Medicine and Health Sciences Commons^™

Evaluating A Technology-Mediated Hpv Vaccination Awareness Intervention: A Controlled, Quasi-Experimental, Mixed Methods Study, Heather M. Brandt, Beth Sundstrom, Courtney M. Monroe, Gabrielle Turner-Mcgrievy, Chelsea Larsen, Melissa Stansbury, Karen Magradey, Andrea Gibson, Delia Smith West

Faculty Publications

College-aged women and men are an important catch-up population for human papillomavirus (HPV) vaccination interventions. Limited research has explored technology-mediated HPV vaccination awareness interventions aimed at college students. The purpose was to evaluate a novel, technology-mediated, social media-based intervention to promote HPV vaccination among college students. A controlled, quasi-experimental, mixed methods study examined the feasibility of a technology-based intervention among two undergraduate classes ( = 58) at a public university in the southeastern United States of America. Classes were randomized to receive one of two cancer prevention programs (i.e., HPV vaccination (intervention) or healthy weight (control)). Both programs contained eight …

The Acute Effects Of 5 Fluorouracil On Skeletal Muscle Resident And Infiltrating Immune Cells In Mice, Brandon N. Vanderveen, Alexander T. Sougiannis, Kandy T. Velazquez, James A. Carson, Daping Fan, E. Angela Murphy

Faculty Publications

5 fluorouracil (5FU) has been a first-choice chemotherapy drug for several cancer types (e.g., colon, breast, head, and neck); however, its efficacy is diminished by patient acquired resistance and pervasive side effects. Leukopenia is a hallmark of 5FU; however, the impact of 5FU-induced leukopenia on healthy tissue is only becoming unearthed. Recently, skeletal muscle has been shown to be impacted by 5FU in clinical and preclinical settings and weakness and fatigue remain among the most consistent complaints in cancer patients undergoing chemotherapy. Monocytes, or more specifically macrophages, are the predominate immune cell in skeletal muscle which regulate turnover and homeostasis …

Information Uncertainty: A Correlate For Acute Stress Disorder During The Covid-19 Outbreak In China, Danhua Lin, Daniela B. Friedman Ph.D., Shan Qiao Ph.D., Cheuk Chi Tam, Xiaoyan Li, Xiaoming Li Ph.D.

Faculty Publications

Background: Individuals’ stress in responding to the current COVID-19 pandemic may be exacerbated by information uncertainty driven by inconsistent, unverified, and conflicting news from various sources. The current study aims to test if information uncertainty during the COVID-19 outbreak was related to acute stress disorder (ASD) over and above other psychosocial stressors.

Methods: An anonymous online survey was conducted with 7800 college students throughout China from January 31 through February 11, 2020. Existing scales were modified to measure ASD and six potential stressors including information uncertainty during the COVID-19 outbreak. Hierarchical regression analysis was conducted to assess the unique association …

Lc-Ms/Ms Quantification Of Nevirapine And Its Metabolites In Hair For Assessing Long-Term Adherence, Haoran Yang, Liuxi Chu, Yan Wu, Wei Wang, Jin Yang, Quan Zhang, Shan Qiao Ph.D., Xiaoming Li Ph. D., Zhiyong Shen, Yuejiao Zhou, Shuaifeng Liu, Huihua Deng

Faculty Publications

The adherence assessment based on the combination of nevirapine (NVP) and its two metabolites (2-hydroxynevirapine and 3-hydroxynevirapine) would more comprehensively and accurately reflect long-term adherence than that of a single prototype. This study aimed to develop a specific, sensitive and selective method for simultaneous detection of the three compounds in hair and explore whether there was consistency among the three compounds in assessing long-term adherence. Furthermore, 75 HIV-positive patients who were taking the NVP drug were randomly recruited and divided into two groups (high-and low-adherence group). All participants self-reported their days of oral drug administration per month and provided their …

Parkindex: Validation And Application Of A Pragmatic Measure Of Park Access And Use, Andrew T. Kaczynski, S. Morgan Hughey, Ellen W. Stowe, Marilyn E. Wende, J. Aaron Hipp, Elizabeth L. Oliphant, Jasper Schipperijn

Faculty Publications

Composite metrics integrating park availability, features, and quality for a given address or neighborhood are lacking. The purposes of this study were to describe the validation, application, and demonstration of ParkIndex in four diverse communities. This study occurred in Fall 2018 in 128 census block groups within Seattle(WA), Brooklyn(NY), Raleigh(NC), and Greenville County(SC). All parks within a half-mile buffer were audited to calculate a composite park quality score, and select households provided data about use of proximal parks via an online, map-based survey. For each household, the number of parks, total park acreage, and average park quality score within one …

A Patient-Centered Asthma Management Communication Intervention For Rural Latino Children: Protocol For A Waiting-List Randomized Controlled Trial, Robin Dawson, Sue P. Heiney, De Anne Hilfinger Messias, Dennis Ownby

Faculty Publications

Background: Rural Latino children with asthma suffer high rates of uncontrolled asthma symptoms, emergency department visits, and repeat hospitalizations. This vulnerable population must negotiate micro- and macrolevel challenges that impact asthma management, including language barriers, primary care access, parental time off from work, insurance coverage, distance from specialty sites, and documentation status. There are few proven interventions that address asthma management embedded within this unique context. Objective: Using a bio-ecological approach, we will determine the feasibility of a patient-centered collaborative program between rural Latino children with asthma and their families, school-based nursing programs, and primary care providers, facilitated by the …

External Stoma Diversion: A Palliative Measure For Peristomal Wound Healing In Resource-Limited Settings, Rachel W. Davis, Youmna A. Sherif, Catherine Anne Morrison

Faculty Publications

The provision of intestinal stoma care is challenging in austere settings due to limitations in surgical and wound care access as well as the high cost and sparsity of ostomy supplies. As a result, many surgical patients suffer from ostomy-related complications such as peristomal wounds and are unable to find relief for these complications from standard treatments and measures. This article describes the external stoma diversion, a cost-effective palliative surgical procedure that assists in the healing of peristomal wounds in resource-limited settings.

The Role Of Mental Health On The Relationship Between Food Insecurity And Immunologic Outcome Among People Living With Hiv In Guangxi, China, Cheng Chen, Xueying Yang, Chengbo Zeng, Xiaoming Li Ph.D., Shan Qiao Ph.D., Yuejiao Zhou

Faculty Publications

BACKGROUND

Previous studies showed that food insecurity could adversely affect clinical outcomes of people living with HIV (PLWH). The mental health pathways of such effects are suggested in existing literature, but empirical data are limited in resource-limited settings.

METHODS

This cross-sectional study aims to explore the role of depressive symptoms and anxiety on the association between food insecurity and CD4 counts among a sample of 2,987 PLWH in Guangxi, China. Path analysis was used to examine a hypothetical model and delta ztest was used to assess the indirect effects of food insecurity on CD4 counts through depressive symptoms and …

Development Of A Comprehensive Measure Of Organizational Readiness (Motivation × Capacity) For Implementation: A Study Protocol, Timothy J. Walker, Heather M. Brandt, Abraham Wandersman, Jonathan Scaccia, Andrea Lamont, Lauren Workman, Emanuelle Dias, Pamela M. Diamond, Derek W. Craig, Maria E. Fernandez

Faculty Publications

BACKGROUND: Organizational readiness is important for the implementation of evidence-based interventions. Currently, there is a critical need for a comprehensive, valid, reliable, and pragmatic measure of organizational readiness that can be used throughout the implementation process. This study aims to develop a readiness measure that can be used to support implementation in two critical public health settings: federally qualified health centers (FQHCs) and schools. The measure is informed by the Interactive Systems Framework for Dissemination and Implementation and R = MC heuristic (readiness = motivation × innovation-specific capacity × general capacity). The study aims are to adapt and further develop …

Building Capacity In Dissemination And Implementation Science: A Systematic Review Of The Academic Literature On Teaching And Training Initiatives, Rachel E. Davis, Danielle D'Lima

Faculty Publications

BACKGROUND: The field of dissemination and implementation (D&I) science has grown significantly over recent years. Alongside this, an increased demand for training in D&I from researchers and implementers has been seen. Research describing and evaluating D&I training opportunities, referred to here as 'capacity building initiatives' (CBIs), can help provide an understanding of different methods of training as well as training successes and challenges. However, to gain a more detailed understanding of the evidence-base and how D&I CBIs are being reported in publications, a field-wide examination of the academic literature is required. METHODS: Systematic review to identify the type and range …

Association Of Patient-Centered Medical Home Designation And Quality Indicators Within Hrsa-Funded Community Health Center Delivery Sites, Nathaniel Bell, Rebecca Wilkerson, Kathy Mayfield-Smith, Ana Lòpez-De Fede

Faculty Publications

BACKGROUND: Patient-Centered Medical Home (PCMH) adoption is an important strategy to help improve primary care quality within Health Resources and Service Administration (HRSA) community health centers (CHC), but evidence of its effect thus far remains mixed. A limitation of previous evaluations has been the inability to account for the proportion of CHC delivery sites that are designated medical homes.

METHODS: Retrospective cross-sectional study using HRSA Uniform Data System (UDS) and certification files from the National Committee for Quality Assurance (NCQA) and the Joint Commission (JC). Datasets were linked through geocoding and an approximate string-matching algorithm. Predicted probability scores were …

Terminal Logic Behavior And Strategic Defection Of Governmental Officials During Presidential Transitions In Guatemala: Implications For The Sustainability Of Food And Nutrition Security Policy, Jessica L. Escobar-Alegria, Edward A. Frongillo Jr., Christine E. Blake

Faculty Publications

Background: Presidents with no possibility of re-election overvalue far-future rewards and succumb to terminal logic behavior (TLB), responding to end-of-tenure legacy concerns despite political context. Government authorities perceiving the outgoing government is losing power at the end of term behave under the logic of strategic defection (SD), dissociating from the outgoing government once it is perceived powerless. In countries where re-election is impossible and government turnover and inconstant political parties are concerns, governmental officials at all levels may show TLB and SD during transitions that affect policy sustainability. Objectives: This study aimed to understand the context during presidential transitions that …

Parental Concerns And Uptake Of Childhood Vaccines In Rural Tanzania – A Mixed Methods Study, Lavanya Vasudevan, Joy Noel Baumgartner, Sara Moses, Esther Ngadaya, Sayoki Godfrey Mfinanga, Jan Ostermann

Faculty Publications

Background

Vaccine hesitancy has been recognized as an important barrier to timely vaccinations around the world, including in sub-Saharan Africa. In Tanzania, 1 in 4 children is not fully vaccinated. The objective of this mixed methods study was to describe and contextualize parental concerns towards vaccines in Tanzania.

Methods

Between 2016 and 2017, we conducted a cross-sectional survey (n = 134) and four focus group discussions (FGDs, n = 38) with mothers of children under 2 years of age residing in Mtwara region in Southern Tanzania. The survey and FGDs assessed vaccination knowledge and concerns and barriers to timely vaccinations. …

Promoting Reading Achievement In Children With Developmental Language Disorders: What Can We Learn From Research On Specific Language Impairment And Dyslexia?, Suzanne M. Adlof

Faculty Publications

Purpose Specific language impairment (SLI; see also developmental language disorder) and dyslexia are separate, yet frequently co-occurring disorders that confer risks to reading comprehension and academic achievement. Until recently, most studies of one disorder had little consideration of the other, and each disorder was addressed by different practitioners. However, understanding how the two disorders relate to each other is important for advancing theories about each disorder and improving reading comprehension and academic achievement. The purpose of this clinical focus article is to integrate research on SLI and dyslexia as well as advocate for the consideration of comorbidities in future research …

Early Breastfeeding Practices Contribute To Exclusive Breastfeeding In Bangladesh, Vietnam And Ethiopia, Phuong Hong Nguyen, Sunny S. Kim, Lan Mai Tran, Purnima Menon, Edward A. Frongillo Jr.

Faculty Publications

Limited evidence exists on the complex relationship among interventions, early initiation of breastfeeding (EIBF), prelacteal feeding and exclusive breastfeeding (EBF). We examined whether early breastfeeding practices are associated with EBF and how much improving EIBF and non-prelacteal feeding contributes to increased prevalence of EBF. Survey data were collected in 2010 and 2014 as part of impact evaluations of Alive & Thrive (A&T) interventions to improve infant and young child feeding (IYCF) practices in Bangladesh, Vietnam and Ethiopia. Multivariable logistic regression analyses were used to examine effects of interventions and early breastfeeding practices on EBF. Structural equation modelling quantified the direct …

A Baker's Dozen Of Top Antimicrobial Stewardship Intervention Publications In 2019, Kayla R. Stover, Elias B. Chahine, David Cluck, Sarah Green, Daniel B. Chastain, Darrell Childress, Carmen Faulkner-Fennell, Katherine Lusardi, Edoabasi U. Mcgee, Michelle Turner, P Brandon Bookstaver, Christopher M. Bland

Faculty Publications

Staying current on literature related to antimicrobial stewardship can be challenging given the ever-increasing number of published articles. The Southeastern Research Group Endeavor (SERGE-45) identified antimicrobial stewardship-related peer-reviewed literature that detailed an actionable intervention for 2019. The top 13 publications were selected using a modified Delphi technique. These manuscripts were reviewed to highlight the actionable intervention used by antimicrobial stewardship programs to provide key stewardship literature for teaching and training and to identify potential intervention opportunities within one's institution.

National Nutrition Strategies That Focus On Maternal, Infant, And Young Child Nutrition In Southeast Asia Do Not Consistently Align With Regional And International Recommendations, Tuan T. Nguyen, Ashley Darnell, Amy Weissman, Jennifer Cashin, Mellissa Withers, Roger Mathisen, Karin Lapping, Timothy D. Mastro, Edward A. Frongillo Jr.

Faculty Publications

We examined the consistency of national nutrition strategies and action plans (NNS) focusing on maternal, infant, and young child nutrition in Southeast Asia with regional and international recommendations. Between July and December 2017, we identified and extracted information on context, objectives, interventions, indicators, strategies, and coordination mechanisms from the most recent NNS in nine Southeast Asian countries. All NNS described context, objectives, and the following interventions: antenatal care, micronutrient supplementation during pregnancy, breastfeeding promotion, improved complementary feeding, nutrition in emergencies, and food fortification or dietary diversity. Micronutrient supplementation for young children was included in eight NNS; breastfeeding promotion during pregnancy …

African American Emerging Adult Perspectives On Unintended Pregnancy And Meeting Their Needs With Mobile Technology: Mixed Methods Qualitative Study, Lucy Annang Ingram, Crystal Stafford, Quentin Mccollum, Mckenzie Isreal

Faculty Publications

Background: In the United States, a disproportionate number of unintended pregnancies occur among African Americans, particularly those in their later teenage years and early 20s. Mobile technology is becoming more ubiquitous as a method for health promotion; however, relatively little research has been done with this population to determine their perspectives about unintended pregnancy, the potential of successfully using mobile technology to prevent unintended pregnancy, and the content of such programs.

Objective: The purpose of this study was to obtain the perspectives of African American emerging adults about unintended pregnancy and the use of mobile technology to reduce unintended pregnancy …

Targeted Engagement Of The Action Selection Network During Task-Oriented Arm Training After Stroke, Jill Campbell Stewart Pt,Phd, Kaci Handlery, Jessica F. Baird, Erika L. Blanck, Geetanjali Pathak, Stacy L. Fritz

Faculty Publications

Action selection (AS), or selection of an action from a set of alternatives, is an important movement preparation process that engages a frontal-parietal network. The addition of AS demands to arm training after stroke could be used to engage this motor planning process and the neural network that supports it. The purpose of this case series is to describe the feasibility and outcomes associated with task-oriented arm training aimed at engaging the AS behavioral process and the related neural network in three individuals with chronic stroke. Three participants with mild to moderate motor deficits completed 13 to 15 sessions of …

Elementary Classroom Teachers’ Self-Reported Use Of Movement Integration Products And Perceived Facilitators And Barriers Related To Product Use, Roddrick Dugger, Aaron Rafferty, Ethan Hunt, Michael W. Beets, Collin Andrew Webster, Brian Chen, Jeffrey Michael Rehling, Robert Glenn Weaver

Faculty Publications

Movement integration (MI) products are designed to provide children with physical activity during general education classroom time. The purpose of this study was to examine elementary classroom teachers’ self-reported use of MI products and subsequent perceptions of the facilitators of and barriers to MI product use. This study utilized a mixed-methods design. Elementary classroom teachers (n = 40) at four schools each tested four of six common MI products in their classroom for one week. Teachers completed a daily diary, documenting duration and frequency of product use. Following each product test, focus groups were conducted with teachers to assess facilitators …

Redox-Sensitive Nanocomplex For Targeted Delivery Of Melittin, Bei Cheng, Peisheng Xu

Faculty Publications

Although peptide therapeutics have been explored for decades, the successful delivery of potent peptides in vitro and in vivo remains challenging due to the poor stability, low cell permeability, and off-target effects. We developed a redox sensitive polymer-based nanocomplex which can efficiently and stably deliver the peptide drug melittin for cancer therapy. The nanocomplex selectively targets cancer cells through lactobionic acid mediated endocytosis and releases melittin intracellularly upon the trigger of elevated redox potential. In vivo study proved that the targeted nanocomplex shows excellent potency in inhibiting tumor growth in a xenograft colon cancer mouse model. Thus, the polymer/melittin nanocomplexes …

Intermittent Pneumatic Compression For Venous Thromboembolism Prevention: A Systematic Review On Factors Affecting Adherence, Richard Greenall, Rachel E. Davis

Faculty Publications

OBJECTIVE: Venous thromboembolism (VTE) is a potentially fatal complication of hospitalisation. Intermittent pneumatic compression (IPC) is one approach to reducing the likelihood of a VTE. Adherence to IPC is known to be inadequate though the reasons for this remain unclear. This systematic review explores factors that affect adherence to IPC in the inpatient context. METHODS: Information sources-EMBASE, MEDLINE and PsycINFO were searched for literature between January 1960 and May 2019. Eligibility criteria-studies were included if they focused on inpatient care and examined factors affecting adherence to IPC devices. RESULTS: Included studies-a total of 20 out of 1476 studies were included. …

Nanoparticles As Antibiotic-Delivery Vehicles (Advs) Overcome Resistance By Mrsa And Other Mdr Bacterial Pathogens: The Grenade Hypothesis, Amjed Alabresm, Yung Pin Chen, Savannah Wichter-Chandler, Jamie Lead, Brian C. Benicewicz

Faculty Publications

Objectives

The aim of this study was to examine how the concentrated delivery of less effective antibiotics, such as the Β-lactam penicillin G, by linkage to nanoparticles (NPs), could influence the killing efficiency against various pathogenic bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) and other multidrug resistant (MDR) strains.

Methods

The Β-lactam antibiotic penicillin G (PenG) was passively sorbed to fluorescent polystyrene NPs (20 nm) that were surface-functionalized with carboxylic acid (COO⁻-NPs) or sulfate groups (SO₄⁻-NPs) to form a PenG-NP complex. Antimicrobial activities of PenG-NPs were evaluated against Gram-negative and Gram-positive bacteria, including antibiotic resistant strains. …

Empirical Fluoroquinolones Versus Broad-Spectrum Beta-Lactams For Gram-Negative Bloodstream Infections In The Absence Of Antimicrobial Resistance Risk Factors, Majdi N. Al-Hasan, Alyssa P. Gould, Chelsea Drennan, Olivia Hill, Julie Ann Justo, Joseph Kohn, P Brandon Bookstaver

Faculty Publications

OBJECTIVES: Increasing antimicrobial resistance rates limit empirical antimicrobial treatment options for Gram-negative bloodstream infections (GN-BSI). However, antimicrobial resistance may be predicted based on patient-specific risk factors using precision medicine concepts. This retrospective, 1:2 matched cohort examined clinical outcomes in hospitalized adults without major risk factors for antimicrobial resistance receiving empirical fluoroquinolones or broad-spectrum beta-lactams (BSBL) for GN-BSI at Prisma Health-Midlands hospitals in Columbia, SC, USA from January 2010 through June 2015. METHODS: Multivariable logistic regression was used to examine early treatment failure at 72-96 h from GN-BSI. Cox proportional hazards regression was used to examine 28-day mortality and hospital length …

Improving Adherence To Adjuvant Hormonal Therapy Among Disadvantaged Women Diagnosed With Breast Cancer In South Carolina: Proposal For A Multimethod Study, Tisha M. Felder, Sue Heiney, James R. Hébert, Daniela B. Friedman, Ronit Elk, Regina Franco, Lucy Gansauer, Barbara Christensen, Marvella E. Ford

Faculty Publications

Background: Current clinical guidelines recommend that hormone receptor-positive breast cancer survivors take adjuvant hormonal therapy (AHT) for 5 to 10 years, following the end of definitive treatment. However, fewer than half of patients adhere to the guidelines, and suboptimal adherence to AHT is associated with an increased risk of breast cancer mortality. Research has extensively documented sociodemographic and disease-specific factors associated with adherence to AHT, but very little evidence exists on behavioral factors (eg, knowledge, patient-provider communication) that can be modified and targeted by interventions. Objective: The goal of this study is to develop and test a theory-based, multilevel intervention …

Building Implementation Science In Nutrition, Andrea M. Warren, Edward A. Frongillo Jr., Rahul Rawat

Faculty Publications

The field of nutrition has been investing in the development of many nutrition-specific and -sensitive policies and programs aimed at improving population-level malnutrition in all its forms. When there is a need to learn about a new system, programmatic context, or target population to understand how to effectively deploy an intervention to help improve nutrition, it is important to be able to ask a broad range of questions, both in topic and in scope. Our aim is to provide a simple and conceptually clear definition and principles to elaborate the science of implementation for nutrition to distinguish it from other …

Immune And Microrna Responses To Infection And Indole-3-Carbinol During Colitis, Rasha Raheem Alkarkoushi, Yvonne Hui, Abbas Tavakoli Drph, Udai Singh, Prakash Nagarkatti, Mitzi Nagarkatti, Ioulia Chatzistamou, Marpe Bam, Traci L. Testerman

Faculty Publications

BACKGROUND:

Indole-3-carbinol (I3C) and other aryl hydrocarbon receptor agonists are known to modulate the immune system and ameliorate various inflammatory and autoimmune diseases in animal models, including colitis induced by dextran sulfate sodium (DSS). MicroRNAs (miRNAs) are also gaining traction as potential therapeutic agents or diagnostic elements. Enterohepatic (EHH) species are associated with an increased risk of inflammatory bowel disease, but little is known about how these species affect the immune system or response to treatment. AIM: To determine whether infection with an EHH species alters the response to I3C and how the immune and miRNA responses of an EHH …

Immune And Microrna Responses To Infection And Indole-3-Carbinol During Colitis, Rasha Raheem Alkarkoushi, Yvonne Hui, Abbas S. Tavakoli, Udai Singh, Prakash Nagarkatti, Mitzi Nagarkatti, Ioulia Chatzistamou, Marpe Bam, Traci L. Testerman

Faculty Publications

BACKGROUND: Indole-3-carbinol (I3C) and other aryl hydrocarbon receptor agonists are known to modulate the immune system and ameliorate various inflammatory and autoimmune diseases in animal models, including colitis induced by dextran sulfate sodium (DSS). MicroRNAs (miRNAs) are also gaining traction as potential therapeutic agents or diagnostic elements. Enterohepatic (EHH) species are associated with an increased risk of inflammatory bowel disease, but little is known about how these species affect the immune system or response to treatment. AIM: To determine whether infection with an EHH species alters the response to I3C and how the immune and miRNA responses of an EHH …

A Method To Measure The Partitioning Coefficient Of Volatile Organic Compounds In Nanoparticles, Guiying Rao, Jeonghyeon Ahn, Abigail Evans, Michelle Casey, Eric P. Vejerano

Faculty Publications

The partitioning behavior of volatile organic compounds (VOCs) into nanoparticles is less studied compared to those of semivolatile organic compounds (SVOCs) because of the lower concentration of the VOCs that is expected to partition into particles. One challenge in measuring the accurate partition coefficient of VOCs is quantifying their low mass fraction that sorbed on nanoparticles and differentiating them from the high VOC concentrations present in the gas-phase. Systematically characterizing the partitioning coefficient at a specific environmental condition is also difficult when sampling in the field. During field sampling, thermal and non-thermal issues such as sampling artifacts and non-equilibrium conditions …

Men’S Vasectomy Knowledge, Attitudes, And Information-Seeking Behaviors In The Southern United States: Results From An Exploratory Survey, Ashley L. White, Rachel E. Davis, Deborah Lynn Billings Phd, Emily S. Mann

Faculty Publications

Vasectomy is one of the few options men have to manage their reproductive capacity and take on a more equitable role in pregnancy prevention. While the method is underused throughout the United States, the southern states have a lower prevalence rate compared to the rest of the country. Existing survey research does not assess what men know or think about the procedure as a means of understanding why this is the case. We created and conducted an exploratory survey to assess men’s knowledge, attitudes, and information-seeking behaviors about vasectomy in the Southern United States. We used targeted Facebook advertising to …