Public Health Commons^™

No Vaccine? Why Not: Causes Of Vaccine Hesitancy And How Governments Can Stop It, Alexander (Alec) Mccarty '25

Honor Scholar Theses

Vaccine hesitancy is a term that has entered the spotlight since the beginning of the COVID-19 pandemic. With concerns about efficacy, safety, and individual choice, many people have developed a hesitancy toward receiving any vaccine, creating concerns for public and global health. Through responses from local and state health departments about their actions during the COVID-19 pandemic, and through analysis of state vaccine rates based on political affiliation, this study suggests that vaccine hesitancy is a current issue that is likely politically motivated. States that are Republican affiliated have lower rates of vaccine uptake, and in turn they have higher …

Parasite Contamination Of Soil In Different Peruvian Locations And Outside Built Environments, Carlos Pineda, Maritza Dalí Camones Rivera, Eddyson Montalva Sabino, Lucia Estela Mejia, Katherine Elizabeth Keegan, Lizbet Pilar Patricio Alvarez, Javier Jorge Mora, Fernanda Espinoza Vega, Emilio Rey Mejia, Patrick Olivas Herrera, Elisa Palomino Pando, Zhen Zeng, Athos Silva De Oliveira, Maria Jose Villar Mondragon, Barton Slatko, Eric J Wetzel, Rojelio Mejia

Faculty, Staff and Students Publications

Background: Soil is a reservoir for many parasites that can affect human and animal health, especially in tropical regions where soil-transmitted helminths and protozoa thrive. Understanding how environmental factors influence parasite distribution will provide a basis for relating how climate changes may intensify their impacts, altering parasite habitats and increasing transmission risks. We surveyed soil parasite prevalence, burden, and diversity in several different Peruvian environmental ecologies to catalog current parasite presence and provide a baseline for future surveys.

Methods: A total of 198 soil samples from 43 locations across three Peruvian regions-Tingo María (TM) (Amazon rainforest), Andabamba/Marabamba (A/M) (Andean highlands), …

Race Has No Impact On Prostate Cancer-Specific Mortality, When Comparing Patients With Similar Risk Of Other-Cause Mortality: An Analysis Of A Population-Based Cohort, Shane A. Tinsley, Marco Finati, Alex Stephens, Giuseppe Chiarelli, Giuseppe O. Cirulli, Eric M. Williams, Chase Morrison, Caleb Richard, Keinnan Hares, Akshay Sood, Nicolos Buffi, Giovanni Lughezzani, Carlo Bettocchi, Andrea Salonia, Alberto Briganti, Francesco Montorsi, Giuseppe Carrieri, Craig G. Rogers, Firas Abdollah

Medical Student Research Symposium

Background: Other-cause mortality (OCM) can serve as a surrogate for access-to-care. The authors sought to compare prostate cancer-specific mortality (PCSM) in Black versus White men matched based on their calculated OCM risk.

Methods: The Surveillance, Epidemiology, and End Results (SEER) database was queried for Black and White men diagnosed with prostate cancer between 2004 to 2009, to collect long-term follow-up. A Cox regression was used to calculate the OCM risk using all available covariates. This calculated OCM risk was used to construct a 1:1 propensity score matched (PSM) cohort. Then, a competing-risks multivariable tested the impact of race on PCSM. …

Assessing Eye Care Needs And Service Accessibility In A Student-Run Free Clinic In An Underserved Urban Population, Hamza Khan, Arifbillah Sarowar, Olivia Jeakle, Sophia Griemert, Olivia Decker, Demetrius Moncrease, Timothy Page, Dominic Sacca, Anju Goyal

Medical Student Research Symposium

Introduction: Student-run free clinics offer valuable firsthand experience in providing care to uninsured and underserved communities. As efforts to enhance eye care expand over time, it is crucial to evaluate the accessibility and effectiveness of these services within the community. This study examines the demographics and needs of patients seeking eye care, as well as the availability of initial screenings at our clinic.

Methods: A retrospective review of patient charts was conducted for individuals who attended the Sight Saver’s free healthcare clinic to receive an eye exam. Data collected includes patient demographics, comorbidities, family history of eye-related diseases, visual acuity …

Building Empathy Through Storytelling: A Living Library Program Focused On Women’S Health, Jess King, Belinda Boelter, Catherine Medici-Thiemann

Posters and Presentations: Leon S. McGoogan Health Sciences Library

An academic health sciences library hosted a grant-funded living library program titled “Bringing Stories of Women’s Health to the Forefront.” With a campus that is increasingly focused on incorporating the humanities into medical education, the library added to this momentum by offering a program which encouraged empathy through the art of storytelling. The program was delivered via three routes: an in-person event for the city’s metro community, a virtual event for the university community and their clinical partners, and oral interview video recordings that are hosted on the library website. In order to host a successful event that met the …

Does A Waiting Room Increase Same-Day Treatment For Sexually Transmitted Infections Among Pregnant Women? A Quality Improvement Study At South African Primary Healthcare Facilities, Ranjana M. Gigi, Mandisa M. Mdingi, Lukas Bütikofer, Chibuzor M. Babalola, Jeffrey D. Klausner, Andrew Medina-Marino, Christina A. Muzny, Christopher M. Taylor, Janneke H. Van De Wijgert, Remco P. Peters, Nicola Low

School of Medicine Faculty Publications

BACKGROUND: Same-day testing and treatment of curable sexually transmitted infections (STI) is a strategy to reduce infection duration and onward transmission. South African primary healthcare facilities often lack sufficient waiting spaces. This study aimed to assess the proportion of, and factors influencing, pregnant women waiting for on-site STI test results before and after the installation of clinic-based waiting rooms. METHODS: We conducted an observational quality improvement study at 5 public primary healthcare facilities in South Africa from March 2021 to May 2023. The intervention was the installation of a waiting room in two clinics. Three clinics were used as comparators: …

Findings From A Qualitative Analysis: Social Media Influencers Of Color As Trusted Messengers Of Hpv Vaccination Messages, Amelia Burke-Garcia, Erin Cutroneo, Dasha Afanaseva, Kayla Madden, Angela Sustaita-Ruiz, Preethi Selvan, Estefany Rivera Sanchez, Amy Leader

Department of Medical Oncology Faculty Papers

BACKGROUND: Despite HPV vaccination reducing the prevalence of cervical cancer by 90%, vaccination rates remain lower among communities of color due to vaccine hesitancy and mistrust in traditional public health messengers. The emergence of social media influencers, a newer kind of messenger, presents a unique opportunity to share immunization messages in new ways with a variety of communities. This paper reviews the qualitative findings from a study aimed at assessing influencers' perceptions of and approaches to sharing messaging about the HPV vaccine.

METHODS: Guided by several theories (Theory of Planned Behavior, Narrative Theory, and Opinion Leader Theory), the study team …

Social Support And Treatment Outcomes Among Multi-Drug Resistant Tuberculosis And Persons Living With Hiv In Nigeria, Abiodun Olusegun Hassan

Walden Dissertations and Doctoral Studies

An estimated 40% of people with tuberculosis (TB) are missed due to underdiagnosis, and among those previously treated TB cases, about a quarter develop drug-resistant TB in Nigeria. The emergence of multi-drug-resistant TB (MDR-TB) is stalling the effort towards TB’s control and eradication. Few studies have examined the impact of the psychosocial effect and support systems for TB, particularly for MDR-TB. In this quantitative, cross-sectional study, the predictive relationship between social support given to MDR-TB patients and their treatment outcomes was examined using secondary data of 594 MDR-TB cases enrolled between January 2018 and December 2021. The theoretical framework for …

Evaluating Engagement In Health Care And Substance Use Disorder Services Among People Who Use Drugs, Tiffany Mckenney, Kevin Cobty, Divya Boorle, Julie Gleason-Comstock

Medical Student Research Symposium

An urban community-based organization conducted a study to examine demographics of individuals who use drugs and their approaches to risk reduction. A substantial proportion reported encountering significant barriers to accessing substance use disorder (SUD) services.

In collaboration with a state survey, the community organization recruited a convenience sample of individuals who actively used drugs, examining substance use patterns, healthcare access, and barriers to SUD services. Community health workers facilitated outreach efforts, focusing on harm reduction engagement, and healthcare access.

Data were collected from 55 individuals. 51% identified as male, 48% as female, and 2% as LGBTQIA+. 67% identified as White/Caucasian, …

Socioeconomic And Demographic Factors In Genetic Testing Utilization Among Advanced Prostate Cancer Patients: A Retrospective Single-Institution Study, Alexandra T. Skowron Ms, Karen Childers, Courtney M. Rose Ms, Kyle C. Mcelyea Md, Avery K. Supernois Bs, Yousuf Hussain, Mohammed Baseer Ms, Sunita Ghosh Phd, Clara Hwang Md

Medical Student Research Symposium

Introduction

Germline genetic testing in patients with advanced prostate cancer (PCa) is underutilized. Socioeconomic and demographic factors are hypothesized to affect low rates of testing, but causality has not been established. This single institution, retrospective study aimed to understand what barriers may affect germline genetic testing for PCa patients.

Methods

The Henry Ford Health (HFH) tumor registry was queried for new diagnoses of stage 3, 4A and 4B PCa from 2017-2022. Census tract levels were assigned using patient addresses and neighborhood-based geocoding was completed for Median household income (gMHI) and Social vulnerability index (SVI). gMHI and SVI were divided into …

Variation In Treatment Recommendations For Low-Risk Prostate Cancer: A Focus On Active Surveillance Across Physician Specialties, Sinyu Yang B.S., Tiffany Chu B.S., Cathryn Bock Ph.D, Jinping Xu M.D.

Medical Student Research Symposium

Prostate cancer (PC) is the second leading cause of cancer-related death in men globally, with 1 in 8 men in the US diagnosed during their lifetime. For Low-Risk Prostate Cancer (LRPC), management options include Watchful Waiting (WW), Active Surveillance (AS), or curative treatments such as prostatectomy or radiation. While curative treatments can have significant long-term side effects like urinary incontinence and sexual dysfunction, AS is less invasive and preferred due to fewer adverse effects. However, variations in physician training may lead to differing recommendations, potentially causing confusion or frustration for patients consulting multiple specialists. This study investigates whether treatment recommendations—AS, …

Evaluating The Current State Of Quality Measure Reporting In The Merit-Based Incentive Payment System, Kinan Sawar, Geoffrey Potts Md

Medical Student Research Symposium

The Merit-Based Incentive Payment System (MIPS) requires physicians to report quality measures along with other metrics that are used to determine an annual percentage adjustment to physician Medicare Part B payments. Unfortunately, physicians have been forced to choose from an ineffective, limited set of quality measures. This has led to an overreliance on process measures, which fail to stratify physician performance effectively; it has also led to differences in the number of reporting options across specialties, resulting in unequal opportunity for physicians to succeed in MIPS. Using Centers for Medicare and Medicaid Services (CMS) public use file data from 2021-2024, …

Patient And Healthcare Provider Knowledge Of Exercise During Pregnancy., Robert J. Leone, Dr. Shihyun Kim, Vidhi Sharma, Monique Swain

Medical Student Research Symposium

Title: Patient and Healthcare Provider Knowledge of Exercise During Pregnancy.

Authors: Leone, R., Kim, S., Sharma, V., Swain, M.

Introduction:

Physical activity before and during pregnancy can significantly improve pregnancy outcomes. ACOG’s evidence-based recommendations help healthcare providers (HCPs) educate patients regarding the benefits of exercise during pregnancy. However, many patients do not engage in regular physical activity. We aim to determine how provider counseling on exercise per ACOG recommendations impacts patients’ exercise and perception of exercise during pregnancy.

Methods:

This is a survey study of HCPs offering prenatal and postpartum care, and pregnant patients. HCPs were given surveys …

Understanding Barriers To Fresh Produce Consumption In Detroit, Riley Ann Macdonald, Kalyyanee Ganesh Nanaaware, Jeff Lu, Derek Zahnleuter, Heather Sun, Sara Naessig, Aminah Bharadia, Eric A. Mcgrath

Medical Student Research Symposium

Title: Understanding Barriers to Fresh Produce Consumption in Detroit

Abstract:

Background Information:

Detroit has barriers to fresh produce consumption and poor health outcomes related to diet, which necessitate further study. We aim to investigate these barriers by understanding current consumption practices of fresh produce, and provide evidence for future solutions to combat these barriers.

Methods:

Surveys were distributed at two urban garden locations (Wayne State University School of Medicine Medical Student Garden and Wayne Pediatrics Garden) in Midtown, Detroit, to patrons (n=34) receiving fresh produce between March-October 2024. Surveys screened for demographics, transportation, what produce patrons took, if they …

Stopping The Cirrhosis: An International Review Of Hep C Screening In Prisons And Jails From 2004-2023, Anastasia Sahu Bs, Jack Spurlock Ba, Mhs, Eliza Beal Md

Medical Student Research Symposium

Background: As of 2023, HCV prevalence in state prisons in the United States was 9 times higher than the general population¹. Without treatment, 20% of people with HCV will develop cirrhosis, and some estimate that 70% of hepatocellular carcinoma (HCC) cases arise from cirrhosis or advanced fibrosis². Despite the high prevalence in prisons, the US does not have nationally standardized Hep C screening in correctional facilities. The goal of this study is to investigate different models of existing programs in prisons internationally. Understanding these models will inform Hep C screening in US prisons on a state …

Low, Current, And Persistent Poverty Area Residence And Social Risks Among Black Cancer Survivors, Leane S. Kuo, Theresa A. Hastert

Medical Student Research Symposium

Background: Persistent area-level poverty may contribute to long-term social and economic disinvestment and fewer health promoting resources even compared with current area-level poverty. This may contribute to unmet social needs, which are associated with adverse health outcomes. This study examines associations between living in persistent (vs. current and low) poverty areas and prevalence of social needs among African American cancer survivors.

Methods: We utilized data from 3,650 participants in the Detroit Research on Cancer Survivors (ROCS) cohort. African American adults were invited to participate if they were ages 20-79 at diagnosis with breast, colorectal, lung, prostate, or endometrial cancer (ages …

Sexual And Reproductive Healthcare Perceptions Among Arab-American Women: Implications For Gynecological Health Outcomes, Munna Hazime, Kaitlyn Zablock, Whitney Bowyer, Natalie Ahmad Mateju, Andrew Markowitz

Medical Student Research Symposium

This literature review analyzes the sexual and reproductive healthcare perceptions of Arab-American (AA) women living in the United States and how this impacts the prevalence of gynecological diseases. Sexual health is viewed promiscuously within the AA population and is generally reduced to the physical act of intercourse. It is considered either an agent of sexual desire or a means to reproduce. This dichotomy overlooks aspects of gynecological health within a broader framework. This attitude is evident in the minimal utilization of preventative screenings and increased rates of sexually transmitted infections (STIs) and gynecological cancers. Consequently, this narrow view of sexual …

The Role Of Churches In Enhancing Cancer Screening Adherence: A Focus On Faith-Based Health Literacy Among African American Women, Miranda I. Goodson, Genevieve Murray

Medical Student Research Symposium

Background: It is estimated that cancer is the second leading cause of death for African American women in the United States. One study revealed that Black women have a 1 in 3 chance of developing cancer with a 1 in 6 chance of mortality. Research has shown a lower breast cancer screening adherence among women in cultural minorities and faith-based communities. The importance of spirituality and religion as an influential factor on Black community members’ beliefs about health and medicine must be considered as churches are pillars of social support within Black American communities.

Methods: A search for studies about …

Assessing Middle Eastern American Attitudes Towards Substance Use Disorders, Hazem Alata, Hussein Bazzi, Saleh Al-Juburi, Angie Achkar, Liam Browning, Nicole Oska, Adam Chaban, Arash Javanbakht

Medical Student Research Symposium

Assessing Middle Eastern American Attitudes Towards Substance Use Disorders

Introduction:

Substance use disorders (SUD) among Middle Eastern and North African (MENA) populations remain largely understudied, despite evidence of high prevalence rates and lower rates of treatment engagement. Unique cultural conceptualizations and beliefs surrounding substance use disorders may perpetuate stigma, further contributing to disparities in access to and utilization of treatment services. This study aims to explore the attitudes and perspectives of individuals from MENA communities regarding substance use disorders, with the goal of identifying and addressing barriers to treatment.

Methods:

An anonymous bilingual Qualtrics survey was administered, gathering responses from …

Implications Of Glyphosate-Based Herbicides On The Female Reproductive System And Reproductive Outcomes, Alexandra Stone, Olivia G. Camp Ms, David Bai Md, Awoniyi Awonuga, Husam M. Abu-Soud

Medical Student Research Symposium

Background

Glyphosate-based herbicides (GBHs) are the most widely used herbicides in the United States, accounting for 19% of estimated global use. Although the Environmental Protection Agency has reaffirmed that the active ingredient glyphosate (GLY) is safe for humans, recent studies on exposure have suggested an association with cancer, metabolic disorders, endocrine disruption and infertility, and Alzheimer’s and Parkinson’s disease. Recently, we have shown that GLY exposure deteriorates metaphase II oocyte quality through zinc deficiency, ROS accumulation, and chromosome disruption. In this work, we review the mechanisms of GLY toxicity in the female reproductive tract and discuss the potential clinical implications …

Oral Hygiene And Cardiovascular Health, Md. S. Zaman, S. M. Golam Alam, Mohammed S. Razzaque

School of Medicine Publications

The human oral microbiome plays a vital role in maintaining oral and systemic health. This diverse microbial community includes over 700 bacterial species, some of which are implicated in developing systemic diseases, particularly cardiovascular diseases (CVDs). Research highlights a strong association between periodontal disease and increased cardiovascular risk, suggesting that good oral hygiene practices may reduce the incidence of CVDs. Porphyromonas gingivalis and Fusobacterium nucleatum drive chronic inflammation in periodontal disease; these bacteria can extend beyond the mouth and contribute to systemic inflammatory responses. The inflammatory factors, including C-reactive protein (CRP), interleukins (IL-1, IL-6), and tumor necrosis factor-alpha (TNF-α), damage …

A Mapping Review And Critique Of The Literature On Translation, Dissemination, And Implementation Capacity Building Initiatives For Different Audiences, Ana A Baumann, Danielle R Adams, Laura-Mae Baldwin, Rachel G Tabak, Sara Malone, Maura M Kepper, Anita D Misra-Hebert, Kathleen R Stevens, Maria E Fernandez, Sunil Kripalani

Faculty, Staff and Student Publications

Background: Capacity building is critical for research and practice as the fields of dissemination, implementation and translation science continue to grow. Some scholars state that capacity building should be grounded in competencies. However, the fields are unclear in determining which competencies are relevant for whom, including the content and appropriate level of information and skills for different roles. The goal of this study was to catalogue competencies across current D&I capacity building initiatives.

Methods: We conducted a mapping review to examine to what extent are theories or frameworks used to guide capacity building, who is being trained, to what extent …

Growing The Good: A Communal Garden Case Study Among Marginalized, Rural Populations, Claire Barbier

LSU Master's Theses

Community and Communal gardens (CG) have been documented as early as the late 1800s during periods of economic recessions and high food insecurity (The MIT Press Reader, 2022). However, C.G. adoption rates are expanding on a global scale as communities and municipalities see the potential for the tool to bring relief to environments in dire need of additional resources. Utilizing a communal garden can be used to address a surplus of systemic barriers a community faces; it has a significant opportunity to bring forth the interconnected tiers of public health altogether (Twiss et. al, 2003). Modernized C.G projects bring forth …

Bone-Induced Her2 Promotes Secondary Metastasis In Hr+/Her2- Breast Cancer, Rahat Alam, Anna Reva, David G Edwards, Bree M Lege, Laura S Munoz-Arcos, Carolina Reduzzi, Swarnima Singh, Xiaoxin Hao, Yi-Hsuan Wu, Zeru Tian, Laura M Natalee, Gargi Damle, Deniz Demircioglu, Yixian Wang, Ling Wu, Elisabetta Molteni, Dan Hasson, Bora Lim, Zbigniew Gugala, Jerry E Chipuk, Julie E Lang, Joseph A Sparano, Chonghui Cheng, Massimo Cristofanilli, Han Xiao, Xiang H-F Zhang, Igor L Bado

Faculty, Staff and Students Publications

Bone metastases can disseminate to secondary sites and promote breast cancer progression creating additional clinical challenges. The mechanisms contributing to secondary metastasis are barely understood. Here, we evaluate the prediction power of Her2-expressing (Her2E) circulating tumor cells (CTCs) after analyzing over 13,000 CTCs from a cohort of 137 metastatic breast cancer (MBC) patients with initial HR+/Her2− status and employ preclinical models of bone metastasis (BM) to validate the role of Her2E CTCs in multi-organ metastases. While Her2 expression was higher in patients with bone metastasis, experimental analyses revealed that Her2E CTCs derived from bone lesions were more dependent on Her2 …

College Healthcare Providers: Are They Prepared To Treat Students Following A Disclosure Of Sexual Assault?, Torrie Piasecki, Lindsay Gietzen

Pacific Journal of Health

Sexual assault is happening on university and college campuses. This study aims to explore the gap in care relative to how on-campus healthcare providers respond to college students following a disclosure of sexual assault and the access to resources provided to them. A sample of seven providers from two major college campuses in Stockton, CA responded to a questionnaire about formal disclosures of sexual assault. Each participant self-reported their knowledge of trauma-informed care (TIC) and what they understand about their campus resources for survivors of sexual assault. Results from participants who completed the survey indicated that although most knew where …

The Impact Of Long Covid On Language Proficiency Across Different School Levels In Hong Kong, Shebe S. Xu, Yixun Li, Wanyi Li, Catherine M. Capio, Winnie W.Y. Tso, Derwin K.C. Chan

Health Sciences Faculty Publications

Long COVID, where symptoms persist after recovering from COVID-19, can affect cognitive functions like language. However, little is known about its impact on children’s language skills, especially across different school levels. This study investigated the impact of long COVID on language proficiency among 1244 children (Asian; 53.5% boys) from kindergartens (N = 408, Mage = 4.42 ± 1.26 years), primary schools (N = 547, Mage = 9.69 ± 1.96 years), and secondary schools (N = 289, Mage = 14.97 ± 1.85 years) in Hong Kong. Language proficiency was assessed using the Language Experience and Proficiency Questionnaire (LEAP-Q), which measured speaking, …

Reevaluating Informed Consent: Integrating Shared Decision-Making Into Spinal Surgery For Better Patient Outcomes., Jeffrey N Wang, Mohamed A Elhakeem, Matthew J Mesimer, Paul G Mastrokostas, Salman Ahmad, Tim Reed, Brandon Klein, Lucas E Bartlett, Adam D Bitterman, Andrew Megas

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Study Design: Narrative review.

Objectives: The objectives of this study were to answer the following questions: (1) What is the quality of informed consent in spine surgery, including both neurosurgery and orthopaedic spine surgery? (2) What limitations impede the ability of surgeons to engage in effective shared decision-making (SDM) and obtain adequate informed consent? (3) What strategies and solutions may improve the quality of informed consent and SDM? (4) What factors decrease the incidence of litigation in spine surgery?

Methods: N/A.

Results: SDM is a collaborative process where patients are involved in their treatment choices through open communication about risks, …

Implementation Of Performance-Based Budgeting For Public Health Care Service Delivery In An Emerging Economy, Isaac O. Randa, Christine A. Adere

Southern African Journal of Policy and Development

This study investigates the determinants and implications of the implementation of performance-based budgeting (PBB) on public health care service delivery at the Ministry of Health and Social Services (MoHSS) in Windhoek, Namibia. Using a cross-sectional survey research design targeting 100 respondents, this study employed a quantitative research approach involving MoHSS's budgeting and health care services departments. Data were analysed using partial least squares structural equation modelling. Communication, bureaucratic structures, and implementers’ disposition significantly influenced PBB implementation alignment, thereby enhancing service delivery. However, resource utilisation showed no significant effect. Additionally, implementation alignment effectively mediated the relationship between latent exogenous variables and …

Summary Of: Financial Impacts Of The Covid-19 Pandemic On Immigrant Communities In Portland, Maine: A Qualitative Study, Eilish W. Carpenter, Claude Rwaganje, Michael Kohut, Elizabeth A. Jacobs, Kathleen Fairfield, Gloria Sclar

Northern New England Clinical & Translational Research

The COVID-19 pandemic not only disproportionately impacted the health of immigrants in the US, but it led to financial disparities as well.

Study found @ "Financial impacts of the COVID-19 pandemic on immigrant communities in" by Eilish W. Carpenter

Irreversible K-Threshold Number Ck(G) And Saturation Probability P[G] For Corona Product And Double Corona Product Graphs, Eric J. Moon, Soumya Bhoumik, Paul Flesher

SACAD: Scholarly Activities

We discuss the Irreversible k-conversion process for graphs, where a vertex becomes saturated and remains saturated indefinitely if at least k of its neighbors are saturated. We investigate sets S₀, which when initially saturated, lead to complete graph saturation. We are interested in the minimum |S₀| = C_k(G), called the k-threshold number. We consider the construction of the Corona Product Graphs (of C_n and K_p). Additionally, we extend our analysis by defining and exploring Double Corona Product Graphs (of C_n and K_p). Then we incorporate …