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Black Poverty Leads White Americans to Blame Racial Inequality on Black Americans Themselves
Get PDFIn this article, we argue that White Americans exposed to Black poverty may rationalize racial inequality in ways that deflect blame from their own racial group. In Study 1 (11,855 participants; 537 counties), White Americans in counties with higher Black poverty rates were ironically more likely to believe in racial equality of opportunity, while Black residents were less likely. In Study 2 (4,297 participants; 227 counties), White Americans living in counties with higher Black poverty attributed racial inequality to more internal causes (lack of effort), which predicted reduced support for racial equity policies. In Study 3 (1,036 participants), White Americans experimentally exposed to Black poverty made more internal attributions, an effect mediated by increased interracial anxiety and identity threat. Effects on external attributions were inconsistent across studies. We discuss how internal attributions function as a psychological tool for White Americans to deflect negative emotions and maintain a positive group identity
Creating Opportunities for Social Engagement, Services, and Support for African Americans in Vance County, North Carolina
Get PDFThis project profoundly examines the growing issue of social isolation and loneliness among African American adults in rural Vance County, North Carolina. These challenges are closely tied to health and are made worse by long-standing barriers like transportation, poor internet access, and lack of welcoming community spaces. By listening to the community and using a systems-thinking lens, the project highlights how these issues are connected and offers practical, culturally grounded solutions. From creating a steering committee to investing in public spaces, the goal is to help people feel more connected and supported. Visual tools like a rich picture or causal loop diagram help bring complexity to life and guide local leaders towards sustainable change.Master of Public Healt
BREAKING THE CYCLE OF ECONOMIC INSTABILITY AMONG BLACK/AFRICAN AMERICAN COMMUNITIES THROUGH STRATEGIES FOR RESILIENCE AND GROWTH IN GRANVILLE AND VANCE COUNTIES
Get PDFGranville and Vance Counties in North Carolina face significant challenges related to social determinants of health (SDOH), which disproportionately affect their Black/African American populations. Key issues such as food insecurity, limited educational opportunities, and poor infrastructure contribute to cycles of poverty and poor health outcomes. In response, this proposal presents sustainable, upstream strategies to improve economic stability and drive systemic change. Central to this approach is the formation of a diverse, community-led task force that prioritizes equitable access to employment, education, housing, and healthcare. The plan includes cross-sector collaboration, stakeholder engagement, and data-driven decision making to ensure long-term impact. By addressing root causes rather than temporary fixes, this initiative aims to reduce disparities and foster resilient communities. Strategic recommendations are grounded in systems thinking, continuous quality improvement, and inclusive design to ensure marginalized voices are heard and empowered throughout the process.Master of Public Healt
Utilizing the Interprofessional Education and Practice (IPEP) Collection in the Carolina Digital Repository
Get PDFDid you know that there was an IPEP Collection in Carolina Digital Repository (CDR)? Have you ever wondered how to use it to enhance your own understanding of IPEP research happening at UNC or how to add your own IPEP research? The CDR is a digital archive for scholarly materials produced by members of the University of North Carolina at Chapel Hill community. The main goal of the CDR is to keep UNC digital scholarly output safe, accessible and discoverable for as long as needed.
Join the Office of IPEP, Rebekah Kati of the CDR and Rebecca Carlson of the Health Sciences Library to learn more about how to utilize the IPEP Collection to deepen and share your IPEP research
The Settler Doctrine: Indians, Religion, and the Land
Get PDFIn this dissertation, I propose the Settler Doctrine to position federal Indian law as profoundly determined by and organized around the legal, historical, and mythical entanglements between land, religion, and indigeneity. Neither land, religion, nor indigeneity are given natural categories. They emerged as anthropological concepts, pop culture fantasies, colonial myths, racist categories, and legal terms from a history of power relations, discursive expressions, lived experiences, and practical negotiations. In federal Indian law, I argue that their genealogies emerged and evolved in codeterminative and deeply entangled relationships. This means that the application of federal Indian law and the interpretation or construction of federal Indian policy depends upon these categories' maintenance and developmental characteristics. In delving deeper into case histories and materials in federal Indian law, I was surprised to learn that “religion” was consistently deployed as an important, if not deciding characteristic, in the judicial opinions supporting a majority of Indian cases that, on the surface, had nothing to do with religion. These cases range from water allocations to fishing rights and property law or into the very bedrock of US federal recognition and protection of tribal sovereignty. Everywhere I looked, I found Indian religion. If not overtly addressed in judicial opinions, courts implicitly relied upon Indian religion through court citations, references, and precedence. In the process of my research, while pulling on the threads of religion, I found statements about land. This connection should not be a surprise. Federal Indian law, after all, is essentially about the land and the result of over five hundred years of colonial endeavors to dispossess Indian peoples of it. In addition, for native peoples in the US, there is a considerable amount of native voices and scholarship stating that whatever Indian religion may be, it is almost certainly tied to the land and quite often to particular places for specific native peoples. When the thread is pulled in the other direction, beginning from legal questions of land, I quickly found court concerns over religion. This dissertation is an analysis of the settler-colonial entanglement between land, religion, and the Indian in federal Indian law.Doctor of Philosoph
Sustainment and adaptation of systems navigation and psychosocial counseling across HIV testing clinics in Vietnam: A qualitative assessment
Get PDFBackground Few evidence-based interventions have been successfully scaled up and sustained long-term. Within an implementation trial testing strategies for scale-up of the Systems Navigation and Psychosocial Counseling (SNaP) intervention for people who inject drugs (PWID) with HIV across HIV testing clinics in Vietnam, we sought to assess if the implementation of SNaP was sustained after study support ended and to identify factors, including adaptations, that affected SNaP sustainment. Method Across all 42 SNaP clinics, we surveyed clinic staff at 6–10 months post-study completion to assess SNaP sustainment. We purposively selected six high and six low-sustaining clinics and conducted 31 in-depth interviews with clinic staff (n = 23) and clinic directors (n = 8). Interviews were coded and analyzed using thematic analysis informed by the Integrated Sustainability Framework. Matrices were used to compare themes across high and low-sustaining clinics. Results 1/12 clinics sustained all of SNaP's core components, 2/12 would continue to sustain SNaP if they had new PWID patients, and the remainder did not fully sustain SNaP but continued conducting a modified version, including shorter or fewer SNaP sessions, tailoring SNaP to participants’ specific needs, and conducting SNaP-style counseling for all clients. Facilitators of sustainment included leadership directives to clinic staff around SNaP sustainment, clinicians’ belief in SNaP's effectiveness, and SNaP's perceived fit with clinic activities and mission. Major barriers to SNaP sustainment included lack of funding for PWID outreach activities, time, staff, training continuity, and systemic challenges with getting PWID into care, such as poverty and lack of transportation. Conclusions We identified the challenge of sustaining the SNaP intervention long-term, the ubiquity of intervention adaptations, and multi-level barriers and facilitators to intervention sustainment. These findings demonstrate the need for sustainment strategies and could inform trials of strategies to improve the longevity of effective HIV interventions for populations that are disproportionately affected by this epidemic.Plain Language Summary Sustainment and Adaptation of an HIV Intervention across HIV Testing Clinics in Vietnam: A Qualitative Assessment. Background: Few evidence-based interventions have been successfully scaled up and sustained long-term. Within a trial testing strategies for scale-up of the Systems Navigation and Psychosocial Counseling (SNaP) intervention for people who inject drugs (PWID) with HIV across HIV testing clinics in Vietnam, we sought to assess if the implementation of SNaP was sustained after study support ended and to identify factors, including adaptations, that affected SNaP sustainment. Method: In 42 SNaP clinics, we surveyed staff to assess SNaP sustainment. We selected six high and six low-sustaining clinics and conducted 31 interviews with staff (n = 23) and directors (n = 8). Interviews were coded and analyzed to identify themes, informed by a framework called Integrated Sustainability Framework. We also compared themes across high and low-sustaining clinics. Results: 1/12 clinics sustained all the essential elements of SNaP, 2/12 would continue to sustain SNaP if they had new PWID patients, and the remainder did not fully sustain SNaP but continued conducting a modified version, including shorter or fewer SNaP sessions, tailoring SNaP to participants’ needs, and conducting SNaP-style counseling for all clients. Sustainment facilitators included leadership directives to staff around SNaP sustainment, clinicians’ belief in SNaP’s effectiveness, and SNaP’s perceived fit with clinic activities and mission. SNaP sustainment barriers included lack of funding for PWID outreach, time, staff, training continuity, and challenges with getting PWID into care, such as poverty and lack of transportation. Conclusions: We identified the challenge of sustaining SNaP long-term, the ubiquity of intervention adaptations, and barriers and facilitators to intervention sustainment. These findings demonstrate the need for sustainment strategies and could inform trials of strategies to improve the longevity of effective HIV interventions for populations that are disproportionately affected by this epidemic
Carolina Blue Honors Fellowship Reflection
No full textA reflection on my time as a Carolina Blue Honors Fellow working as a data analyst in Hiroshima Japan for a baseball team in the summer of 2024
Pharmacokinetic interaction assessment of an HIV broadly neutralizing monoclonal antibody VRC07-523LS: a cross-protocol analysis of three phase 1 trials in people without HIV
Get PDFVRC07-523LS is a safe and well-tolerated monoclonal antibody (mAb) targeting the CD4 binding site on the HIV envelope (Env) trimer. Efficacy of VRC07-523LS, in combination with mAbs targeting other HIV epitopes, will be evaluated in upcoming trials to prevent HIV acquisition in adults. However, differences in the pharmacokinetics (PK) of VRC07-523LS when administered alone vs. in combination with other mAbs have not been formally assessed. We performed a cross-protocol analysis of three clinical trials and included data from a total of 146 adults without HIV who received intravenous (n = 95) or subcutaneous (n = 51) VRC07-523LS, either alone (‘single’; n = 100) or in combination with 1 or 2 other mAbs (‘combined’; n = 46). We used an open, two-compartment population PK model to describe serum concentrations of VRC07-523LS over time, accounting for inter-individual variabilities. We compared individual-level PK parameters between the combined vs. single groups using the targeted maximum likelihood estimation method to adjust for participant characteristics. No significant differences were observed in clearance rate, inter-compartmental clearance, distribution half-life, or total VRC07-523LS exposure over time. However, for the combined group, mean central volume of distribution, peripheral volume of distribution, and elimination half-life were slightly greater, corresponding to slightly lower predicted concentrations early post-administration with high levels being maintained in both groups. These results suggest potential PK interactions between VRC07-523LS and other mAbs, but with small clinical impact in the context of HIV prevention. Our findings support coadministration of VRC07-523LS with other mAbs, and the use of the developed PK models to design future trials for HIV prevention
Opportunities and Challenges in Using Electronic Health Record Systems to Study Postacute Sequelae of SARS-CoV-2 Infection: Insights From the NIH RECOVER Initiative
Get PDFThe benefits and challenges of electronic health records (EHRs) as data sources for clinical and epidemiologic research have been well described. However, several factors are important to consider when using EHR data to study novel, emerging, and multifaceted conditions such as postacute sequelae of SARS-CoV-2 infection or long COVID. In this article, we present opportunities and challenges of using EHR data to improve our understanding of long COVID, based on lessons learned from the National Institutes of Health (NIH)-funded RECOVER (REsearching COVID to Enhance Recovery) Initiative, and suggest steps to maximize the usefulness of EHR data when performing long COVID research
TAME 2.0: expanding and improving online data science training for environmental health research
Get PDFData science training has the potential to propel environmental health research efforts into territories that remain untapped and holds immense promise to change our understanding of human health and the environment. Though data science training resources are expanding, they are still limited in terms of public accessibility, user friendliness, breadth of content, tangibility through real-world examples, and applicability to the field of environmental health science. To fill this gap, we developed an environmental health data science training resource, the inTelligence And Machine lEarning (TAME) Toolkit, version 2.0 (TAME 2.0). TAME 2.0 is a publicly available website that includes training modules organized into seven chapters. Training topics were prioritized based upon ongoing engagement with trainees, professional colleague feedback, and emerging topics in the field of environmental health research (e.g., artificial intelligence and machine learning). TAME 2.0 is a significant expansion upon the original TAME training resource pilot. TAME 2.0 specifically includes training organized into the following chapters: (1) Data management to enable scientific collaborations; (2) Coding in R; (3) Basics of data analysis and visualizations; (4) Converting wet lab data into dry lab analyses; (5) Machine learning; (6) Applications in toxicology and exposure science; and (7) Environmental health database mining. Also new to TAME 2.0 are “Test Your Knowledge” activities at the end of each training module, in which participants are asked additional module-specific questions about the example datasets and apply skills introduced in the module to answer them. TAME 2.0 effectiveness was evaluated via participant surveys during graduate-level workshops and coursework, as well as undergraduate-level summer research training events, and suggested edits were incorporated while overall metrics of effectiveness were quantified. Collectively, TAME 2.0 now serves as a valuable resource to address the growing demand of increased data science training in environmental health research. TAME 2.0 is publicly available at: https://uncsrp.github.io/TAME2/