University of the Virgin Islands

ABSTRACT This article provides two examples (an external and an internal evaluation with the NSF INCLUDES SEAS Islands Alliance) of a people‐centered approach to evaluation. We review how we came to our people‐centered approaches and how we used that approach in this particular context. First, we discuss an external evaluation of the Alliance examining relationships among Alliance members and with their community partners, and then we offer a discussion of the internal evaluation strategy used to better understand relationships within the Alliance. There were some differences, as well as many commonalities, in the way we, as evaluators, approached building authentic relationships that valued the context and the Alliance members. We contend that, regardless of an evaluation's goals, there are ways to incorporate people‐centered evaluation approaches into evaluation work .

Ocean warming threatens the persistence of tropical corals and the biologically diverse ecosystems they sustain. While field-based studies on heat impact have predominantly focused on quantifying coral bleaching, a symptom of thermal stress, less attention has been given to understanding trends in coral mortality, a critical metric for assessing and predicting the long-term effects of rising temperatures. Consequently, the relationships between varying heat exposures and resultant coral cover changes remain poorly quantified. Such trends are challenging to establish in the Tropical and Subtropical Western Atlantic (TWA), because climate change impacts are compounded by local anthropogenic and natural disturbances. Additionally, many coral communities have already been substantially altered, with those remaining dominated by relatively resilient species. This study addresses this issue by quantifying coral cover loss as a function of maximum Degree Heating Weeks (DHW) exposure using observed in-situ coral cover changes across reefs in the TWA. Of the five locations assessed (the Florida Keys, Dry Tortugas, Puerto Rico, the US Virgin Islands, and the East and West Flower Garden Banks), all exhibited significant declines in mean coral cover with increasing DHW exposure. Rates ranged from 0.3% to 2.4% annual loss in relative mean cover per unit DHW, with spatial variability largely reflecting pre-impact system conditions and variations in the life-history traits of geographically distinct coral assemblages (e.g., Puerto Rico vs East and West Flower Garden Banks). Variation in responses to DHW among species was also observed across locations. By establishing site-specific coral loss parameters, this study contributes to our understanding of how future coral cover may evolve under escalating thermal stress in the TWA. It also provides practical guidance for targeted restoration by identifying species that have fared comparatively well across locations, grounding efforts in what is possible under current and future conditions rather than idealised historical baselines.

The Caribbean region suffers from a high burden of diabetes and diabetes-associated mortality. Despite the evidence for diabetes prevention programs, there have been very few such initiatives in the region. To address this gap, we describe the effectiveness and implementation of the Lifestyle Intervention and Metformin Escalation (LIME) Clinical Trial in reducing the risk of diabetes among individuals with pre-diabetes in the Caribbean. LIME is a quasi-experimental pre-post study that took place between 2018 and 2021. LIME recruited individuals with high-risk pre-diabetes (hemoglobin A1c (HbA1c) between 6.0 and 6.4%) across clinical sites in Barbados, Trinidad and Tobago, Puerto Rico, and the US Virgin Islands. Eligible participants were enrolled in a 6-week lifestyle modification workshop. Six months later, individuals who did not lose at least 5% of their bodyweight or had an HbA1c of 6% or higher were prescribed metformin medication. The primary outcome was a change in HbA1c at 6- and 12-months. Paired t-test and McNemar's test were used to examine change in primary outcome. Implementation outcomes of reach, adoption, and implementation fidelity were assessed using programmatic data. Of 914 individuals screened, 211 (23%) had high-risk pre-diabetes. Of those, 114 enrolled in the study (54% Reach). At the 6-month follow-up, there was a significant reduction in average HbA1c from 6.19% to 5.95% (p < 0.001), average weight from 86.7kg to 85kg (p < 0.001), with a reduction in added sugar intake from 7.3 tsp/day to 3.8 tsp/day (p < 0.0001) but no significant change in physical activity level or fruit and vegetable intake. Reduction in HbA1c (6.19% to 5.67%, p < 0.0001) and weight (85.1kg to 83.7kg, p = 0.0149) was maintained at 12 months. Trained facilitators variably engaged in leading workshops (adoption 25%-100%), and were 100% adherent to the protocol (fidelity). LIME is an effective diabetes prevention intervention for individuals with pre-diabetes in the Caribbean. Future work should investigate approaches to improve reach (eligible participant engagement) and adoption (participation of trained facilitators), and report on cost-effectiveness to inform scale-up of the intervention. clinicaltrials.gov NCT03258723 (23/08/2017).

Chemical communication is one of the most important capabilities of zooplankton, yet it remains understudied. We report observations of marine parasitic isopods Gnathia marleyi and coral larvae Orbicella faveolata in an aquatic olfactometer where individuals can respond to chemical signals from host fish species and crustose coralline algae, respectively. We complement these observations with a gradient search model inspired by the theory of Braitenberg vehicles. The mathematical model allows the agent to switch between periods of motion and periods of rest, guided by the behavior of G. marleyi. We further implement a temporary coupling of the agent to the signal gradient, interspersed with periods of seemingly aimless wandering. We find a favorable comparison between the experimental and simulated trajectories. This study gives us further insight on the chemosensory behavior of ecologically important marine invertebrates using novel instrumentation and methodology and is the first to attempt to model the chemosensory behavior of these two groups of aquatic invertebrates. Further research should seek to observe and model their behavior in three-dimensional space.

The crucial role of coastal wetlands supporting diverse terrestrial wildlife is often asserted but has not been demonstrated in broad-scale field evaluations; a comprehensive assessment of wildlife use of these vital habitats is therefore needed. Our

Abstract Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder with significant implications for educational attainment. Previous research has established a bidirectional relationship between ADHD symptoms and academic outcomes, but the underlying mechanisms remain poorly understood. This study employs a novel Random Intercept Cross-Lagged Panel Model (RI-CLPM) incorporating instrumental variables to improve precision of bidirectional effects estimation between ADHD and educational performance. Utilizing a large, longitudinal dataset from the Adolescent Brain and Cognitive Development Study (ABCD Study®), we examine the reciprocal influences between ADHD symptoms and academic achievement across multiple time points. Our findings reveal significant within-wave bidirectional effects, with ADHD symptoms negatively impacting subsequent academic attainment, and poor academic outcomes exacerbating ADHD symptoms over time. These results underscore the need for integrated interventions targeting both ADHD symptoms and academic support.

Abstract Chemical communication is one of the most important capabilities of zooplankton, yet it remains understudied. We report observations of marine parasitic isopods Gnathia marleyi and coral larvae Orbicella faveolata in an aquatic olfactometer where individuals can respond to chemical signals from host fish species and crustose coralline algae, respectively. We complement these observations with a gradient search model inspired by the theory of Braitenberg vehicles. The mathematical model allows the agent to switch between periods of motion and periods of rest, guided by the behavior of G. marleyi. We further implement a temporary coupling of the agent to the signal gradient, interspersed with periods of seemingly aimless wandering. We find a favorable comparison between the experimental and simulated trajectories. This study gives us further insight on the chemosensory behavior of ecologically important marine invertebrates using novel instrumentation and methodology and is the first to attempt to model the chemosensory behavior of these two groups of aquatic invertebrates. Further research should seek to observe and model their behavior in three-dimensional space.

This study aimed to quantify prevalence, awareness, and control of hypertension in the Eastern Caribbean and identify sociodemographic correlates. Baseline data (2013-2018) from the Eastern Caribbean Health Outcomes Research Network Cohort Study (ECS) was used (n=2961). The ECS is an ongoing longitudinal study of community-dwelling persons 40 years and older conducted in Barbados, Puerto Rico, Trinidad and Tobago, and U.S. Virgin Islands. Participants completed a self-administered health survey, clinical examination, and laboratory testing. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) guidelines defined hypertension prevalence and control. Self-reported hypertension and clinical blood pressure values defined awareness. Binomial proportions, including 95% confidence intervals and logistic regression, were used for analyses. Analyses included 2932 participants with complete data. The mean age of participants was 57 (SD=10.3) years, and 65.3% (n=1916/2932) were women. Prevalence of hypertension was 57.9% (n=1698/2932), among whom 36.8% (n=591/1698) were unaware, and 56.4 percent (n=624/1107) of aware persons lacked control. Persons who were 70 and older (82.9%, n=325/392, 95% CI:79.2%-86.6%), had low educational attainment (63.4%, n=642/1012, 95% CI:60.5%-66.4%), obese (67.2%, n=753/1121, 95% CI:64.4%-69.9%), and low physical activity (63.3%, n=766/1210, 95% CI:60.6%-66.0%) had the highest prevalences of hypertension. Awareness was highest among persons 70 and older (76.6%, n=249/325, 95% CI:72.0%-81.2%), women (70.7%, n=781/1104, 95% CI:68.1%-73.4%), and those with a usual source of healthcare (70.4%, n=1042/1480, 95% CI:68.1%-72.7%). Persons with lower educational attainment had lowest control across sociodemographic groups (36.1%, n=154/427, 95% CI:31.5%-40.6%). Multivariable results showed ages 70 and older (OR=10.6, 95% CI:7.4-15.2) and obesity (OR=4.0, 95% CI:3.1-5.1) were the strongest predictors of hypertension. Usual source of care (OR=5.66, 95% CI:3.8-8.4) and ages 70 and older (OR=4.2, 95% CI:2.7-6.5) were most strongly associated with awareness. Results for control were not statistically significant. Findings highlight challenges across the hypertension care cascade in the Eastern Caribbean, particularly with control. These findings have implications for public health and healthcare system solutions to improve screening and blood pressure control. National Heart, Lung, and Blood Institute Award--1K01HL145347-01A1, National Institute on Minority Health and Health Disparities (Yale-TCC)--U54MD010711, and National Institute on Minority Health and Health Disparities through the Eastern Caribbean Health Outcomes Research Network (ECHORN)--U24MD006939.