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Opportunities For Mental Health Interventions In Rural Mississippi Communities During The Covid-19 Pandemic: A Quantitative Analysis, Brice Fortinberry Dec 2023

Opportunities For Mental Health Interventions In Rural Mississippi Communities During The Covid-19 Pandemic: A Quantitative Analysis, Brice Fortinberry

Theses and Dissertations

COVID-19 presented unique challenges for rural Mississippi communities including impacts on the mental health of rural individuals. This research study aimed to identify opportunities for mental health interventions to provide health promotion professionals with quantitative data on the accessibility and the likelihood of engagement with mental health-fostering behaviors. A secondary objective of this research was to categorize these behaviors within the constructs of the Social Ecological Model. Demographics for rural Mississippi communities were collected and displayed, and using multivariate analyses including Spearman’s correlation and a Mann-Whitney U test the correlation between mental health fostering behaviors and demographic factors was obtained. …


Assessing The Impact Of Employee Wellness Programs On Healthcare Employee’S Weight, Reja F. Basyyoni Dec 2023

Assessing The Impact Of Employee Wellness Programs On Healthcare Employee’S Weight, Reja F. Basyyoni

Theses and Dissertations

Introduction: Over 32% of employees in healthcare are clinically overweight with a BMI over 30. This level of obesity is more significant in healthcare than in other professions. (Aldana, 2021). The growing prevalence of diseases among employees in healthcare settings has increased the concern about their health, well-being, and productivity. (Aldana, 2021). Notably, the reduction of obesity rates holds the potential to avert 40 million instances of chronic diseases, encompassing hypertension, diabetes, and cardiovascular ailments. (Milken Institute Study, 2022) Therefore, maintaining a healthy body weight or shedding excess pounds is crucial to reduce the risk of developing these. As a …


Big Data Applications And Challenges In Giscience (Case Studies: Natural Disaster And Public Health Crisis Management), Amir Masoud Forati Dec 2023

Big Data Applications And Challenges In Giscience (Case Studies: Natural Disaster And Public Health Crisis Management), Amir Masoud Forati

Theses and Dissertations

This dissertation examines the application and significance of user-generated big data in Geographic Information Science (GIScience), with a focus on managing natural disasters and public health crises. It explores the role of social media data in understanding human-environment interactions and in informing disaster management and public health strategies. A scalable computational framework will be developed to model extensive unstructured geotagged data from social media, facilitating systematic spatiotemporal data analysis.The research investigates how individuals and communities respond to high-impact events like natural disasters and public health emergencies, employing both qualitative and quantitative methods. In particular, it assesses the impact of socio-economic-demographic …


The Relationship Between Parental Trauma History And Perceptions Regarding Their Child’S Healthcare And Utilization Of Healthcare Services, Krishna Patel Nov 2023

The Relationship Between Parental Trauma History And Perceptions Regarding Their Child’S Healthcare And Utilization Of Healthcare Services, Krishna Patel

Theses and Dissertations

Abstract

TITLE: The Relationship Between Parental Trauma History and Perceptions Regarding Their Child’s Healthcare and Utilization of Healthcare Services

Adverse child events (ACEs) have been associated with a number of physical and mental health problems and have also been linked to increased health care utilization. While parents who have an ACE history may tend to seek healthcare services for themselves, limited studies have examined the impact of their trauma history on seeking healthcare services for their child. Healthcare utilization may also depend on the parents’ level of health anxiety, as well as their anxiety about their child’s health status. This …


Correlates Of Immunization Timeliness In Three South Asian Countries: Secondary Analysis Of Demographic And Health Surveys, Tanzir Ahmed Shuvo Oct 2023

Correlates Of Immunization Timeliness In Three South Asian Countries: Secondary Analysis Of Demographic And Health Surveys, Tanzir Ahmed Shuvo

Theses and Dissertations

Despite the availability of effective vaccines, 1.5 million children under the age of 5 years die every year because of vaccine preventable diseases. Improvements in vaccine delivery infrastructure have resulted in relatively high coverage of vaccines, but many children are not receiving their vaccines on a timely basis. Timely administration of routine vaccines recommended by the Expanded Programme on Immunization (EPI) ensures maximum efficacy. It is vital to explore rates of vaccination timeliness and the correlates of timely vaccination among children to design targeted interventions for improving both coverage and timeliness. We conducted a secondary data analysis of the Demographic …


Dietary Inflammatory Index During Pregnancy And Changes Over Time: Associations With Post-Partum Sleep Duration And Quality And Depressive Symptoms., Nowrin Tamanna Oct 2023

Dietary Inflammatory Index During Pregnancy And Changes Over Time: Associations With Post-Partum Sleep Duration And Quality And Depressive Symptoms., Nowrin Tamanna

Theses and Dissertations

STUDY OBJECTIVES: Sleep and mental health are two important factors for a new mother, as adequate sleep and a healthy mind help her prioritize self-care, seek support when needed, and create a nurturing environment for both her and her baby. Among various plausible theories exploring the etiology of sleep disturbances and depression, the concept of inflammation is gaining attention. This study examined the hypothesis that more pro-inflammatory diets during pregnancy are associated with a decrease in sleep quality and duration, abnormal sleep timing and higher Edinburg Postnatal depression score (EPDS) scores 6 months and 12 months post-partum. METHODS: A secondary …


No More Loosies: A Mixed-Methods Study On The Implementation And Enforcement Of The Loose Cigarette And Bidi Sale Ban In India, Mayank Sakhuja Oct 2023

No More Loosies: A Mixed-Methods Study On The Implementation And Enforcement Of The Loose Cigarette And Bidi Sale Ban In India, Mayank Sakhuja

Theses and Dissertations

Background: Sale of loose cigarettes and bidis (loosies) is widely accepted as a key factor in promoting the tobacco epidemic in India. This mixed-methods study aimed to broaden understanding around the sale and purchase of loosies addressed three aims: 1) To determine the prevalence and correlates of loosies purchase in India; 2) To examine the association between purchase behavior and health warning labels (HWLs) exposure and responses, and 3) To conduct a stakeholder analysis regarding the ban on the sale of loosies in India. Methods: Data from the 2018-19 Tobacco Control Policy (TCP) India survey (643 current cigarette users and …


Black American Men's Resiliency And Persistence To Grow Old: A Midwest Qualitative Study, Kimberly Ann Walker Aug 2023

Black American Men's Resiliency And Persistence To Grow Old: A Midwest Qualitative Study, Kimberly Ann Walker

Theses and Dissertations

AbstractAs Black American men continue to experience the highest premature morbidity and mortality, few studies have centered on the intersection of class (low-income) and race (middle-aged and older Black men) with multiple morbidity from a critical race approach in the Midwest region of the U.S. Middle-aged Black men have 31% higher death rate than their White counterparts. A qualitative study was conducted by a community health nurse in the spring of 2021 in a metropolitan city. Thirty-one, low-income Black American men were interviewed focusing on their understanding and perceptions of their complex comorbidities, symptom management for quality of life, short …


Detection Of Pharmaceuticals, Personal Care Products (Ppcps) And Illicit Drugs In Wastewater Treatment Plants And Urban River Systems, Mary L. Seaman Aug 2023

Detection Of Pharmaceuticals, Personal Care Products (Ppcps) And Illicit Drugs In Wastewater Treatment Plants And Urban River Systems, Mary L. Seaman

Theses and Dissertations

ABSTRACT

DETECTION OF PHARMACEUTICALS AND PERSONAL CARE PRODUCTS (PPCPS) AND ILLICIT DRUGS IN WASTEWATER TREATMENT PLANTS AND URBAN RIVER SYSTEMS

by Mary L Seaman The University of Wisconsin-Milwaukee, 2023 Under the Supervision of Professor Todd Miller, PhD

Pharmaceuticals, personal care products (PPCPs) and illicit drugs are a threat to human health and the aquatic environment globally. Their usage and consumption is rapidly increasing potentially due to an aging population, the development of new drugs, the overprescribing of prescription drugs and easier accessibility of drugs legally and illegally prescribed. These compounds enter wastewater treatment plants influent through urine or feces, pass …


The Context And The Commissioner: The Effect Of Milwaukee’S Health Commissioners’ Social, Cultural, And Historical Understanding Of Milwaukee’S People During The Last Five Pandemics, Madeline O'Dea Fruehe Aug 2023

The Context And The Commissioner: The Effect Of Milwaukee’S Health Commissioners’ Social, Cultural, And Historical Understanding Of Milwaukee’S People During The Last Five Pandemics, Madeline O'Dea Fruehe

Theses and Dissertations

Resistance to pandemic response policies was observed globally throughout the COVID-19 pandemic. This resistance has been linked by researchers to the prolonged duration and higher mortality rate of COVID-19 compared to previous pandemics, despite advancements in modern medicine, extensive surveillance networks and record vaccine production. However, the strategies implemented by public health officials during the COVID-19 pandemic closely mirrored those successful in mitigating past pandemics. To elucidate this disparity, a historical analysis encompassing the 1918, 1957, 1968, 2009, and Covid-19 pandemics was conducted within the city of Milwaukee. By examining archival documents and over 800 newspaper articles, this research found …


Establishing Validity And Preliminary Clinical Utility Of A Behavioral Economic Measure Of Social Risk Discounting For Health Behaviors, Connor A. Burrows Jul 2023

Establishing Validity And Preliminary Clinical Utility Of A Behavioral Economic Measure Of Social Risk Discounting For Health Behaviors, Connor A. Burrows

Theses and Dissertations

The COVID-19 pandemic has been the most profound public health emergency of the past several decades and the United States has faced numerous challenges with the timely adoption of mitigating health behaviors. Sustained ambivalence surrounding perceptions of public health recommendations of social distancing, mask wearing, and timely vaccination remain a barrier to slowing the spread of the virus years after its initial onset. Behavior analysis and behavioral economics offer compelling theoretical and quantitative models for framing the relationship between behaviors that are aversive in the short term but beneficial for individual and public good in the long term. The present …


Phoneme Stability In Speech Production Of Cognate And Non-Cognate Nouns In A Bilingual With Aphasia, Katherine Vlach Jul 2023

Phoneme Stability In Speech Production Of Cognate And Non-Cognate Nouns In A Bilingual With Aphasia, Katherine Vlach

Theses and Dissertations

With the growing bilingual population in the world comes a greater incidence of bilingual aphasia, a communication disorder characterized by expressive or receptive language impairment in one or both of a bilingual speaker’s languages. The cognate facilitation effect, which has greatly been explored in healthy bilingual studies, has shown that cognates are named faster and more accurately than non-cognates; as the cognate facilitation effect is also retained in bilingual speakers with aphasia, it is thought that cognates could potentially be used as a treatment tool to facilitate lexical access, particularly when a bilingual speaker with aphasia presents with one of …


Differential Levels Of Nutrients And Heavy Metals In Tilapia Collected From Drains In Egypt, Emily Burch Jun 2023

Differential Levels Of Nutrients And Heavy Metals In Tilapia Collected From Drains In Egypt, Emily Burch

Theses and Dissertations

Tilapia is one of the most widely cultivated and consumed fish globally. In terms of human health, tilapia is an excellent source of protein, polyunsaturated fatty acids, and micronutrients. Tilapia and other aquatic species have become increasingly susceptible to contamination, as anthropogenic activities have been increasing around the world. Anthropogenetic activities often introduce high levels of contaminants, including heavy metals, into the marine environment. These contaminants often do not biodegrade, and they are absorbed by aquatic species. Contaminants can bioaccumulate and proceed in biomagnification up the fish food chain putting consumers at an increased risk of exposure. Heavy metals can …


Global Health Governance And Its Role In Health Equity: The Case Of Covid-19, Wafa Abu El Kheir-Mataria Jun 2023

Global Health Governance And Its Role In Health Equity: The Case Of Covid-19, Wafa Abu El Kheir-Mataria

Theses and Dissertations

In the globalized world, we are living in, health became the joint responsibility of individuals, their governments, and the global health governance system. Moreover, based on the right to health, health equity is increasingly in demand, and adopting it to a global level has become an even more complex task to realize. This thesis is focuses on health equity at a global level. The main research questions addressed are: Is health equity present at an intercountry /global level? how is it related to Global Health Governance (GHG)? Is GHG performing well in achieving health equity? what are the reasons behind …


Association Of Health Literacy With Demographic Features, Health-Related Behaviors, And Health Risk Indicators Among Egyptian Adults: Online Cross-Sectional Study, Rana Gamal Hassan Jun 2023

Association Of Health Literacy With Demographic Features, Health-Related Behaviors, And Health Risk Indicators Among Egyptian Adults: Online Cross-Sectional Study, Rana Gamal Hassan

Theses and Dissertations

Health literacy is recognized as a significant determinant of health. Limited health literacy is a growing issue worldwide. It has a significant role facing the rising trends of non-communicable diseases (NCDs) through improving its modifiable risk factors. Therefore, studying the association between health literacy and different health-related behaviors is very important to guide both healthcare professionals and policy makers to set up the proper interventions. Our study aims to a) examine the health literacy levels among Egyptian adults, b) investigate the association of health literacy relative to socio-demographic features, health related behaviors, and self-reported health status. This is a cross-sectional …


Assessing The Correlation Between The Socioeconomic Level And Cognitive Function Among Older Adults In Egypt, Macy Abougabal Jun 2023

Assessing The Correlation Between The Socioeconomic Level And Cognitive Function Among Older Adults In Egypt, Macy Abougabal

Theses and Dissertations

The number of older adults is increasing worldwide at an unprecedented rate. Some countries began to understand the challenges of aging, while others are still at the stage of comprehending the true dimensions of the situation. There is a global focus on aging research to appropriately mitigate the negative impact of aging and cognitive decline. Not only that dementia add economic pressure on governments, it also increase the psychological and physical burden of the caregivers. Scholars have previously studied socioeconomic level in three variables, namely work, education, and income, and their relationship with cognitive function. It was concluded that the …


Inoculation For Neutralizing Misinformation: Replication Of An Experiment On The Effect Of The Fake Experts’ Strategy In Climate Change Communication’S Context, Joseph Abdalla Jun 2023

Inoculation For Neutralizing Misinformation: Replication Of An Experiment On The Effect Of The Fake Experts’ Strategy In Climate Change Communication’S Context, Joseph Abdalla

Theses and Dissertations

Low acceptance of climate change and low support for its mitigation efforts can be due to public misconceptions towards climate change. Climate skeptics use a communication strategy of fake experts to spread misinformation through spokespersons who are not experts in the field. Inoculation can be a protective approach for tackling the misinformation’s effect. Previous research was conducted in the United States and Germany and was never conducted in Africa. This study aimed to complement the previous research findings with results for Egypt by replication an experiment by Cook et al. with a 2 × 2 between-subjects design. A total of …


The Impact Of The Tobacco-Free Policy On The Auc New Cairo Campus, Fatimah Badawy May 2023

The Impact Of The Tobacco-Free Policy On The Auc New Cairo Campus, Fatimah Badawy

Theses and Dissertations

In 2019, the American University in Cairo (AUC) conducted a research study on campus attitudes towards tobacco use and smoking behaviors within their community, in light of the then newly enforced tobacco-free policy. They found most campus members in support of the policy, with higher rates of disapproval from the smoking community. In 2021, this research aimed to follow-up on changes in attitudes towards the policy as well was smoking behaviors. It hypothesized that over time, levels of support to the policy would increase, smoking habits would be positively impacted and that positive health behaviors would correlate with policy support. …


Educational Environments And Children's Physical Activity And Sedentary Behaviors, Nathan R. Tokarek May 2023

Educational Environments And Children's Physical Activity And Sedentary Behaviors, Nathan R. Tokarek

Theses and Dissertations

Children and adolescents spend the majority of their day engaged in sedentary behaviors (SB), while also not meeting physical activity (PA) recommendations. The failure to develop and maintain health enhancing behaviors from a young age may impact an individual throughout their life. With children and adolescents spending a large proportion of their waking hours in a school setting, the educational environment presents an opportunity in which children and adolescents’ PA and SB can be positively influenced. Therefore, the purpose of this dissertation was to explore how children and adolescent’s school time PA and SB are associated with the educational setting, …


Food Insecurity In Youth And Young Adults With Diabetes: Prevalence And Association With Health Behaviors, Lauren Helene Martini Apr 2023

Food Insecurity In Youth And Young Adults With Diabetes: Prevalence And Association With Health Behaviors, Lauren Helene Martini

Theses and Dissertations

Given the life-long impact of diabetes(1-5), it is important to engage in behaviors that promote health and wellness to delay or prevent negative health outcomes(3, 6-10). Despite this, youth and young adults with diabetes generally do not adhere to nutritional(11-17) or physical activity(18, 19) recommendations. In households experiencing financial difficulties, especially those who are having difficulty providing sufficient food to all of its members, adhering to recommendations may be even more difficult.

The purpose of this dissertation is to better understand and contextualize food insecurity among youth and young adults (YYA) with youth-onset T1DM and T2DM. The first aim addresses …


Cross Cultural Adaptation And Validation Of A Self-Reporting Tool To Assess Health-Related Quality Of Life For Egyptians With Extremity Bone Sarcomas In Childhood Or Adolescence, Nesma Farid Feb 2023

Cross Cultural Adaptation And Validation Of A Self-Reporting Tool To Assess Health-Related Quality Of Life For Egyptians With Extremity Bone Sarcomas In Childhood Or Adolescence, Nesma Farid

Theses and Dissertations

Validated self-reporting tools are required to evaluate the functional outcome and health-related quality of life (HRQOL) for Egyptians who had extremity bone sarcomas in their childhood or adolescence. Thus, we pursued cross-cultural adaptation and validation of the pediatric Toronto Extremity Salvage Score (pTESS) and Toronto Extremity Salvage Score (TESS) to assess the physical function of children and adult survivors following surgeries of extremity bone sarcomas. Modified versions of pTESS and TESS, which contain additional mental domains, were developed to allow the evaluation of HRQOL using a specific instrument for childhood bone cancer. The internal consistency of the original pTESS and …


Human Gut Microbiota And Parkinson's Disease In An Egyptian Population, Sara Hashish Feb 2023

Human Gut Microbiota And Parkinson's Disease In An Egyptian Population, Sara Hashish

Theses and Dissertations

Multiple lines of evidence suggest the role of the gut microbiome in the predisposition and progression of Parkinson’s disease. This present cross-sectional study was performed to compare the composition of the gastrointestinal microbiota in patients with Parkinson's disease to their counterparts. Stringent inclusion criteria were followed to reliably identify our target population. Parkinson’s patients (n = 40) along with reference subjects (n = 39) were recruited from November 2021 to August 2022. Detailed demographic and clinical data were obtained at baseline using a set of questionnaires and clinical assessment tools. Fecal specimens were collected from all participants, and gut commensals …


Differential Transcriptional Alterations In Detoxification Genes In Parkinson’S Disease In Egypt, Nourhan Shebl Jan 2023

Differential Transcriptional Alterations In Detoxification Genes In Parkinson’S Disease In Egypt, Nourhan Shebl

Theses and Dissertations

PD is the most common motor neurodegenerative disease worldwide. The underlying cause of PD is still unknow, owingthis to the complexity of the disease. Often, genetics and environmental factors are collaborating in the initiation of the disease. Despite the diversity of its genetical and environmental profiles, the Egyptian population is one of the mostunderrepresented population in terms of PD research. In this study, we investigated PD through various perspectives tohighlight the complexity of the disease in Egypt, taking into consideration the diversity of the Egyptian population. We recruited PD patients and reference controls from 4 governorates: Cairo, Giza, Alexandria, and …


An Examination Of The Sufficiency Of Emergency Planning In New York City Hospitals For Vulnerable Populations Needing Communication Or Language Assistance, Rosemary Mcdonnell Jan 2023

An Examination Of The Sufficiency Of Emergency Planning In New York City Hospitals For Vulnerable Populations Needing Communication Or Language Assistance, Rosemary Mcdonnell

Theses and Dissertations

Background: While all populations are susceptible to certain hazards that may expose their vulnerabilities in a disaster, populations with no or limited English proficiency, sight limitations, and hearing limitations are especially at risk due to communication and language barriers that they consistently experience. Purpose: This study explored the sufficiency of emergency planning that vulnerable populations with communication barriers may receive in a New York City hospital setting. It investigated the emergency plans, procedures, and practices that hospitals have for these specific, at-risk populations. The sufficiency of these were measured in accordance with their ability to meet the appropriate regulatory standards …


The Impact Of A Parent-Only Pediatric Obesity Intervention Program On Quality Of Life In Racially Diverse Children, Taylor Vashro Jan 2023

The Impact Of A Parent-Only Pediatric Obesity Intervention Program On Quality Of Life In Racially Diverse Children, Taylor Vashro

Theses and Dissertations

Pediatric obesity has been associated with significant decrements in pediatric quality of life (QOL) comparable with severe pediatric diseases such as cancer. Parenting interventions have yielded health benefits for children with obesity; however, few studies have investigated the impact of parent-focused interventions on QOL in children with overweight and obesity. This study investigated the impact of a 6-week intensive parenting intervention program on the QOL of 5-12 year old, predominantly Black children with overweight and obesity. Parents were randomized into either the parenting intervention (NOURISH+) or a control group, and QOL, as well as variables related to child and parenting …


Development Of A Qa Plan For A 3.0t Cannon Galan Mr-Sim, Nathaniel D. Teague Jan 2023

Development Of A Qa Plan For A 3.0t Cannon Galan Mr-Sim, Nathaniel D. Teague

Theses and Dissertations

Purpose: To develop and incorporate a QA (quality assurance) program for a Canon Galan 3 tesla MR Simulator for applications in radiation therapy.

Methods and materials: The QA program was centered around tests performed with three separate levels of frequency. The daily QA procedure consisted of scanning a vendor provided daily QA cube phantom that measures basic performance parameters. Additionally, a series of basic safety check were performed. The monthly QA procedure consisted of several tests, including scanning the ACR MRI large accreditation phantom and manually performing its corresponding image quality tests. Scanning the MagPhan RT for its detailed geometric …


Meta-Analysis Of Factors Impacting Reading Impairment Rates In Studies Of Children With Developmental Language Disorder (Dld), Kayla Dewey Jan 2023

Meta-Analysis Of Factors Impacting Reading Impairment Rates In Studies Of Children With Developmental Language Disorder (Dld), Kayla Dewey

Theses and Dissertations

Purpose - Developmental language disorder (DLD) is a common yet underdiagnosed disorder centered on difficulties with oral language, and often associated with word reading and reading comprehension difficulties. Numerous studies have documented high rates of reading impairment in children with DLD, but the specific rates vary widely across studies. The purpose of this meta-analysis was to help provide accurate prognostic information about this disorder by determining the average proportion of participants with DLD who also had reading impairment, and to determine whether variability in the rate of reading impairment was significantly influenced by studies’ methodological features, including recruitment method, type …


The Genetic Associations Of Circadian Rhythm And Sleep Disorder Traits With Risk Of Monoclonal Gammopathy Of Undetermined Significance And Multiple Myeloma, Brittany Crawford Jan 2023

The Genetic Associations Of Circadian Rhythm And Sleep Disorder Traits With Risk Of Monoclonal Gammopathy Of Undetermined Significance And Multiple Myeloma, Brittany Crawford

Theses and Dissertations

Background: Circadian rhythm disruption and sleep have been widely studied for their roles in immunity and cancer development. Evidence for an association of circadian rhythm and sleep traits with multiple myeloma (MM) risk is inconclusive. No studies have investigated these traits in relation to monoclonal gammopathy of undetermined significance (MGUS). Given that MGUS precedes almost all MM cases, investigating sleep and circadian rhythm in relation to both MM and MGUS is necessary. The purpose of this dissertation was to explore the genetic influences of circadian rhythm and sleep traits on the risk of MGUS and MM. Methods: Data were leveraged …


Social Network Attributes Associated With Conversations About Smoking And Cessation And Differences By Socioeconomic Status, Victoria Catherine Lambert Jan 2023

Social Network Attributes Associated With Conversations About Smoking And Cessation And Differences By Socioeconomic Status, Victoria Catherine Lambert

Theses and Dissertations

Conversations about smoking and cessation in response to cessation messages appear to encourage quit attempts, yet there is some evidence that smokers with lower income and education have these conversations less often than their counterparts with higher income and education. No research has investigated the social network characteristics that encourage smokers to have these conversations or the mechanisms for SES differences in these conversations. Because social factors play a role in SES disparities in smoking and cessation as well as other health behaviors and outcomes, social network characteristics likely explain some SES differences in conversations about smoking and cessation. The …


Access To Hiv Prevention, Care, And Treatment Services In The Us: The Role Of Primary Care, Jessica S. Kiernan Jan 2023

Access To Hiv Prevention, Care, And Treatment Services In The Us: The Role Of Primary Care, Jessica S. Kiernan

Theses and Dissertations

This dissertation examines the role of access to primary care in benefitting HIV outcomes through increased access to HIV prevention, care, and treatment services, among populations disproportionately affected by HIV in the US. Over 30,000 individuals are newly diagnosed with HIV annually in the US and diagnoses are concentrated in specific populations. At an individual-level, ~ 70% of new diagnoses are among gay and bisexual men and of those diagnoses, 70% are among Non-Hispanic Black and Hispanic gay and bisexual men. At a community-level, over 50% of new HIV diagnoses occur in less than 2% of US counties (48), Washington, …