Medical College of Wisconsin
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CURRICULUM VITAE

Aprill Z. Dawson PhD, MPH
Assistant Professor
Department of Medicine
Division of General Internal Medicine


OFFICE ADDRESS:
Medical Education Building
8701 Watertown Plank Rd
Milwaukee, WI 53226

EDUCATION:
08/1999 - 05/2003 B.S., Xavier University of Louisiana, New Orleans, LA
01/2005 - 08/2007 M.P.H., University of Texas Health Science Center, Houston, TX
08/2015 - 12/2018 Ph.D., Medical University of South Carolina, Charleston, SC

FACULTY APPOINTMENTS:
07/2019 - Present Assistant Professor, Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226

AWARDS AND HONORS:
11/2019 Outstanding Graduate School Educator for academic year 2018 - 2019
11/2020 Outstanding Graduate School Educator for academic year 2019 - 2020
10/2021 Gerontological Society of America Mentoring and Career Development Technical Assistance Workshop Diversity Fellow Award
11/2021 Outstanding Graduate School Educator for academic year 2020 - 2021
08/2022 Kendall Research Gift Award

MEMBERSHIPS IN HONORARY AND PROFESSIONAL SOCIETIES:
01/2018 - Present Society of General Internal Medicine
01/2018 - Present American Diabetes Association
10/2021 - Present Gerontological Society of America

EDITORSHIPS/EDITORIAL BOARDS/JOURNAL REVIEWS:
Editorial Board
06/2023 - Present Guest Editor - Behavioral Sciences
10/2023 - Present Editorial Board Member - BMC Public Health
06/2024 - Present Associate Editor - Journal of General Internal Medicine

RESEARCH GRANTS/AWARDS/CONTRACTS/PROJECTS:
Active
Peer Review
Title:
Combined diabetes education/skills training and social needs resolution intervention for older African Americans with poorly controlled type 2 diabetes (DM Social Needs)
Source:
American Diabetes Association Career Development Award
Role & Effort:
Principal Investigator
Dates:
11/15/2022 - 11/14/2025
Direct Funds:
$443,994
  
Title:
Joint Patient and Caregiver Intervention for Older African Americans with Poorly Controlled Type 2 Diabetes (Joint Home-DM-BAT)
Source:
NIH NIDDK R21
Role & Effort:
Principal Investigator
Dates:
08/11/2023 - 07/31/2026
Direct Funds:
$393,678
  
Prior
Peer Review
Title:
Home-based Diabetes-Modified Behavioral Activation Treatment for Low Income Seniors with T2DM (HOME DM-BAT)
Source:
NIH NIDDK R01
Role & Effort:
Diversity Supplement Recipient
Dates:
02/13/2020 - 02/12/2022
Direct Funds:
$277,156 (The goal of this study was to test the effectiveness of an in-home, group-based, manualized diabetes-modified behavioral activation treatment delivered by trained diabetes nurse educators in independent senior housing, senior centers, and subsidized senior housing centers in low income and high minority zip codes in Milwaukee.)
  
Title:
Home-based Diabetes-Modified Behavioral Activation Treatment for Elderly Minorities with Uncontrolled Type 2 Diabetes (HOME DM-BAT)
Source:
NIH NIDDK Loan Repayment Program
Role & Effort:
Principal Investigator
Dates:
07/2021 - 06/2023
Direct Funds:
$100,000 (The goal of this study was to understand the association between cognitive impairment, functional limitations, and clinical and behavioral outcomes in elderly minorities with poorly controlled type 2 diabetes. )
  


BIBLIOGRAPHY
Refereed Journal Publications/Original Papers
1. Dawson AZ, Walker RJ, Campbell JA, Egede LE. Effect of perceived racial discrimination on self-care behaviors, glycemic control, and quality of life in adults with type 2 diabetes. Endocrine. 2015 Jun;49(2):422-8. PMCID: PMC4440842
2. Achuko O, Walker RJ, Campbell JA, Dawson AZ, Egede LE. Pathways Between Discrimination and Quality of Life in Patients with Type 2 Diabetes. Diabetes Technol Ther. 2016 Mar;18(3):151-8. PMCID: PMC4790216
3. Dawson AZ, Walker RJ, Campbell JA, Egede LE. Effective strategies for global health training programs: a systematic review of training outcomes in low and middle income countries. Global Journal of Health Sciences. 2016; 8(11): 278-292. Doi: 10.5539/gjhs.v8n11p278. PMID: 27241428.
4. Dawson AZ, Walker RJ, Campbell JA, Egede LE. Validation of theoretical pathway between discrimination, diabetes self-care and glycemic control. J Diabetes Complications. 2016 Jul;30(5):858-63. PMCID: PMC7061439
5. Dawson AZ, Walker RJ, Egede LE. Differential Relationships Between Diabetes Knowledge Scales and Diabetes Outcomes. Diabetes Educ. 2017 Aug;43(4):360-366. PMCID: PMC7029816
6. Simmons M, Bishu KG, Williams JS, Walker RJ, Dawson AZ, Egede LE. Racial and Ethnic Differences in Out-of-Pocket Expenses among Adults with Diabetes. J Natl Med Assoc. 2019 Feb;111(1):28-36. PMCID: PMC7995684
7. Tefera YA, Bishu KG, Gebregziabher M, Dawson AZ, Egede LE. Source of Education, Source of Care, Access to Glucometers, and Independent Correlates of Diabetes Knowledge in Ethiopian Adults with Diabetes. J Natl Med Assoc. 2019 Apr;111(2):218-230.
8. Campbell JA, Walker RJ, Dawson AZ, Egede LE. Prevalence of Diabetes, Prediabetes, and Obesity in the Indigenous Kuna Population of Panamá. J Racial Ethn Health Disparities. 2019 Aug;6(4):743-751.
9. Walker RJ, Campbell JA, Dawson AZ, Egede LE. Prevalence of psychological distress, depression and suicidal ideation in an indigenous population in Panamá. Soc Psychiatry Psychiatr Epidemiol. 2019 Oct;54(10):1199-1207. PMCID: PMC6790172
10. Hanna DR, Walker RJ, Smalls BL, Campbell JA, Dawson AZ, Egede LE. Prevalence and correlates of diagnosed and undiagnosed hypertension in the indigenous Kuna population of Panamá. BMC Public Health. 2019 Jun 28;19(1):843. PMCID: PMC6599360
11. Dawson AZ, Walker RJ, Gregory C, Egede LE. Relationship between social determinants of health and systolic blood pressure in United States immigrants. International Journal of Cardiology- Hypertension. August 2019
12. Neitzel AL, Smalls BL, Walker RJ, Dawson AZ, Campbell JA, Egede LE. Examination of dietary habits among the indigenous Kuna Indians of Panama. Nutr J. 2019 Aug 01;18(1):44. PMCID: PMC6670206
13. Dawson AZ, Walker RJ, Gregory C, Egede LE. Examination of the Association Between Latent Variables for Social Determinants of Health and Blood Pressure Control in Immigrants using Structural Equation Modeling. J Natl Med Assoc. 2020 Apr;112(2):186-197. PMCID: PMC7253342
14. Spector AL, Nagavally S, Dawson AZ, Walker RJ, Egede LE. Examining racial and ethnic trends and differences in annual healthcare expenditures among a nationally representative sample of adults with arthritis from 2008 to 2016. BMC Health Serv Res. 2020 Jun 12;20(1):531. PMCID: PMC7291726
15. Ikonte CO, Prigmore HL, Dawson AZ, Egede LE. Trends in prevalence of depression and serious psychological distress in United States immigrant and non-immigrant populations, 2010 – 2016 Journal of Affective Disorders. September 2020; 274:719-725.
16. Dawson AZ, Walker RJ, Campbell JA, Davidson TM, Egede LE. Telehealth and indigenous populations around the world: a systematic review on current modalities for physical and mental health. Mhealth. 2020;6:30. PMCID: PMC7327286
17. Ikonte CO, Prigmore HL, Dawson AZ, Egede LE. Trends in prevalence of depression and serious psychological distress in United States immigrant and non-immigrant populations, 2010 - 2016. J Affect Disord. 2020 Sep 01;274:719-725. PMCID: PMC7363966
18. Dawson AZ, Garacci E, Ozieh M, Walker RJ, Egede LE. The Relationship Between Immigration Status and Chronic Kidney Disease Risk Factors in Immigrants and US-Born Adults. J Immigr Minor Health. 2020 Dec;22(6):1200-1207. PMCID: PMC7686246
19. Dawson AZ, Bishu KG, Walker RJ, Egede LE. Trends in Medical Expenditures by Race/Ethnicity in Adults with Type 2 Diabetes 2002-2011. J Natl Med Assoc. 2021 Feb;113(1):59-68. PMCID: PMC7865019
20. Egede LE, Walker RJ, Campbell JA, Dawson AZ, Davidson T. A New Paradigm for Addressing Health Disparities in Inner-City Environments: Adopting a Disaster Zone Approach. J Racial Ethn Health Disparities. 2021 Jun;8(3):690-697. PMCID: PMC7878568
21. Walker RJ, Garacci E, Dawson AZ, Williams JS, Ozieh M, Egede LE. Trends in Food Insecurity in the United States from 2011-2017: Disparities by Age, Sex, Race/Ethnicity, and Income. Popul Health Manag. 2021 Aug;24(4):496-501. PMCID: PMC8403212
22. Campbell JA, Walker RJ, Garacci E, Dawson AZ, Williams JS, Egede LE. Relationship between adverse childhood experiences and perceived discrimination in adulthood. J Affect Disord. 2020 Dec 01;277:999-1004. PMCID: PMC7574677
23. Bhandari S, Dawson AZ, Walker RJ, Egede LE. Elderly African Americans: The vulnerable of the vulnerable in the COVID-19 era. Aging Med (Milton). 2020 Dec;3(4):234-236. PMCID: PMC7771566
24. Egede LE, Walker RJ, Dawson AZ, Williams JS, Campbell JA, Ozieh MN, Palatnik A. Team Science, Population Health, and COVID-19: Lessons Learned Adapting a Population Health Research Team to COVID-19. J Gen Intern Med. 2021 May;36(5):1407-1410. PMCID: PMC7822580
25. Egede LE, Campbell JA, Walker RJ, Dawson AZ, Williams JS. Financial incentives to improve glycemic control in African American adults with type 2 diabetes: a pilot randomized controlled trial. BMC Health Serv Res. 2021 Jan 13;21(1):57. PMCID: PMC7803385
26. Egede J, Campbell JA, Walker RJ, Garacci E, Dawson AZ, Egede LE. Relationship between physical and mental health comorbidities and COVID-19 positivity, hospitalization, and mortality Journal of Affective Disorders. 15 March 2021;283:94-100.
27. Hilgeman B, Egede L, Silverstein R, Kastner M, Stulac-Motzel W, Dawson A, Walker R, Simms A, Ayala K, MacKinney T. Details of developing and implementing an intensive interdisciplinary care program for high need, high cost patients. Healthc (Amst). 2021 Jun;9(2):100452.
28. Shour A, Garacci E, Palatnik A, Dawson AZ, Anguzu R, Walker RJ, Egede L. Association between pregestational diabetes and mortality among appropriate-for-gestational age birthweight infants. J Matern Fetal Neonatal Med. 2022 Dec;35(25):5291-5300. PMCID: PMC8324595
29. Dawson AZ, Walker RJ, Gregory C, Egede LE. Relationship between social determinants of health and systolic blood pressure in United States immigrants. Int J Cardiol Hypertens. 2019 Aug;2:100011. PMCID: PMC7803058
30. Dawson AZ, Walker RJ, Gregory C, Egede LE. Quantifying direct effects of social determinants of health on systolic blood pressure in United States adult immigrants. J Behav Med. 2021 Jun;44(3):345-354. PMCID: PMC8131216
31. Egede J, Campbell JA, Walker RJ, Garacci E, Dawson AZ, Egede LE. Relationship between physical and mental health comorbidities and COVID-19 positivity, hospitalization, and mortality. J Affect Disord. 2021 Mar 15;283:94-100. PMCID: PMC7830241
32. Dawson AZ, Walker RJ, Gregory C, Egede LE. Contributions of social determinants of health to systolic blood pressure in United States adult immigrants: Use of path analysis to validate a conceptual framework. Chronic Illn. 2022 Dec;18(4):757-769. PMCID: PMC8443685
33. Egede LE, Walker RJ, Dismuke-Greer CE, Pyzyk S, Dawson AZ, Williams JS, Campbell JA. Cost-effectiveness of financial incentives to improve glycemic control in adults with diabetes: A pilot randomized controlled trial. PLoS One. 2021;16(3):e0248762. PMCID: PMC7971847
34. Anguzu R, Nagavally S, Dawson AZ, Walker RJ, Egede LE. Age and Gender Differences in Trends and Impact of Depression on Quality of Life in the United States, 2008 to 2016. Womens Health Issues. 2021;31(4):353-365. PMCID: PMC8260438
35. Gliedt JA, Walker RJ, Lu K, Dawson AZ, Egede LE. The Relationship Between Patient Satisfaction and Healthcare Expenditures in Adults with Spine Related Disorders: An Analysis of the 2008 to 2015 Medical Expenditures Panel Survey (MEPS). Spine (Phila Pa 1976). 2021 Oct 15;46(20):1409-1417. PMCID: PMC8463412
36. Dawson AZ, Segon A, Levine D, Nagavally S, Walker RJ, Egede LE. Location Matters: Type of Hospital Unit Can Influence Medicine Patients' Satisfaction with Physician Communication. Am J Med Qual. 2021 May-Jun 01;36(3):180-184.
37. Mendez CE, Walker RJ, Dawson AZ, Lu K, Egede LE. Using a Diabetes Risk Score to Identify Patients Without Diabetes at Risk for New Hyperglycemia in the Hospital. Endocr Pract. 2021 Aug;27(8):807-812. PMCID: PMC8608267
38. Egede LE, Walker RJ, Monroe P, Williams JS, Campbell JA, Dawson AZ. HIV and cardiovascular disease in sub-Saharan Africa: Demographic and Health Survey data for 4 countries BMC Public Health. December 2021;21(1).
39. Egede C, Dawson AZ, Walker RJ, Garacci E, Campbell JA, Egede LE. Relationship between mental health diagnoses and COVID-19 test positivity, hospitalization, and mortality in Southeast Wisconsin. Psychol Med. 2023 Feb;53(3):927-935. PMCID: PMC8185414
40. Dawson AZ, Walker RJ, Campbell JA, Williams JS, Egede LE. Prevalence and sociodemographic correlates of diabetes among adults in Namibia and South Africa Journal of the National Medical Association. 2021.
41. Walker RJ, Dawson AZ, Campbell JA, Egede LE. Prevalence of food insecurity and association with mental health in an indigenous population in Panamá. Public Health Nutr. 2021 Dec;24(17):5869-5876. PMCID: PMC10195598
42. Egede LE, Dawson AZ, Walker RJ, Garraci E, Knapp RG. Randomized controlled trial of technology-assisted case management in low-income adults with type 2 diabetes: Effect on quality of life and blood pressure. J Telemed Telecare. 2024 Jan;30(1):107-115.
43. Dawson AZ, Walker RJ, Campbell JA, Williams JS, Egede LE. Prevalence and sociodemographic correlates of diabetes among adults in Namibia and South Africa. J Natl Med Assoc. 2022 Jan;113(6):636-644. PMCID: PMC8702571
44. Egede LE, Walker RJ, Monroe P, Williams JS, Campbell JA, Dawson AZ. HIV and cardiovascular disease in sub-Saharan Africa: Demographic and Health Survey data for 4 countries. BMC Public Health. 2021 Jun 12;21(1):1122. PMCID: PMC8196536
45. Hanna DR, Campbell JA, Walker RJ, Dawson AZ, Egede LE. Association between Health and Wealth among Kenyan Adults with Hypertension. Glob J Health Sci. 2021;13(4):86-94. PMCID: PMC8188623
46. Egede LE, Davidson TM, Knapp RG, Walker RJ, Williams JS, Dismuke CE, Dawson AZ. HOME DM-BAT: home-based diabetes-modified behavioral activation treatment for low-income seniors with type 2 diabetes-study protocol for a randomized controlled trial. Trials. 2021 Nov 08;22(1):787. PMCID: PMC8574935
47. Martinez M, Dawson AZ, Lu K, Walker RJ, Egede LE. Effect of cognitive impairment on risk of death in Hispanic/Latino adults over the age of 50 residing in the United States with and without diabetes: Data from the Health and Retirement Study 1995-2014. Alzheimers Dement. 2022 Sep;18(9):1616-1624. PMCID: PMC9170835
48. Obaoye JO, Dawson AZ, Thakkar M, Williams JS, Egede LE. Understanding the relationship between perceived discrimination and mortality in United States adults. Aging Ment Health. 2023 Feb;27(2):445-451. PMCID: PMC9349476
49. Egede LE, Walker RJ, Dawson AZ, Zosel A, Bhandari S, Nagavally S, Martin I, Frank M. Short-term impact of COVID-19 on quality of life, perceived stress, and serious psychological distress in an adult population in the midwest United States. Qual Life Res. 2022 Aug;31(8):2387-2396. PMCID: PMC8753941
50. O'Toole SM, Walker RJ, Garacci E, Dawson AZ, Campbell JA, Egede LE. Explanatory role of sociodemographic, clinical, behavioral, and social factors on cognitive decline in older adults with diabetes. BMC Geriatr. 2022 Jan 10;22(1):39. PMCID: PMC8751249
51. Gliedt JA, Dawson AZ, Daniels CJ, Spector AL, Cupler ZA, King J, Egede LE. Manual therapy interventions in the management of adults with prior cervical spine surgery for degenerative conditions: a scoping review. Chiropr Man Therap. 2022 Mar 07;30(1):13. PMCID: PMC8900329
52. Bhasin B, Veitla V, Dawson AZ, Garacci Z, Sturgill D, Ozieh MN, Regner KR. AKI in Hospitalized Patients with COVID-19 and Seasonal Influenza: A Comparative Analysis. Kidney360. 2021 Apr 29;2(4):619-628. PMCID: PMC8791326
53. Renta V, Walker RJ, Nagavally S, Dawson AZ, Campbell JA, Egede LE. Differences in the relationship between social capital and hypertension in emerging vs. established economies in Sub-Saharan Africa. BMC Public Health. 2022 May 24;22(1):1038. PMCID: PMC9128267
54. Bhandari S, Dawson AZ, Kobylarz Z, Walker RJ, Egede LE. Interventions to Reduce Hospital Readmissions in Older African Americans: A Systematic Review of Studies Including African American Patients. J Racial Ethn Health Disparities. 2023 Aug;10(4):1962-1977. PMCID: PMC9889568
55. Egede LE, Walker RJ, Linde S, Campbell JA, Dawson AZ, Williams JS, Ozieh MN. Nonmedical Interventions For Type 2 Diabetes: Evidence, Actionable Strategies, And Policy Opportunities. Health Aff (Millwood). 2022 Jul;41(7):963-970. PMCID: PMC9563395
56. Walker SL, Williams JS, Lu K, Dawson AZ, Egede LE. Trends in Healthcare Expenditures among Adults in the United States by Cancer Diagnosis Status, 2008-2016: A Cross-Sectional Study. Cancer Epidemiol Biomarkers Prev. 2022 Aug 02;31(8):1661-1668. PMCID: PMC9348759
57. Shay LA, Schmidt S, Thurston AJ, Campbell JA, Dawson AZ, Egede LE, Ozieh MN, Phillips SA, Walker RJ, Williams JS, Tsevat J. Advancing diversity, equity, and inclusion within clinical and translational science training programs: A qualitative content analysis of the training breakout session at the national CTSA program meeting. J Clin Transl Sci. 2022;6(1):e110. PMCID: PMC9549480
58. Obaoye JO, Dawson AZ, Thorgerson A, Ikonte CO, Williams JS, Egede LE. Understanding the relationship between perceived discrimination, allostatic load, and all-cause mortality in US older adults: A mediation analysis. J Am Geriatr Soc. 2023 May;71(5):1515-1525. PMCID: PMC10175160
59. Campbell JA, Walker RJ, Dawson AZ, Ozieh MN, Schmidt S, Shay LA, Williams JS, Phillips SA, Egede LE. Feasibility, impact, and priority of key strategies to enhance diverse and inclusive training programs in clinical and translational research: A mixed methods study. J Clin Transl Sci. 2023;7(1):e16. PMCID: PMC9884544
60. Bhandari S, Campbell JA, Walker RJ, Thorgerson A, Dawson AZ, Egede LE. Dose response relationship between food insecurity and quality of life in United States adults: 2016-2017. Health Qual Life Outcomes. 2023 Mar 08;21(1):21. PMCID: PMC9997014
61. Williams JS, Walker RJ, Burgess KM, Shay LA, Schmidt S, Tsevat J, Campbell JA, Dawson AZ, Ozieh MN, Phillips SA, Egede LE. Mentoring strategies to support diversity in research-focused junior faculty: A scoping review. J Clin Transl Sci. 2023;7(1):e21. PMCID: PMC9879913
62. Walker SL, Walker RJ, Palatnik A, Dawson AZ, Williams JS, Egede LE. Examining the Relationship between Social Determinants of Health and Adverse Pregnancy Outcomes in Black Women. Am J Perinatol. 2024 May;41(S 01):e2326-e2335. PMCID: PMC10799964
63. Conroy M, Kamaraju S, Powell M, Harris A, Beckius A, Nagavally S, Dawson A, Min H, Wright T, Wainaina N, Binder AF. Racial and Ethnic Differences in the Use of Electronic Medical Record Messaging Among Patients With Breast Cancer: A Quality Improvement Study. Clin Breast Cancer. 2023 Oct;23(7):e434-e440.
64. Smith ZL, Thorgerson AM, Dawson AZ, Wani S. Incidence of Esophageal Adenocarcinoma, Mortality, and Esophagectomy in Barrett's Esophagus Patients Undergoing Endoscopic Eradication Therapy. Dig Dis Sci. 2023 Dec;68(12):4439-4448.
65. Walker RJ, Thorgerson AM, Yan A, Williams JS, Campbell JA, Dawson AZ, Renta V, Egede LE. Prevalence and correlates of pre-diabetes in Sub-Saharan Africa using Demographic and Health Survey Data: a cross-sectional study. BMJ Open. 2023 Oct 18;13(10):e069640. PMCID: PMC10603485
66. Walker RJ, Dawson AZ, Thorgerson A, Campbell JA, Engel S, Kastner M, Egede LE. Relationship between Satisfaction Scores and Racial/Ethnic and Sex Concordance in Primary Care. Healthcare (Basel). 2023 Aug 12;11(16). PMCID: PMC10454330
67. Dawson AZ, Hawks L, Walker RJ, Egede LE. Differential Effect of Patient- and Provider-Level Factors on Patient Satisfaction Scores in Academic General Internal Medicine Clinics. J Gen Intern Med. 2024 Sep;39(12):2261-2267. PMCID: PMC11347540
68. Papadimitriou A, Dawson AZ, Thorgerson A, Bhandari S, Martinez M, Egede LE. Understanding the Relationship Between Wealth and Cognitive Function by Race/Ethnicity Among Older United States Adults with Diabetes. J Alzheimers Dis. 2024;98(3):1145-1155.
69. Hamid A, Dawson AZ, Xu Y, Egede LE. Independent Correlates of Glycemic Control among Adults with Diabetes in South Africa. Int J Environ Res Public Health. 2024 Apr 16;21(4). PMCID: PMC11050191
70. Marfowaa G, Campbell JA, Nagavally S, Dawson AZ, Walker RJ, Egede LE. (2024). Prevalence of diabetes and the relationship between wealth and social demographic characteristics across 6 low- and middle-income countries. Global Journal of Health Science. 16(4): 22-31.
71. Marfowaa G, Campbell JA, Nagavally S, Dawson AZ, Walker RJ, Egede LE. Prevalence of Diabetes and the Relationship Between Wealth and Social Demographic Characteristics Across 6 Low-and-Middle Income Countries. Glob J Health Sci. 2024;16(4):22-31. PMCID: PMC11419324
72. Dawson AZ, Walker RJ, Davidson TM, Knapp R, Egede LE. Combined Diabetes Education/Skills Training and Social Needs Resolution Intervention for Older African Americans with Poorly Controlled Type 2 Diabetes (DM Social Needs): Study Protocol for a Randomized Controlled Trial. Healthcare (Basel). 2024 Oct 06;12(19). PMCID: PMC11475830
 
Non-Refereed Journal Publications/Original Papers
1. Dawson AZ. Analyses of maternal and child mortality rates of five West African countries: Cote d'Ivoire, Guinea, Liberia, Senegal, Sierra Leone. Texas Medical Center Dissertations (via ProQuest). 2007 Jan; Paper AAl1444901. http://digitalcommons.library.tmc.edu/dissertations.AAl1444901.