Medicine and Health Sciences Commons^™

Language Variation In The Writing Of African American Students: 6 Factors Predicting Reading Achievement, Lisa Fitton Ph.D., Lakeisha Johnson, Carla Wood, Christopher Schatschneider, Sara A. Hart

Faculty Publications

Purpose

This study aims to examine the predictive relation between measures obtained from African American students' written narrative language samples and reading achievement, as measured by standardized academic assessments.

Method

Written language samples were elicited from 207 African American students in Grades 1–8. The samples were examined for morphosyntactic variations from standardized written Generalized American English (GAE). These variations were categorized as either (a) specific to African American English (AAE) or (b) neutral across AAE and standardized written GAE (i.e., considered ungrammatical both in AAE and in standardized written GAE). Structural equation modeling was employed to then examine the predictive …

Trends In Insulin Prescribing For Patients With Diabetes During The Covid-19 Pandemic In The Us, Ismaeel Yunusa Ph.D., Bryan L. Love Pharm D., Chao Cai, Tessa Hastings, Claiborne E. Reeder, Elizabeh W. Blake, Cynthia Phillips

Faculty Publications

Introduction

For the approximately 7 million US individuals with diabetes who rely on insulin,¹ the number of insulin prescriptions rose steadily in the decade before the COVID-19 pandemic.² Reduced access to medical care and disruptions in supply related to the pandemic may have decreased access to insulin,³ with possible adverse consequences for diabetes control.⁴ Conversely, emergency Medicaid expansions that increased capacity for telemedicine services during the pandemic may have been associated with improved access to treatment.⁵ Therefore, this study aimed to assess whether changes to insulin prescription claims occurred during the COVID-19 pandemic.

Methods

In …

Impact Of Front-Of-Pack Labels On The Perceived Healthfulness Of A Sweetened Fruit Drink: A Randomised Experiment In Five Countries, Alejandra Jauregui, Christine M. White, Lana Vanderlee, Marissa G. Hall, Alejandra Contreras-Manzano, Claudia Nieto, Gary Sacks, Jim Thrasher Ph.D., Ma, Ms, David Hammond, Simón Barquera

Faculty Publications

Objective: Front-of-pack (FOP) nutrition labelling is a globally recommended strategy to encourage healthier food choices. We evaluated the effect of FOP labels on the perceived healthfulness of a sweetened fruit drink in an international sample of adult consumers.

Design: Six-arm randomised controlled experiment to examine the impact of FOP labels (no label control, Guideline Daily Amounts (GDA), Multiple Traffic Lights, the Health Star Ratings (HSR), Health Warning Labels, and 'High-in' Warning Labels (HIWL)) on the perceived healthfulness of the drink. Linear regression models by country examined healthfulness perceptions on FOP nutrition labels, testing for interactions by demographic characteristics.

Setting: Online …

Dissociable Roles Of The Nucleus Accumbens Core And Shell Subregions In The Expression And Extinction Of Conditioned Fear, Sohini Dutta, Jasmin Beaver, Carly J. Halcomb, Aaron M. Jasnow

Faculty Publications

The nucleus accumbens (NAc), consisting of core (NAcC) and shell (NAcS) sub-regions, has primarily been studied as a locus mediating the effects of drug reward and addiction. However, there is ample evidence that this region is also involved in regulating aversive responses, but the exact role of the NAc and its subregions in regulating associative fear processing remains unclear. Here, we investigated the specific contribution of the NAcC and NAcS in regulating both fear expression and fear extinction in C57BL/6J mice. Using Arc expression as an indicator of neuronal activity, we first show that the NAcC is specifically active …

Effects Of Sesame Consumption On Inflammatory Biomarkers In Humans: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Shabnam Rafiee, Roghaye Faryabi, Mohammad Ali Zareian, Jessie Hawkins, Nitin Shivappa Mbbs, Mph, Ph.D., Laila Shirbeigi

Faculty Publications

Objectives. Existing evidence produces conflicting findings regarding the effect of sesame intake on inflammatory biomarkers; thisknowledge gap has yet to be met through systematic review and meta-analysis. )is meta-analysis of randomized, controlledclinical trials (RCTs) was conducted to evaluate the effects of sesame consumption on markers of inflammation in humans. Methods. PubMed, Scopus, and the Cochrane Database of Systematic Reviews were searched through August 2020 to identify relevant papers for inclusion. Using the random-effects model, data were evaluated as weighted mean differences (WMD) with 95% confidence intervals (CI). Cochrane’s Q and I-squared (I2) tests were used to …

Reporting Of Concussion Symptoms By A Nationwide Survey Of United States Parents Of Middle School Children, Zachary Y. Kerr, Brittany M. Ingram, Christine E. Callahan, Aliza K. Nedimyer, Avinash Chandran, Melissa K. Kossman, Julia Hoang, Paula Gildner, Johna K. Register-Mihalik

Faculty Publications

This cross-sectional study assessed concussion symptom knowledge of parents of middle school (MS) children (aged 10–15 years) through a free-response item that solicited concussion symptoms and compared findings to a pre-validated scale-based measure. A self-administered online questionnaire was sent to a panel of randomly selected United States residents who were recruited by a third-party company, aged ≥ 18 years, and identified as parents of MS children. Via a free-response item, parents listed what they believed were concussion symptoms. Multiple sections later, parents identified potential concussion symptoms via a scale measure, which featured 25 items (22 actual symptoms, three distractor symptoms) …

The Fmr1 Premutation Phenotype And Mother-Youth Synchrony In Fragile X Syndrome, Carly Moser, Laura Mattie, Leonard Abbeduto, Jessica Klusek

Faculty Publications

A subset of mothers who carry the FMR1 premutation may express a unique phenotype. The relationship between the FMR1 phenotype and mother-child interaction in families with fragile X-associated disorders has not been well characterized, despite the importance of high-quality mother-child interaction for child development. This study examined the association between the FMR1 phenotype and the quality of interactions between mothers and their adolescent/young adult sons with fragile X syndrome. Mother-youth synchrony was coded from a dyadic interaction. Maternal anxiety and depression symptoms, executive function deficits, and pragmatic language difficulties were evaluated. Results indicated that pragmatic language was associated with mother-youth …

A Comparison Of Bayesian Spatial Models For Hiv Mapping In South Africa, Kassahun Abere Ayalew, Samuel Manda, Bo Cai Ph.D.

Faculty Publications

Despite making significant progress in tackling its HIV epidemic, South Africa, with 7.7 million people living with HIV, still has the biggest HIV epidemic in the world. The Government, in collaboration with developmental partners and agencies, has been strengthening its responses to the HIV epidemic to better target the delivery of HIV care, treatment strategies and prevention services. Population-based household HIV surveys have, over time, contributed to the country’s efforts in monitoring and understanding the magnitude and heterogeneity of the HIV epidemic. Local-level monitoring of progress made against HIV and AIDS is increasingly needed for decision making. Previous studies have …

Criterion Validation And Interpretability Of The Single Assessment Numerical Evaluation (Sane) Of Self-Reported Recovery In Patients With Neck Pain, Elizabeth Oakley, Chad E. Cook, Bryan O'Halloran

Faculty Publications

Background

The SANE is a PROM of recovery, which may assist clinicians in clinical decision-making and discharge planning. The psychometric measurement properties of the SANE have yet to be determined for neck pain.

Objectives

Threefold objectives included: 1)determine the numerical threshold for the SANE at which patients with neck pain determine their symptoms are acceptable; 2)determine the association between scores for the NDI and VAS, with the SANE; 3)determine the average number of visits, costs and value associated with the management of neck pain.

Design

Longitudinal repeated measures cohort design.

Methods

Threshold measures for self-reported recovery with the …

Towards Collaborative And Intelligent Learning Environments Based On Eye Tracking Data And Learning Analytics: A Survey, Yuehua Wang, Shulan Lu, Derek Harter

Faculty Publications

The current pandemic has significantly impacted educational practices, modifying many aspects of how and when we learn. In particular, remote learning and the use of digital platforms have greatly increased in importance. Online teaching and e-learning provide many benefits for information retention and schedule flexibility in our on-demand world while breaking down barriers caused by geographic location, physical facilities, transportation issues, or physical impediments. However, educators and researchers have noticed that students face a learning and performance decline as a result of this sudden shift to online teaching and e-learning from classrooms around the world. In this paper, we focus …

Determining Diagnosis Date Of Diabetes Using Structured Electronic Health Record (Ehr) Data: The Search For Diabetes In Youth Study, Kristin M. Lenoir, Lynne E. Wagenknecht, Jasmin Divers, Ramon Casanova, Dana Dabelea, Sharon Saydah, Catherine Pihoker, Angela D. Liese Ph.D., Debra Standiford, Richard Hamman, Brian J. Wells, The Search For Diabetes In Youth Study Group

Faculty Publications

Background Disease surveillance of diabetes among youth has relied mainly upon manual chart review. However, increasingly available structured electronic health record (EHR) data have been shown to yield accurate determinations of diabetes status and type. Validated algorithms to determine date of diabetes diagnosis are lacking. The objective of this work is to validate two EHR-based algorithms to determine date of diagnosis of diabetes. Methods A rule-based ICD-10 algorithm identified youth with diabetes from structured EHR data over the period of 2009 through 2017 within three children’s hospitals that participate in the SEARCH for Diabetes in Youth Study: Cincinnati Children’s Hospital, …

Voice-Activated Virtual Home Assistant Use And Social Isolation And Loneliness Among Older Adults: Mini Review, Cynthia F. Corbett, Pamela J. Wright Phd, Ms, Med, Rn, Cen, Kate Jones, Michael Parmer

Faculty Publications

A lack of social connectedness is common among older adults due to living alone, loss of loved ones, reduced mobility, and, more recently, social distancing created by the global Covid-19 pandemic. Older adults are vulnerable to social isolation and loneliness, which pose significant health risks comparable to those of smoking, obesity, physical inactivity, and high blood pressure. A lack of social connectedness is also correlated with higher mortality rates even when controlling for other factors such as age and comorbid conditions. The purpose of this mini review was to explore the emerging concepts of older adults' use of commercially available …

Tracking Development Assistance For Health And For Covid-19: A Review Of Development Assistance, Government, Out-Of-Pocket, And Other Private Spending On Health For 204 Countries And Territories, 1990–2050, Angela E. Micah, Ian E. Cogswell, Brandon Cunningham, Satoshi Ezoe, Anton C. Harle, Ismaeel Yunusa Ph. D.

Faculty Publications

Background

Methods

The Individual Water Insecurity Experiences (Iwise) Scale: Reliability, Equivalence And Validity Of An Individual-Level Measure Of Water Security, Sera L. Young, Hilary J. Bethancourt, Zacchary R. Ritter, Edward A. Frongillo Jr.

Faculty Publications

Objective: The lack of a validated and cross-culturally equivalent scale for measuring individual-level water insecurity has prevented identification of those most vulnerable to it. Therefore, we developed the 12-item Individual Water InSecurity Experiences (IWISE) Scale to comparably measure individual experiences with access, use, and stability (reliability) of water. Here, we examine the reliability, cross-country equivalence, and cross-country and within-country validity of the scale in a cross-sectional sample.

Methods: IWISE items were implemented by the Gallup World Poll among nationally representative samples of 43 970 adults (15 y) in 31 low-income and middle-income countries (LMICs). Internal consistency was assessed …

Fatal Police Violence By Race And State In The Usa, 1980–2019: A Network Meta-Regression, Fablina Sharara, Eve E. Wool, Gregory J. Bertolacci, Nicole Davis Weaver, Shelley Balassyano, Ismaeel Yunusa Ph. D., Et Al.

Faculty Publications

Background

The burden of fatal police violence is an urgent public health crisis in the USA. Mounting evidence shows that deaths at the hands of the police disproportionately impact people of certain races and ethnicities, pointing to systemic racism in policing. Recent high-profile killings by police in the USA have prompted calls for more extensive and public data reporting on police violence. This study examines the presence and extent of under-reporting of police violence in US Government-run vital registration data, offers a method for correcting under-reporting in these datasets, and presents revised estimates of deaths due to police violence in …

Predictors Of Complementary Feeding Practices Among Children Aged 6–23 Months In Five Countries In The Middle East And North Africa Region, Linda Shaker-Berbari, Vilma Qahoush Tyler, Chaza Akik, Zeina Jamaluddine, Hala Ghattas Ph.D.

Faculty Publications

Ensuring diets of children aged 6–23 months meet recommended guidance is crucial for growth and development and for the prevention of malnutrition including stunting, wasting and micronutrient deficiencies. Despite some improvement, indicators related to undernutrition and overnutrition fall short of global targets in the Middle East and North Africa (MENA) region that consist of low- and middle-income countries witnessing political and social changes and a nutrition transition. This research aims at reviewing the situation related to the diets of children aged 6–23 months in five selected countries in the MENA region, examining factors affecting complementary feeding and providing recommendations for …

Prolonged Time From Diagnosis To Breast-Conserving Surgery Is Associated With Upstaging In Hormone Receptor-Positive Invasive Ductal Breast Carcinoma, Natalie Hills, Macall Leslie, Rachel Davis, Marielle Crowell, Hiroyasu Kameyama, Hallgeir Rui, Inna Chervoneva, William Dooley, Takemi Tanaka

Faculty Publications

BACKGROUND: Time to surgery (TTS) has been suggested to have an association with mortality in early-stage breast cancer. OBJECTIVE: This study aims to determine the association between TTS and preoperative disease progression in tumor size or nodal status among women diagnosed with clinical T1N0M0 ductal breast cancer. METHODS: Women diagnosed with clinical T1N0M0 ductal breast cancer who had breast-conserving surgery as their first definitive treatment between 2010 and 2016 (n = 90,405) were analyzed using the National Cancer Database. Separate multivariable logistic regression models for hormone receptor (HR)-positive and HR-negative patients, adjusted for clinical and demographic variables, were used to …

Global, Regional, And National Burden Of Stroke And Its Risk Factors, 1990–2019: A Systematic Analysis For The Global Burden Of Disease Study 2019, Valery L. Feigin, Benjamin A. Stark, Catherine Owens Johnson, Gregory A. Roth, Gdiom Gebreheat Abady, Ismaeel Yunusa Ph. D., Et Al.

Faculty Publications

Background

Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels.

Methods

We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and …

Global, Regional, And National Sex-Specific Burden And Control Of The Hiv Epidemic, 1990-2019, For 204 Countries And Territories: The Global Burden Of Diseases Study 2019, Deepa Jahagirdar, Magdalene K. Walters, Amanda Novotney, Edmond D. Brewer, Tahvi D. Frank, Ismaeel Yunusa Ph.D., Et. Al.

Faculty Publications

Background The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic.

Methods To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal …

How Analogizing Socio-Legal Responses To Organ Transplantation Can Further The Legalization Of Reproductive Genetic Innovation, Myrisha S. Lewis

Faculty Publications

The Nobel Foundation emphasized the significance of genetic innovation to society, science, and medicine by awarding the 2020 Nobel Prize in Chemistry to “the CRISPR/Cas9 genetic scissors.” This Article focuses on “reproductive genetic innovation,” a term that includes cytoplasmic transfer, mitochondrial transfer, and germline or heritable gene editing techniques that are all categorized as “experimental” in the United States. These techniques all use in vitro fertilization, a legal and widely available practice. Yet reproductive genetic innovation has resulted in controversy and numerous barriers including a recurring federal budget rider, threats of federal enforcement action, and the unavailability of federal funding. …

Pre-Licensure Nursing Students' Experiences Of Psychological Safety: A Qualitative Descriptive Study, Bret Lyman, Camille R. Mendon

Faculty Publications

Background: Organizational learning is essential for consistently providing safe, efficient, high-quality patient care. Psychological safety is foundational for organizational learning. For pre-licensure nursing students psychological safety is crucial for both their learning and patient safety. Understanding pre-licensure nursing students' experiences of psychological safety can guide efforts to cultivate clinical environments conducive to learning and excellent patient care.

Objectives: The objective of this study was to gain insight into pre-licensure nursing students' first-hand experiences with psychological safety in clinical settings.

Design: A qualitative, descriptive design was used for this study.

Settings: Participants were recruited from 12 different nursing programs across eight …

Reinvigorating A Technical Countering Weapons Of Mass Destruction Distance Learning Graduate Certificate Program, James C. Petrosky, Gaiven Varshney, Jeremy Slagley, Sara Shaghaghi

Faculty Publications

Current Countering Weapons of Mass Destruction (CWMD) demands can be divided broadly into policy and science. The science of chemical, biological, and radiological/nuclear weapons informs the limits of development, production, employment, operation, detection, risk characterization, human and material protection, and medical intervention. In short, the science of weapons of mass destruction (WMD) should precede and inform the development of policy. It is to this end that the Air Force Institute of Technology (AFIT) CWMD program was re-established, providing a technical educational option for practitioners to understand the science behind a very technically challenging subject.

Coronary Heart Disease (Chd) In Elderly Patients: Which Drug To Choose, Ticagrelor And Clopidogrel? A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Mohammed Ahmed Akkaif, Abubakar Sha'aban, Nur Aizati Athirah Daud, Ismaeel Yunusa Ph.D., Mei Li Ng, Muhamad Ali Sk Abdul Kader, Dzul Azri Mohamed Noor, Baharudin Ibrahim

Faculty Publications

Background: A new generation P2Y12 receptor inhibitor (ticagrelor) is recommended in current therapeutic guidelines to treat patients with coronary heart disease (CHD). However, it is unknown if ticagrelor is more effective than clopidogrel in elderly patients. Therefore, a systematic review was done to assess the effectiveness and safety of ticagrelor and clopidogrel in older patients with CHD to determine the appropriate antiplatelet treatment plan. Methodology: We performed a systematic review of randomized controlled trials (RCTs) to compare the effectiveness and safety of ticagrelor vs. clopidogrel in elderly patients with CHD. We selected eligible RCTs based on specified study criteria following …

Estimated Prevalence Of Smoking And Smoking-Attributable Mortality Associated With Graphic Health Warnings On Cigarette Packages In The Us From 2022 To 2100, Jamie Tam, Jihyoun Jeon, Jim Thrasher Ph.D., Ma, Ms, David Hammond, Theodore R. Holford, David T. Levy, Rafael Meza

Faculty Publications

Question What are the estimated population health outcomes associated with implementation of graphic health warnings on cigarette packages in 2022 and with delayed implementation of the warnings since 2012, as originally planned, in the US?

Findings In this decision analytical model using simulation modeling of smoking prevalence and smoking-attributable mortality in the US from 2012 to 2100, graphic health warnings, if implemented from 2022 to 2100, would be associated with 539 000 smoking-attributable deaths averted and 7.9 million life-years gained, and if implemented in 2012, with 718 000 deaths averted and 11.2 million life-years gained through 2100.

Meaning These findings …

Computationally Assisted Lead Optimization Of Novel Potent And Selective Mao-B Inhibitors, Vedanjali Goineni, Manal A. Neal, Narayan D. Chaurasiya, Khaled M. Elokely, Christopher R. Mccurdy, John M. Rimoldi, Stephen J. Cutler Ph.D., Babu L. Tekwani, Francisco León Ph.D.

Faculty Publications

A series of dietary flavonoid acacetin 7-O-methyl ether derivatives were computationally designed aiming to improve the selectivity and potency profiles against monoamine oxidase (MAO) B. The designed compounds were evaluated for their potential to inhibit human MAO-A and -B. Compounds 1c, 2c, 3c, and 4c were the most potent with a Ki of 37 to 68 nM against MAO-B. Compounds 1c–4c displayed more than a thousand-fold selectivity index towards MAO-B compared with MAO-A. Moreover, compounds 1c and 2c showed reversible inhibition of MAO-B. These results provide a basis for further studies on the potential application of these modified flavonoids for …

Men’S Comfort In Distributing Or Receiving Hiv Self-Test Kits From Close Male Social Network Members In Dar Es Salaam, Tanzania: Baseline Results From The Step Project, Joseph K.B. Matovu, Gaspar Mbita, Akeen Hamilton, Frank Mhando, Wynton M. Sims, Noah Thompson, Albert N. Komba, Jackson Lija, Jiajia Zhang Ph.D., Thomas Van Den Akker, Dustin T. Duncan, Augustine T. Choko, Donaldson F. Conserve

Faculty Publications

Background

A variety of strategies have been used to reach men with HIV self-testing services, including social network-based HIV self-test kits distribution. However, few studies have assessed men’s comfort to distribute to or receive HIV self-test kits from close male friends within the same social network. In this study, we assessed men’s comfort to distribute to and/or receive HIV self-test kits from close male friends and associated factors among men who socialize in networks locally referred to as “camps” in Tanzania.

Methods

Data are from the baseline survey of a cluster-randomized controlled trial conducted in June 2019 with 18 social …

Facial Expression Processing Of Children Orphaned By Parental Hiv/Aids: A Cross-Sectional Erp Study With Rapid Serial Visual Presentation, Qiong Zhao, Hui He, Huang Gu, Junfeng Zhao, Peilian Chi, Xiaoming Li Ph.D.

Faculty Publications

Existing behavioral studies have suggested that individuals with early life stress usually show abnormal emotional processing. However, limited event-related brain potentials (ERPs) evidence was available to explore the emotional processes in children orphaned by parental HIV/AIDS (“AIDS orphans”). The current study aims to investigate whether there are behavioral and neurological obstacles in the recognition of emotional faces in AIDS orphans and also to further explore the processing stage at which the difference in facial emotion recognition exists. A total of 81 AIDS orphans and 60 non-orphan children were recruited through the local communities and school systems in Henan, China. Participants …

The Assessment Of An Extended Set Of Socio-Economic Determinants To Explain Anxiety And Uncertainty, Insufficient Quality And Food Intake Of Afghan Refugees, Mohammad Reza Pakravan-Charvadeh, Hassan Vatanparast, Edward A. Frongillo Jr., Mahasti Khakpour, Cornelia Flora

Faculty Publications

OBJECTIVES:

In this study, socio-economic factors associated with Afghan refugee households' food insecurity, anxiety and uncertainty, insufficient quality and food intake were determined.

DESIGN:

Household Food Insecurity Assess Scale measurement was applied to assess food insecurity, anxiety and uncertainty, insufficient quality and insufficient food intake. Descriptive analysis and multivariable regression models were used to determine the associated factors.

SETTING:

The study was carried out in urban areas of Tehran province in Iran. PARTICIPANTS: To collect data, interviews were conducted among 317 Afghan households. The questionnaire was administered via face-to-face interviews to either the breadwinner of the selected households or a …

Recognition And Screening For Chagas Disease In The Usa, Rachel Marcus, Andres F. Henao-Martinez, Melissa Nolan Ph.D., Mph, Elizabeth Livingston, Stephen A. Klotz, Robert H. Gilman, Monica Miranda-Schaeubinger, Sheba Meymandi

Faculty Publications

Chagas disease (CD), caused by the protozoan Trypanosoma cruzi, is a public health concern, mainly among countries in South and Central America. However, despite the large number of immigrants from endemic countries living in the USA, awareness of CD is poor in the medical community, and therefore it is significantly underdiagnosed. To avoid the catastrophic cardiac complications of CD and to prevent maternal–fetal transmission, widespread educational programs highlighting the need for diagnosis are urgently needed.

Advancing Use Of Nutrition Knowledge To Improve Practice By Policy And Program Communities In India During A Political Transition, Edward A. Frongillo Jr., Jessica L. Escobar-Alegria

Faculty Publications

Models are needed for how to advance use of knowledge by programs and policy officials to make evidence-based decisions about nutrition. How to advance use of nutrition knowledge in India from 2011 to 2015 during a political transition was investigated through studying a knowledge initiative led by the International Food Policy Research Institute. Semistructured interviews were conducted with 37 diverse participants, and 1091 news articles, 318 Twitter and 175 Facebook posts, 12 YouTube events, 65 knowledge products, and 130 engaging events were assessed. Open-axial coding, content and themes analysis, triangulation, and process tracing were used. The knowledge initiative analyzed the …