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The Relationship Between Symptom Catastrophizing And Sociocultural Factors Among Adults With Persistent Sympathetic Activation Syndromes, Whitney M. Redemer Jan 2026

The Relationship Between Symptom Catastrophizing And Sociocultural Factors Among Adults With Persistent Sympathetic Activation Syndromes, Whitney M. Redemer

Theses and Dissertations

Persistent Sympathetic Activation (PSA) has emerged as a potential unifying mechanism underlying a range of complex chronic health conditions yet remains poorly characterized within biomedical and psychosocial research. Limited research has delineated how PSA manifests across diverse populations or how diagnostic and sociocultural factors shape lived experiences of this phenomenon; thus, the objective of the present study was to examine whether diagnostic certainty – operationalized as provider-confirmed versus self-suspected PSA-related diagnoses – is associated with symptom catastrophizing, and whether this relationship varies as a function of sociocultural factors. Drawing on data from a larger study aimed at characterizing the lived …


Your Left Or Mine: A Journey To Accessibility For Learning Disabilities And Neurodivergence In Stage Combat Pedagogy, Ambria Campbell Jan 2026

Your Left Or Mine: A Journey To Accessibility For Learning Disabilities And Neurodivergence In Stage Combat Pedagogy, Ambria Campbell

Theses and Dissertations

This thesis examines stage combat pedagogy from its inception to the present day through the lens of accessibility for learning disabilities and neurodivergence. Relevant research in education as it relates to disability is analyzed and applied to the field of stage combat pedagogy. What follows is a deconstruction and reconstruction of beginning level stage combat pedagogy to increase accessibility. These ideas are then tested and the results reflected on. This thesis focuses on college level and aged students who are the most likely demographic for beginning stage combat students. The completion of this thesis does not represent an endpoint in …


Dimension Reduction Involving Exogenous Variables With Applications In Manufacturing And Healthcare, Linxi Li Jan 2026

Dimension Reduction Involving Exogenous Variables With Applications In Manufacturing And Healthcare, Linxi Li

Theses and Dissertations

High-dimensional data analysis presents diverse challenges, including the curse of dimensionality, the complexities of working with datasets that combine large feature spaces with limited sample sizes, and difficulties in identifying meaningful relationships among variables. As datasets grow in size and complexity across different fields, it is increasingly important to develop practical approaches for extracting essential information from such data. Dimension reduction methods address these challenges by alleviating the effects of high dimensionality, enhancing the ability to reveal hidden patterns, and uncovering latent structures within the data to support further analysis. Some methods reduce dimensionality while preserving all relevant information, offering …


Development Of A Practical Lu-177 Activity Calibration Protocol For Clinical Nuclear Medicine: Dosimetric Impact Analysis And Implementation Tools, Azam Almolaiki Jan 2026

Development Of A Practical Lu-177 Activity Calibration Protocol For Clinical Nuclear Medicine: Dosimetric Impact Analysis And Implementation Tools, Azam Almolaiki

Theses and Dissertations

Lutetium-177 (Lu-177) is widely used in radionuclide therapy, where accurate activity measurement prior to administration is essential for safe and effective treatment delivery. However, variability in dose calibrator response due to measurement conditions and source geometry remains a practical challenge in routine clinical settings. This study presents a practical clinical calibration strategy under real-world constraints for Lu-177 activity measurement using standard nuclear medicine instrumentation. A vial-based approach was implemented using a well-type ionization chamber (Capintec CRC-15R) to evaluate measurement repeatability, temporal stability, and geometry dependence. All measurements were performed under consistent conditions with appropriate decay correction applied using the physical …


Spilt Milk, Fatima Kaleem Jan 2026

Spilt Milk, Fatima Kaleem

Theses and Dissertations

Spilt Milk explores how institutional discipline is rehearsed across the Pakistani home, school, and television soap opera. These seemingly domestic spaces converge at the military-industrial complex, where media propaganda (ISPR) and consumer commodities collaborate to manufacture a unified national identity.

Through an installation of school desks and re-fabricated cereal boxes, this project examines the ‘cereal/serial’ as a site of ideological consumption. By refabricating these boxes with embroidery, drawing, lace, and synthetic hair, the work subverts state-mandated narratives. These material interventions replace assembly lines with spills of hair and sweat to highlight the vulnerability of the body under surveillance. This project …


In-Between Echoes, Jiayi Liang Jan 2026

In-Between Echoes, Jiayi Liang

Theses and Dissertations

In this dissertation, I explore memory, diaspora, labor, and intergenerational trauma through constructed photography and experimental film. Informed by Homi K. Bhabha’s concept of the Third Space, I examine how identity is shaped through displacement, cultural negotiation, and inherited memory. Drawing from my relationship with my grandmother and my experience as a Chinese woman living in diaspora, I consider labor as both survival and care, tracing how domestic gestures and emotional structures continue across generations. Through collage, reconstruction, and animation, I rework fragments of family archives, colonial landscape imagery, and personal photographs to address grief, racialized perception, belonging, and the …


Plumbed 3-Manifolds And Neumann Moves, Noah J. Pope Jan 2026

Plumbed 3-Manifolds And Neumann Moves, Noah J. Pope

Theses and Dissertations

We give a constructive proof that every weakly negative definite plumbing tree can be transformed into a negative definite one by a finite sequence of Neumann moves. The argument combines Neumann’s plumbing calculus with the diagonalization algorithm of Duchon, Eisenbud, and Neumann, which extracts the eigenvalues of the framing matrix directly from the combinatorics of the tree. We show that any positive eigenvalues are supported on linear branches and can be eliminated systematically via controlled applications of Neumann moves. This provides an explicit algorithm reducing weakly negative definite plumbing trees to negative definite ones.


The Transition From School To Work For Students With Emotional And Behavioral Disorders: Examining The Lived Experiences Of Students In Private Day Schools, Gabrielle S. Pickover Jan 2026

The Transition From School To Work For Students With Emotional And Behavioral Disorders: Examining The Lived Experiences Of Students In Private Day Schools, Gabrielle S. Pickover

Theses and Dissertations

This qualitative phenomenological study examined the lived experiences of young adults with Emotional and Behavioral Disorders (EBD) as they transitioned from private day school settings into sustained employment. Guided by Schlossberg’s Transition Theory, the study explored participants’ perceptions of the barriers, supports, and strategies that shaped their transition experiences. Data were collected through twelve semi-structured interviews with six participants who maintained at least one year of continuous employment following high school. Analysis revealed four primary themes: structure as a stabilizing force, resilience developed through adversity, experiential learning as a pathway to employment, and employment as identity and independence. Findings suggest …


Cb1 Allosteric Modulation: Preclinical Insights Into Therapeutic Potential And Misuse Liability, Mohammed A. Mustafa Jan 2026

Cb1 Allosteric Modulation: Preclinical Insights Into Therapeutic Potential And Misuse Liability, Mohammed A. Mustafa

Theses and Dissertations

Cannabinoid type-1 (CB1) allosteric modulators represent a promising approach to modulate CB1 receptor signaling by binding to distinct receptor sites, without producing adverse cannabimimetic and dependence-related effects associated with Δ9-tetrahydrocannabinol (THC) and other CB1 agonists. This dissertation investigates the pharmacological, behavioral, and dependence-related profiles of CB1 allosteric modulators for their therapeutic potential and misuse liability. Presented here, the chiral CB1 positive allosteric modulator (PAM) ZCZ011 was resolved into its R- and S-enantiomers and characterized across in vitro and in vivo assays. Both enantiomers enhance CB1 agonist activity and produce intrinsic effects in vitro. Behaviorally, they produce antinociceptive effects in the …


Munajat: Design As A Dialogue With The Divine, Shawky Abdalla Jan 2026

Munajat: Design As A Dialogue With The Divine, Shawky Abdalla

Theses and Dissertations

Contemporary design discourse remains grounded in functional, seemingly user-centered paradigms, often neglecting what lies beyond the tangible within a human experience. This research challenges such frameworks by positioning design as a dialogue with what exceeds the physical, moving toward the experiential, where meaning precedes and informs form. Drawing on Islamic philosophy, particularly the relationship between zahir and batin (outward form and inward meaning), the study repositions design as a medium for remembrance (dhikr) rather than mere utility.

Through a critique of modernist and postmodernist principles, the research proposes a series of objects that engage with memory, introspection, and transcendence in …


Contours Of Duration: Movement Authored Through Form—A Behavior Archive, Jood Senussi Elbeshti Jan 2026

Contours Of Duration: Movement Authored Through Form—A Behavior Archive, Jood Senussi Elbeshti

Theses and Dissertations

Insect anatomy offers an elegant example of motion derived from structure. Inspired by insect movement, Contours of Duration employs a cam-and-follower system consisting of moving, leg-like parts, designed to engage a series of rotating cams, such that the shape of each cam’s surface activates the legs in unique ways, generating repetitive movement, and demonstrating how geometry produces distinct motion behaviors over time. Through iterative experimentation and controlled variation, trace emerges as a central methodology, whereby movement, over time, creates a distinct pattern of marks, making motion legible and reflecting how subtle changes to surface and form generate different behavioral outcomes. …


Fused Filament Fabrication Additive Manufacturing Of 17-4 Ph Stainless Steel: Process–Structure–Property Relationships In Magnetic Materials, Maanav Patel Jan 2026

Fused Filament Fabrication Additive Manufacturing Of 17-4 Ph Stainless Steel: Process–Structure–Property Relationships In Magnetic Materials, Maanav Patel

Theses and Dissertations

Additive manufacturing (AM) enables the fabrication of complex metallic components through layer-by-layer processing directly from digital models. Among AM techniques, material extrusion–based processes such as fused filament fabrication (FFF) provide an accessible method for producing metal parts using filament feedstocks composed of metal powders and polymer binders. When applied to precipitation-hardening stainless steels such as 17-4 PH, the processing route and heat treatments can influence the resulting microstructure and functional properties. This work investigates the magnetic behavior of 17-4 PH stainless steel fabricated using FFF and evaluates how heat treatment conditions influence measured magnetic properties. Samples were produced and analyzed …


Tms Phantoms For Investigating Multimodal Neuromodulation Procedures, Wesley H. Lohr Jan 2026

Tms Phantoms For Investigating Multimodal Neuromodulation Procedures, Wesley H. Lohr

Theses and Dissertations

Evidence suggests that combining deep brain stimulation (DBS) and transcranial magnetic stimulation (TMS) is potentially unsafe for certain TMS target locations, though TMS can alleviate several DBS-resistant PD symptoms such as speech impairment, freezing of gait, and dysphagia. Addressing this issue, head phantoms designed for TMS with embedded electric field (E-field) triaxial dipole probes (TDPs) are used to investigate a tunable magnetic shield that can protect implants from periphery E-fields and focalize magnetic fields. Through segmentation of MRI files, 3D printing, and injection molding of CNT-PDMS conductive composites, anatomical head phantoms are created. Anchoring TDPs to clinically relevant regions in …


Waxing And Waning: Hidden Interiors Of Grassroots Expression, Asmita Baskar Jan 2026

Waxing And Waning: Hidden Interiors Of Grassroots Expression, Asmita Baskar

Theses and Dissertations

Concealed interiors historically emerged from necessity in response to dominant systems around surveillance, control, and visibility. These hidden spaces carefully regulated access, cultivated intimacy, and enabled self-expression within grassroots groups and marginalized communities. Operating free from surveillance and in contrast to surrounding architectural and urban systems, these concealed spaces were not formally “interior designed”, yet they reveal how communities activate the interiors they encounter to retain agency.

Scholarship on grassroots resistance is largely examined through sociology, anthropology, psychology, or political science, with limited literature directly linking interiority, interior design, and resistance within covert spaces. This thesis addresses the gap in …


Vitality: Wellness For Female Collegiate Athletes, Kristin Beach Jan 2026

Vitality: Wellness For Female Collegiate Athletes, Kristin Beach

Theses and Dissertations

Vitality is a wellness center for female collegiate athletes. It is rooted in female oriented design strategies for comfort, recovery, and wellbeing. This project aims to provide an inclusive environment in which women within the VCU athletics department can come and support their health and wellbeing.  Spaces include physical therapy, academic support, movement studios, gathering lounge, locker room, private therapy, and grab and go food options. This program aims to provide spaces that support the busy schedule of a collegiate athlete, while using design strategies that enhance social, mental, and physical wellbeing while visiting. Located in a historic sauers building, …


Machine Learning-Based Spatio-Temporal Modeling Of Climate Dynamics And Desertification In The Sahara–Sahel Region, Stephen M. Tivenan Jan 2026

Machine Learning-Based Spatio-Temporal Modeling Of Climate Dynamics And Desertification In The Sahara–Sahel Region, Stephen M. Tivenan

Theses and Dissertations

Arid climate classifications are threshold-dependent and easily interpretable mappings that are widely used in ecological, agricultural, and climate-related studies. These classifications inform scientific understanding, support policy and land management decisions, and provide an intuitive summary of environmental conditions. Despite their usefulness, traditional arid climate classifications often fail to quantify uncertainty, incorporate spatial context, or account for complex relationships among relevant environmental variables. Existing approaches to uncertainty assessment have largely relied on comparing classifications across multiple datasets or alternative formulas, but these methods generally overlook important spatial dependence and latent structure in the data.

This dissertation develops three machine learning-based statistical …


Characterization Of Growth, Motility And C-Di-Gmp In Selenomonas Sputigena Atcc 35185, Margaret E J Stiker Jan 2026

Characterization Of Growth, Motility And C-Di-Gmp In Selenomonas Sputigena Atcc 35185, Margaret E J Stiker

Theses and Dissertations

Selenomonas sputigena is an obligate anaerobic, Gram-negative pathobiont that transitions from a low-abundance commensal bacteria to a structural component in dysbiotic oral biofilms associated with early childhood caries and periodontitis. Analysis of S. sputigena ATCC 35185 cultures optimized in TYGVS media revealed robust growth, characteristic crescent morphology with flagellar tuft motility, and strong monospecies biofilm formation comparable to Streptococcus mutans via crystal violet assays.

ELISA quantification demonstrated significantly elevated c-di-GMP levels in sessile biofilm fractions relative to motile planktonic cells (p=0.0009), establishing the secondary messenger’s correlation with the motile-sessile lifestyle switch. Recombinant expression and purification yielded PilZ-domain effector proteins, Selsp_1666 …


"It's The People, Not The Place:" Queering Shared Space In Richmond, Virginia, Kathleen Brown Jan 2026

"It's The People, Not The Place:" Queering Shared Space In Richmond, Virginia, Kathleen Brown

Theses and Dissertations

The intersection of queerness and planning is an understudied subject area that has implications for equity and access. Queer communities face real barriers to equitable access of resources that stem from a long history of legal, cultural, and economic marginalization. Experiences of shared spaces for queer groups and organizations is important to understand, as outward expressions of queerness are not always welcome in shared spaces, depending on sociopolitical context. Richmond, Virginia has a rich queer history both filled with challenges as well as examples of queer success and joy that makes it a prime case study selection.

This thesis utilizes …


The Mundo I Imagine, Angeliky Castrellon Jan 2026

The Mundo I Imagine, Angeliky Castrellon

Theses and Dissertations

My work investigates the human experience of belonging and how the force of displacement alters the perception of one's present and enables dissociation. After leaving my home and starting a new life overseas, coming back never felt the same; I couldn’t find peace and comfort anywhere. This made me create an imaginary world called “Mundo.” Shelters for the souls of the displaced, looking for comfort. As I became a graduate student in the Craft/Materials Studies department, my perspective widened, and my work itself answered a question for me: I want to be comfortable everywhere; how can my home be everywhere …


Exploring, Understanding, And Supporting Academic Help-Seeking In Context, Molly L. Taylor Jan 2026

Exploring, Understanding, And Supporting Academic Help-Seeking In Context, Molly L. Taylor

Theses and Dissertations

Conceptualized as a self-regulated learning (SRL) strategy, academic help-seeking is a fascinating behavior because it is self-directed while also reliant on social interactions with help-givers (Karabenick, 2004). What is known about help-seeking in academic settings largely revolves around individual traits, strategies, motivations, beliefs, and identities, and how each of these constructs influence help-seeking outcomes (Bornschlegl et al., 2020; Fong et al., 2023; Karabenick & Gonida, 2018). What is underexplored in these areas, however, is how features of the learning context interact with student-level factors to shape academic help-seeking behaviors and beliefs. This dissertation attempts to address some of these gaps …


Tuberculosis In Jim Crow Virginia, 1900-1972, Elizabeth Dooley Jan 2026

Tuberculosis In Jim Crow Virginia, 1900-1972, Elizabeth Dooley

Theses and Dissertations

Tuberculosis (TB) was a major public health concern in the United States, especially in the first half of the twentieth century. Transmission and treatment of the disease, which is spread between humans through close contact, was complicated by racial segregation laws in the South known as Jim Crow laws. Virginia subscribed to these laws, which played a role in how and where Black Virginians with TB could be treated. Segregated treatment facilities with an inadequate number of beds for the number of infected people and deaths in the state added to these complications of disease control and plan for eradication. …


Early Math Readiness And Later Achievement: A Longitudinal Study, Bailey Bontrager Jan 2026

Early Math Readiness And Later Achievement: A Longitudinal Study, Bailey Bontrager

Theses and Dissertations

The current body of literature provides much evidence that mathematics skills at the start of kindergarten are predictive of later mathematics achievement, and that students enrolled in early childhood education (ECE) programs are better prepared for mathematics at the start of kindergarten. However, the potential for children to develop mathematical skills prior to entering kindergarten relies on access to ECE programs and resources in families’ surrounding communities. Recent use of geospatial data collection techniques and measures of community resource availability have enabled researchers to examine specific localities for the ways in which community organizations and institutions support residents in particular …


Class-Aware Early-Exit Networks For Efficient And Secure Edge Deployment, Mohammed Ayyat Jan 2026

Class-Aware Early-Exit Networks For Efficient And Secure Edge Deployment, Mohammed Ayyat

Theses and Dissertations

Edge devices increasingly run high-stakes machine learning workloads under strict latency, power, memory, and communication constraints. Deep neural networks provide the accuracy needed for tasks such as network intrusion detection, health monitoring, autonomous sensing, and human activity recognition, but conventional inference executes the same computational path for every input. Early-exit neural networks reduce average inference cost by allowing confident samples to terminate before the final layer. However, existing early-exit systems are largely class-agnostic: they allocate computation according to confidence or uncertainty, without considering that different output classes may carry different operational urgency. This dissertation develops class-aware early-exit inference, a framework …


Discrete Cell Signaling Differences Cause Female-Dominant Il-33 Responses In Mast Cells, Tania D. Maldonado Jan 2026

Discrete Cell Signaling Differences Cause Female-Dominant Il-33 Responses In Mast Cells, Tania D. Maldonado

Theses and Dissertations

Many allergic diseases are more common and severe in women than in men. A key component of allergic inflammation is IL-33, a cytokine released by epithelial cells after allergen exposure. Because mast cells are a central early responder in allergic disease and are activated by IL-33, we investigated sex differences in mast cell responses to IL-33. We first found that male mast cells expanded poorly in standard RPMI-based culture media containing phenol red, which has estrogenic properties. Male cells also responded poorly to IL-33 when cultured with in media containing phenol red. In contrast, female mast cells expanded 3-fold less …


Positive Body Image In Postpartum Women: A Psychometric Evaluation Of The Body Appreciation Scale-2 And A Phenomenological Exploration, Taylor Vashro Jan 2026

Positive Body Image In Postpartum Women: A Psychometric Evaluation Of The Body Appreciation Scale-2 And A Phenomenological Exploration, Taylor Vashro

Theses and Dissertations

Postpartum women appear particularly vulnerable to body dissatisfaction due to the rapid physiological, emotional, and environmental changes that occur across the perinatal experience (Baskin et al., 2021; Nippert et al., 2021). Recent studies have demonstrated the experience of both negative and positive body image during postpartum (Rodgers et al., 2024; Watson et al., 2016). However, there is limited research regarding the measurement and exploration of positive body image in postpartum women. The current study aimed to: 1) evaluate the factor structure and psychometric properties of the Body Appreciation Scale-2 (BAS-2), a widely used measure of positive body image in postpartum …


Resilience In The Wake Of Faith-Based Trauma: Investigating The Role Of Social Support In Complex Posttraumatic Stress And Well-Being After Religious/Spiritual Abuse, Ellen Murphy Jan 2026

Resilience In The Wake Of Faith-Based Trauma: Investigating The Role Of Social Support In Complex Posttraumatic Stress And Well-Being After Religious/Spiritual Abuse, Ellen Murphy

College of Graduate Studies: Theses & Dissertations

Religious/spiritual (r/s) abuse involves the mistreatment of individuals within religious or spiritual contexts, often resulting in psychological and spiritual harm (Ellis et al., 2022; Johnson & VanVonderen, 1991). Although research examining the potential benefits of religion and spirituality has proliferated, harm stemming from religious/spiritual experiences remains relatively understudied (Ward, 2011). This study investigated associations between r/s abuse severity, complex posttraumatic stress disorder (CPTSD) symptoms, and psychological well-being. To identify potential protective factors, the moderating role of perceived social support in the relationships between r/s abuse and CPTSD and well-being outcomes was examined. Additional exploratory variables included current spirituality and religiosity, …


How Does Language Influence Interest In Psychological Treatment?, Alexis B. Dixon Jan 2026

How Does Language Influence Interest In Psychological Treatment?, Alexis B. Dixon

College of Graduate Studies: Theses & Dissertations

In 2022, approximately 59 million adults in the United States were diagnosed with a mental health disorder, and approximately half received mental health services (NIMH, 2023). Given the number of individuals whose mental health concerns remain untreated, it is vital to investigate mechanisms predicting treatment-seeking behaviors. Health literacy, which influences treatment-seeking, is largely absent from research on barriers to mental health treatment. Health literacy is related to readability, the ease of reading (Adkins & Singh, 2001), and jargon, the technical language used by professionals in a field (Shulman et al., 2020). Health materials are often written at a high reading …


Towards An Evaluation Of The Business Value Of Ai: A System Dynamics Approach, Ganesh Sankaran Jan 2026

Towards An Evaluation Of The Business Value Of Ai: A System Dynamics Approach, Ganesh Sankaran

School of Engineering, Computing and Mathematics Theses

In the early 2010s, when Artificial Intelligence (AI) emerged from the latest "winter" of disillusionment, discussions about its use in decision-making tended to be dichotomous: humans or AI. More recently, consensus has shifted toward a complementary humans-and-AI perspective, recognising that augmentation, not substitution, is the more appropriate frame for AI's role in the foreseeable future. This shift foregrounds the challenge of evaluating outcomes in collaborative decision-making contexts.The thesis proposes a simulation-based framework, drawing on system dynamics, to evaluate whether complex, time-varying interactions between humans and AI agents result in collectively rational behaviour. The framework extends the observation of dynamic complexity …


Self-Guided Functional Imagery Training To Reduce Anxiety, Jackie Andrade, Stephanie Hartgen-Walker, Caroline Morgan, Ayan, Idil Aytekin, Khadijah Sekoni, Kardelen Sengul, Jonathan Rhodes Jan 2026

Self-Guided Functional Imagery Training To Reduce Anxiety, Jackie Andrade, Stephanie Hartgen-Walker, Caroline Morgan, Ayan, Idil Aytekin, Khadijah Sekoni, Kardelen Sengul, Jonathan Rhodes

School of Psychology

Objectives: Many university students experience high anxiety but have limited access to effective interventions. We evaluated a novel digital intervention for anxiety based on functional imagery training (FIT), designed to help individuals identify the impacts of anxiety, set engagement goals, and strengthen motivation for change. Functional Imagery for Keeping Anxiety low (FIKA) uses speak-aloud tasks, journalling, empathic questions, and personalised guided imagery for a person-centred approach. It builds motivation for engagement goals over safety goals through development and practice of vivid and emotionally laden multisensory imagery. Design: Study 1 used semi-structured interviews and thematic analysis to explore user experiences of …


Optimization Of A Group-Based Intervention For People Living With Severe Obesity (Progroup): Understanding Fidelity To Delivery And The Patient Experience, Lily Hawkins, Mark Tarrant, Shokraneh Moghadam, Dawn Swancutt, Rod Sheaff, Laura Hollands, Jonathan Pinkney, Jenny Lloyd Jan 2026

Optimization Of A Group-Based Intervention For People Living With Severe Obesity (Progroup): Understanding Fidelity To Delivery And The Patient Experience, Lily Hawkins, Mark Tarrant, Shokraneh Moghadam, Dawn Swancutt, Rod Sheaff, Laura Hollands, Jonathan Pinkney, Jenny Lloyd

School of Psychology

Objectives: Understanding the fidelity of delivery of complex health behaviour interventions is crucial in determining their effectiveness and identifying aspects needing refinement. PROGROUP is a group-based intervention for people with severe obesity. It aims to promote a shared social identity to support behaviour change. Data from a feasibility randomized controlled trial (fRCT) were used to assess fidelity of intervention delivery and the impact on patient experiences, to optimize the intervention for a main trial. Methods: Data from 18 patient and five facilitator interviews, audio and video data of group sessions, two fidelity checklists, support calls and a group processes questionnaire …