About

Dr. Gregory Smith is an Assistant Professor at the UNC School of Medicine, specializing in the investigation of genetic and genomic mechanisms of susceptibility to airborne toxicants and related lung diseases such as asthma and COPD. His research combines systems genetics approaches with in vivo inhalation exposure models to study air pollutants like ozone. He manages the Kelada Lab inhalation exposure facility, which provides ozone and e-cigarette aerosol exposures, and is actively developing new capabilities for respiratory phenotyping and exposure assessment.

Research topics

• Political Science
• Sociology
• Medicine
• Psychology
• Computer Science
• Virology
• Gerontology
• Nursing
• Economic growth
• Economics
• Social Science
• Medical education
• Public relations
• Demography
• Development economics
• Law
• Gender studies
• Management science
• Knowledge management
• Social psychology
• Geography
• Psychiatry
• Engineering
• Applied psychology

Selected publications

• Evaluating Leadership Development Competencies of Clinicians to Build Health Equity in America

  UNC Libraries · 2025-02-06

  articleOpen access

  INTRODUCTION: To achieve more equitable health, health care must be grounded in an understanding of social determinants of health. Clinicians need hands-on, equity-centered training in interdisciplinary settings where they can further develop leadership skills and apply learnings in real-time. The Clinical Scholars program trained five cohorts of health care professionals in 25 leadership development competencies to contribute toward advancing health equity within the organizations and communities where they work. This study describes the self-reported ratings of three dimensions of competencies within four domains. METHODS: Data from 169 Fellows were collected at three time-points during the three-year training program using Qualtrics and Research Electronic Data Captrue software. Analysis was conducted in R and included descriptive statistics, fitting a linear mixed-effects model using random intercepts, and paired-sample t tests to assess significance between baseline and endpoint ratings. RESULTS: We found improved ratings over time for each of the three competency dimensions (knowledge, self-efficacy, use) and significant differences in ratings from baseline to endpoint, by domain (personal, interpersonal, organizational, community, and systems). DISCUSSION: These findings support the effectiveness of an equity-centered leadership development curriculum in training health care professionals to address health challenges in their communities and organizations, thereby furthering the broader goal of achieving more equitable health for all.

  PublisherDOI

• A Community-Engaged Research Approach to Improve Mental Health Among Latina Immigrants: ALMA Photovoice

  UNC Libraries · 2025-02-21

  articleOpen access

  Recent Latina immigrants are at increased risk of poor mental health due to stressors associated with adapting to life in the United States. Existing social and health care policies often do not adequately address the mental health concerns of new Latino populations. Amigas Latinas Motivando el Alma, a community-partnered research project, seeks to improve immigrant Latinas’ mental health outcomes. Using Photovoice methodology, promotoras (lay health advisors) reflected on community factors affecting mental health through photography and guided discussion. Discussions were audio-recorded, transcribed, and coded using content analysis to identify salient themes. Promotoras reviewed codes to develop themes that they presented in community forums to reach local policy makers and to increase community awareness. These forums included an exhibit of the promotoras’ photographs and discussion of action steps to address community concerns. Themes included transitioning to life in the United States, parenting, education, and combating racism. Nearly 150 stakeholders attended the community forums and proposed responses to promotoras’ photographic themes. Our findings suggest that Photovoice provides an opportunity for Latinas and the larger community to identify issues that they find most important and to explore avenues for action and change by creating sustainable partnerships between the community and forum attendees.

  PublisherDOI

• The potential impact of the Affordable Care Act and Medicaid expansion on reducing colorectal cancer screening disparities in African American males

  UNC Libraries · 2025-02-06

  articleOpen access

  Few investigations have explored the potential impact of the Affordable Care Act on health disparity outcomes in states that chose to forgo Medicaid expansion. Filling this evidence gap is pressing as Congress grapples with controversial healthcare legislation that could phase out Medicaid expansion. Colorectal cancer (CRC) is a commonly diagnosed, preventable cancer in the US that disproportionately burdens African American men and has substantial potential to be impacted by improved healthcare insurance coverage. Our objective was to estimate the impact of the Affordable Care Act (increasing insurance through health exchanges alone or with Medicaid expansion) on colorectal cancer outcomes and economic costs among African American and White males in North Carolina (NC), a state that did not expand Medicaid. We used an individual-based simulation model to estimate the impact of ACA (increasing insurance through health exchanges alone or with Medicaid expansion) on three CRC outcomes (screening, stage-specific incidence, and deaths) and economic costs among African American and White males in NC who were age-eligible for screening (between ages 50 and 75) during the study period, years of 2013-2023. Health exchanges and Medicaid expansion improved simulated CRC outcomes overall, though the impact was more substantial among AAs. Relative to health exchanges alone, Medicaid expansion would prevent between 7.1 to 25.5 CRC cases and 4.1 to 16.4 per 100,000 CRC cases among AA and White males, respectively. Our findings suggest policies that expanding affordable, quality healthcare coverage could have a demonstrable, cost-saving impact while reducing cancer disparities.

  PublisherDOI

• Concept mapping and evaluation of the Clinical Scholars healthcare leadership program: understanding what makes health a shared value

  Journal of Leadership Education · 2025-06-21

  articleOpen access

  Purpose As part of a formative evaluation of the Robert Wood Johnson Foundation’s (RWJF) healthcare leadership program Clinical Scholars, we used concept mapping to understand the factors that influence making health a shared value from the perspectives of program participants and, more broadly, provide a real-world example of concept mapping as an evaluation tool for healthcare leadership programs. Design/methodology/approach Twenty-six participants in their final year of the three-year leadership program addressed the focal prompt: “What components are essential for making health a shared value?” Participant-identified factors were then rated for their level of importance across three areas of importance determined by the evaluation team (i.e. mindsets and expectations civic engagement; sense of community). Point and cluster maps were generated through hierarchical cluster analyses to identify and understand the relationships between the identified factors and their subsequent ratings of importance. Findings A four-cluster solution best fit the data, with the following identified clusters: (1) Shared Understanding and Awareness of Health; (2) Big Picture Strategies and Growth Mindset; (3) Collaboration and Community Engagement and (4) Health Equity and Inclusion. Go-zone plots within each cluster were developed to best understand the relationship between the three previously identified areas of importance. Originality/value Participants were exposed to a wide range of health equity and leadership-related concepts and tools supporting the central concept of “how to create a Culture of Health (COH).” The four above-stated concepts emerged from the participants as a way to organize and focus their collective understanding as they reached the end of their training experience. Results from the concept mapping were aligned with the overall goals of the program and RWJF-led COH initiative.

  PublisherDOI

• Bibliometrics approach to evaluating the research impact of CTSAs: A pilot study

  UNC Libraries · 2025-02-13

  articleOpen access

  INTRODUCTION: To enhance the performance evaluation of Clinical and Translational Science Award (CTSA) hubs, we examined the utility of advanced bibliometric measures that go beyond simple publication counts to demonstrate the impact of translational research output. METHODS: The sampled data included North Carolina Translational and Clinical Science Institute (NC TraCS)-supported publications produced between September 2008 and March 2017. We adopted advanced bibliometric measures and a state-of-the-art bibliometric network analysis tool to assess research productivity, citation impact, the scope of research collaboration, and the clusters of research topics. RESULTS: Totally, 754 NC TraCS-supported publications generated over 24,000 citation counts by April 2017 with an average of 33 cites per article. NC TraCS-supported research papers received more than twice as many cites per year as the average National Institute of Health-funded research publications from the same field and time. We identified the top productive researchers and their networks within the CTSA hub. Findings demonstrated the impact of NC TraCS in facilitating interdisciplinary collaborations within the CTSA hub and across the CTSA consortium and connecting researchers with right peers and organizations. CONCLUSION: Both improved bibliometrics measures and bibliometric network analysis can bring new perspectives to CTSA evaluation via citation influence and the scope of research collaborations.

  PublisherDOI

• If you build it, will they use it? Use of a Digital Assistant for Self-Reporting of COVID-19 Rapid Antigen Test Results during Large Nationwide Community Testing Initiative

  UNC Libraries · 2025-02-21

  articleOpen access

  Importance: Wide-spread distribution of rapid-antigen tests is integral to the United States' strategy to address COVID-19; however, it is estimated that few rapid-antigen test results are reported to local departments of health. Objective: To characterize how often individuals in six communities throughout the United States used a digital assistant to log rapid-antigen test results and report them to their local Department of Health. Design: This prospective cohort study is based on anonymously collected data from the beneficiaries of The Say Yes! Covid Test program, which distributed 3,000,000 rapid antigen tests at no cost to residents of six communities between April and October 2021. We provide a descriptive evaluation of beneficiaries' use of digital assistant for logging and reporting their rapid antigen test results. Main outcome and measures: Number and proportion of tests logged and reported to the Department of Health through the digital assistant. Results: A total of 178,785 test kits were ordered by the digital assistant, and 14,398 households used the digital assistant to log 41,465 test results. Overall, a small proportion of beneficiaries used the digital assistant (8%), but over 75% of those who used it reported their rapid antigen test results to their state public health department. The reporting behavior varied between communities and was significantly different for communities that were incentivized for reporting test results (p < 0.001). In all communities, positive tests were less reported than negative tests (60.4% vs 75.5%; p<0.001). Conclusions and relevance: These results indicate that app-based reporting with incentives may be an effective way to increase reporting of rapid tests for COVID-19; however, increasing the adoption of the digital assistant is a critical first step.

  PublisherDOI

• Association of neighborhood-level sociodemographic factors with Direct-to-Consumer (DTC) distribution of COVID-19 rapid antigen tests in 5 US communities

  UNC Libraries · 2025-02-21

  articleOpen access

  Background: Many interventions for widescale distribution of rapid antigen tests for COVID-19 have utilized online, direct-to-consumer (DTC) ordering systems; however, little is known about the sociodemographic characteristics of home-test users. We aimed to characterize the patterns of online orders for rapid antigen tests and determine geospatial and temporal associations with neighborhood characteristics and community incidence of COVID-19, respectively. Methods: This observational study analyzed online, DTC orders for rapid antigen test kits from beneficiaries of the Say Yes! Covid Test program from March to November 2021 in five communities: Louisville, Kentucky; Indianapolis, Indiana; Fulton County, Georgia; O’ahu, Hawaii; and Ann Arbor/Ypsilanti, Michigan. Using spatial autoregressive models, we assessed the geospatial associations of test kit distribution with Census block-level education, income, age, population density, and racial distribution and Census tract-level Social Vulnerability Index. Lag association analyses were used to measure the association between online rapid antigen kit orders and community-level COVID-19 incidence. Results: In total, 164,402 DTC test kits were ordered during the intervention. Distribution of tests at all sites were significantly geospatially clustered at the block-group level (Moran’s I: p < 0.001); however, education, income, age, population density, race, and social vulnerability index were inconsistently associated with test orders across sites. In Michigan, Georgia, and Kentucky, there were strong associations between same-day COVID-19 incidence and test kit orders (Michigan: r = 0.89, Georgia: r = 0.85, Kentucky: r = 0.75). The incidence of COVID-19 during the current day and the previous 6-days increased current DTC orders by 9.0 (95% CI = 1.7, 16.3), 3.0 (95% CI = 1.3, 4.6), and 6.8 (95% CI = 3.4, 10.2) in Michigan, Georgia, and Kentucky, respectively. There was no same-day or 6-day lagged correlation between test kit orders and COVID-19 incidence in Indiana. Conclusions: Our findings suggest that online ordering is not associated with geospatial clustering based on sociodemographic characteristics. Observed temporal preferences for DTC ordering can guide public health messaging around DTC testing programs.

  PublisherDOI

• Factors influencing evidence-based cardiovascular disease prevention programming in rural African American communities: a community-engaged concept mapping study

  UNC Libraries · 2025-02-08

  articleOpen access
  PublisherDOI

• Developing a family-based diabetes program for Latino immigrants: Do men and women face the same barriers?

  UNC Libraries · 2025-02-21

  articleOpen access1st authorCorresponding

  This study examined barriers and facilitators to diabetes self-management among Latino immigrants with diabetes and whether similarities and differences were observed by gender. Eight focus groups were conducted with 24 women and 21 men Latinos; four focus groups involved women only and four involved men only. Themes were identified using a combined deductive/inductive approach and an iterative process of consensus coding. Gender similarities and differences emerged. Barriers to self-management were primarily social for the women, whereas for men, structural aspects related to work were prominent. Interventions aimed at improving diabetes self-management among US Latino immigrants should consider tailored approaches to help men and women overcome distinct barriers.

  PublisherDOI

• Social Isolation and Incident Heart Failure Hospitalization in Older Women: Women’s Health Initiative Study Findings

  UNC Libraries · 2025-02-06

  articleOpen access

  Background The association of social isolation or lack of social network ties in older adults is unknown. This knowledge gap is important since the risk of heart failure (HF) and social isolation increase with age. The study examines whether social isolation is associated with incident HF in older women, and examines depressive symptoms as a potential mediator and age and race and ethnicity as effect modifiers. Methods and Results This study included 44 174 postmenopausal women of diverse race and ethnicity from the WHI (Women's Health Initiative) study who underwent annual assessment for HF adjudication from baseline enrollment (1993-1998) through 2018. We conducted a mediation analysis to examine depressive symptoms as a potential mediator and further examined effect modification by age and race and ethnicity. Incident HF requiring hospitalization was the main outcome. Social isolation was a composite variable based on marital/partner status, religious ties, and community ties. Depressive symptoms were assessed using CES-D (Center for Epidemiology Studies-Depression). Over a median follow-up of 15.0 years, we analyzed data from 36 457 women, and 2364 (6.5%) incident HF cases occurred; 2510 (6.9%) participants were socially isolated. In multivariable analyses adjusted for sociodemographic, behavioral, clinical, and general health/functioning; socially isolated women had a higher risk of incident HF than nonisolated women (HR, 1.23; 95% CI, 1.08-1.41). Adding depressive symptoms in the model did not change this association (HR, 1.22; 95% CI, 1.07-1.40). Neither race and ethnicity nor age moderated the association between social isolation and incident HF. Conclusions Socially isolated older women are at increased risk for developing HF, independent of traditional HF risk factors. Registration URL: http://www.clinicaltrials.gov; Unique identifier: NCT00000611.

  PublisherDOI

Frequent coauthors

• Gaurav Dave

  University of North Carolina at Chapel Hill

  53 shared

• Andrea Cherrington

  47 shared

• Guadalupe X. Ayala

  San Diego State University

  45 shared

• Connie Blumenthal

  44 shared

• Aletha Y. Akers

  40 shared

• JoAnn E. Manson

  Brigham and Women's Hospital

  40 shared

• Crystal W. Cené

  University of California, San Diego

  39 shared

• Charles B. Eaton

  Kent Hospital

  36 shared

Labs

• Curriculum in Toxicology & Environmental MedicinePI

Education

• Ph.D., Toxicology

  University of North Carolina at Chapel Hill

  2005

• M.S., Toxicology

  University of North Carolina at Chapel Hill

  2002

• B.S., Toxicology

  University of North Carolina at Chapel Hill

  2000