R Lustri, Katherine L Ludorf, Timothy Ihongbe, Wei Yang, Eva M Williford, Marilyn L Browne, Adrian M Michalski, Lindsay A Williams, Wendy Nembhard, Eirini Nestoridi, Gary M Shaw, Andrew F Olshan, A J Agopian, National Birth Defects Prevention Study

Faculty, Staff and Student Publications

Objective: To investigate nongenetic factors that may contribute to observed differences in nonsyndromic orofacial clefts by infant sex.

Study design: Using data for 1997-2011 deliveries from the National Birth Defects Prevention Study, a case-control study, we separately examined associations between 23 maternal factors and cleft lip with or without cleft palate (CL/P) and cleft palate alone (CP) using multivariable logistic regression stratified by infant sex.

Results: We compared 2986 infants with CL/P and 1557 with CP to 11 271 control infants without birth defects. After adjusting for maternal age at conception and education, lower odds of nonsyndromic orofacial clefts were …

Enhancing Data Compatibility In An Evolving Landscape: Medical Cannabis And Polysubstance Use Protocols In The Phenx Toolkit, Anne Buu, Johannes Thrul, Amanda Bunting, Tamara Haegerich, Wayne Huggins, Christian Hopfer, Denise Vidot, Cataia Ives, Ryan Mcneil, Sarah Zemore, Corrie Vilsaint, Elizabeth Fallon, Christine Hill, Carol Hamilton, John Kelly

Faculty, Staff and Student Publications

Introduction: With increasing legalization of medical cannabis and prevalence of polysubstance use in the United States comes the need for standard psychometrically validated measures to study these substances' health effects in the population. The PhenX (consensus measures for Phenotypes and eXposures) Toolkit (www.phenxtoolkit.org) is a freely accessible catalog of recommended measurement protocols to promote data compatibility across studies, but this extensive catalog did not include measures in these important areas.

Methods: In 2024, a PhenX Working Group of experts followed a well-established consensus process to identify and recommend measurement protocols suitable for inclusion in studies on medical cannabis and polysubstance …

A Case Of Rocky Mountain Spotted Fever, Deepa Nuthalapati, Natalie Kuo-Hsuan Yang, Rajiv Shah, Valerie Sinkler

South Atlantic Division GME Research Days 2026

No abstract provided.

Contralateral Breast Cancer After Radiotherapy And Hormone Therapy In Two Cohorts Of Us Breast Cancer Survivors, Lene H S Veiga, Gretchen L Gierach, Susan A Smith, Rebecca M Howell, Matthew M Mille, Monjoy Saha, Rochelle E Curtis, Cody Ramin, Clara Bodelon, Heather Spencer Feigelson, Erin J Aiello Bowles, Diana S M Buist, Sheila Weinmann, Jacqueline B Vo, Choonsik Lee, Amy Berrington De Gonzalez

Faculty, Staff and Student Publications

Background: Radiotherapy increases contralateral breast cancer risk, while hormone therapy reduces it; their combined effects are unclear.

Methods: Data from two US retrospective cohort studies of 5-year breast cancer survivors (stage I-III, ages 20-84), Kaiser Permanente (KP, 1990-2012) and SEER (1990-2013), were analysed. Contralateral breast radiation doses were estimated for the KP cohort. Multivariable Poisson regression estimated relative risks (RRs) and excess relative risks per Gray (ERR/Gy), stratified by hormone therapy use.

Results: KP cohort (n = 9053) included 353 contralateral breast cancer cases (73% ER+); SEER cohort (n = 244,834) included 10,470 cases (72% ER+). Among women with ER+ …

An Insidious Interstice: Understanding Cognition And Language Behaviour Through The Eyes Of Juvenile Justice Professionals, Anne M. Perrotti, Allison T. Chappell, Tancy Vandecar-Burdin

Human Movement Studies & Special Education Faculty Publications

Introduction

Despite evidence suggesting language and cognition deficits are prevalent for justice involved youth, little research explores how juvenile justice personnel experience language and cognition behaviours in the youth they serve.

Aims

This qualitative study explored how juvenile justice personnel understand language and cognition skills and deficits in justice involved youth.

Methods

Twenty-two U.S. juvenile justice professionals participated in individual, semi-structured interviews. Questions focused on individual understanding of receptive language, expressive language, social communication, and cognition (i.e., problem-solving, predicting consequences and impulsiveness) in juveniles served. Using a phenomenological lens, transcripts were coded identifying themes and sub-themes of participant responses.

Results …

Patterns, Pressures, And Pathways : An Ethnographic Study Of Discipleship In Nepali-Speaking Immigrant Churches In The United States, Ram Kumar Budhathoki

ATS Dissertations

No abstract provided.

Congenital Syphilis: From Near-Elimination To Crisis, Chad J Abresch, Irene A Stafford, Regan M Johnson, Kayode Olabanji, Ashleigh M Sutphen, Helen E Cejtin, Ashley Hoover

Faculty, Staff and Student Publications

This analytic essay examines the transformation of congenital syphilis (CS) in the United States from near-elimination to crisis. Drawing from the January 2025 Congenital Syphilis Summit in Atlanta, Georgia-convening public health leaders, Tribal health departments, the National Coalition of STD Directors, and Centers for Disease Control and Prevention experts-we contrast prevention systems during near-elimination (1998-2005) with the current crisis (2018-2025). Evidence revealed how dismantling public health infrastructure produced dramatically different outcomes, with CS cases increasing 937% over the past decade and racial/ethnic disparities worsening. American Indian/Alaska Native communities face rates up to 100 times higher than White populations in some …

Contemporary Trends In Pediatric Extubation Failure And Noninvasive Respiratory Support Use, Jeremy M Loberger, Mitchell Moore, Matthew Scanlon, Robinder G Khemani, Samer Abu-Sultaneh, Colin M Rogerson

Faculty, Staff and Student Publications

Background: Prolonged invasive mechanical ventilation (IMV) is associated with morbidity and mortality in children. Timely extubation is essential and must balance the competing risks of extubation failure (EF) and prolonged use of noninvasive respiratory support after extubation.

Research question: Did EF risk factors, EF rates, noninvasive respiratory support after extubation practices, and patient-centered outcomes changed between 2013 and 2022?

Study design and methods: Retrospective cross-sectional study of patients younger than 19 years receiving IMV for ≥ 24 hours and extubated between 2013 and 2022 from 158 North American sites in the Virtual Pediatric Intensive Care, LLC, quality improvement database.

Results: …

Elementary Teachers’ Perspectives On Science Of Reading Mandates: A Q Methodology Study Of Autonomy And Cultural Responsiveness, Gui Ying Annie Yang-Heim

Faculty Publications - College of Education

This study examines elementary teachers’ perspectives on Science of Reading (SoR) mandates, with particular attention to tensions between instructional autonomy and cultural responsiveness. Using Q methodology, 26 elementary literacy teachers sorted 48 statements reflecting beliefs about literacy instruction, assessment, and equity. Factor analysis with varimax rotation yielded 3 distinct factors, with significant loading set at ± 0.37 (p <  .01). The resulting factor structures reveal differentiated viewpoints regarding the perceived benefits and constraints of SoR-aligned policies. While some teachers emphasized the value of structured, skills-based instruction for supporting early reading development, others foregrounded concerns about reduced professional autonomy and the marginalization of culturally responsive and contextually grounded practices. Post-sort interviews were analyzed alongside factor arrays to support interpretation and to clarify how teachers articulated the reasoning underlying their rankings. The findings indicate that teachers’ responses to SoR mandates are not uniformly oppositional or compliant but reflect nuanced negotiations among policy expectations, professional judgment, and commitments to equity. By integrating quantitative patterning with qualitative interpretation, this study contributes methodologically to Q research in education and substantively to ongoing debates about prescriptive literacy reforms and culturally responsive teaching.