Doctor of Philosophy, The Ohio State University, 2020, Environment and Natural Resources

Policy makers, farm family advocates, and researchers have overall focused on resolving issues connected to the farm operation such as access to land or farm transition. The consideration of household level issues, such as difficulties paying for health insurance or saving for retirement, has however been inadequate despite the evidence that these difficulties can negatively impact the development and viability of the farm operation. To work towards a greater understanding of the factors that shape and support family farms, I explore the links between farm household social needs, social policy, and farm persistence in three stand-alone, yet, connected research articles. The farm persistence literature, a body of work with a long tradition of studying how family farms adapt to on-going changes, provides the theoretical foundation of this dissertation. My methodological approach is based on a mix of qualitative and quantitative data and a comparative approach. In the first article, I broadly consider the role of social policy in the farm sector and propose a research framework to integrate social policy into the international family farm research agenda. Then, I focus on health policy, a large component of social policy in Western industrialized countries, and health needs, a major social need, for U.S. farm households as an empirical case. In particular, I assess U.S. farm households' access to health insurance and health care along the life course in the second article and I assess their medical economic vulnerability in the third article. Taken together, my findings point to difficulties accessing and paying for health insurance and health care and a general sense of vulnerability. Farm households of all ages juggle trade-offs between household consumption, savings, and on-farm investments but it is the younger households that are the most vulnerable despite being in better health. Meanwhile, the eligibility for old-age universal coverage (i.e. Medicare) does no (open full item for complete abstract)

Doctor of Philosophy, The Ohio State University, 2010, Art Education

The purpose of this dissertation study is to conduct an art-based, community action research study as a means (1) to support the recovery process of domestic violence survivors; (2) to produce social capital among members of the community to initiate civic discussions on the consequences of domestic violence; and (3) to investigate its implications for cultural policy as the outcomes of this study highlight the unique role of the arts in making a difference in people's lives and communities. The art works produced by the workshop participants of this study (i.e., domestic violence survivors) were exhibited in a professional gallery as a form of visual narrative that speaks for their wounded past and difficult journeys. The collected data strongly indicates that art can be an exceptionally powerful tool for communication and healing, when words and discussions fall short. Overall, this research investigates the instrumental functions of the arts as a means to produce social capital for personal well-being, social support, and social justice. The study was framed within action research methodology and the triangulation model in data sources, research methods, and theoretical lenses, while both quantitative and qualitative techniques were employed. The collected data were analyzed at three different levels: (1) Personal level (i.e., the art workshop participants: n=16), (2) Organizational level (i.e., the staff of the transitional housing facility and the gallery: n=6), and (3) Community level (i.e., the general audience who came to the exhibit: n=74).

Ed.D., Antioch University, 2025, Education

The persistent health disparities faced by Black, Indigenous, and People of Color (BIPOC) in the United States are deeply rooted in systemic racism embedded within medical education and clinical practice. Historical acceptance of racial supremacy in the United States has shaped both the foundations and continued practices of medical education, leading to entrenched biases that affect healthcare delivery and patient outcomes. This dissertation critically examines the intersection of race, education, and health by analyzing how historical and contemporary understandings of race and ethnicity shape medical curricula, healthcare practices, and patient care. Through the integration of Critical Race Theory (CRT), Social Cognitive Theory (SCT), and ScT, this study deconstructs racialized knowledge systems in medicine and examines their impact on health equity. CRT provides a lens to analyze how systemic racism is embedded within medical education and practice, illuminating the ways racial bias is institutionalized and perpetuated in healthcare structures. SCT contributes by exploring how individuals internalize societal norms and beliefs, which influence the attitudes and behaviors of both medical practitioners and patients. Finally, ScT emphasizes the role of social networks and relationships, highlighting how disparities in access to healthcare resources and support systems affect health outcomes in marginalized communities. Together, these theories offer a comprehensive framework for understanding the layered and interconnected influences of race, education, and healthcare, guiding the study's aim to challenge and dismantle biased practices within medical training and clinical care. Chapters I and II introduce the research problem and establish a comprehensive foundation, outlining key theoretical frameworks—CRT, SCT, and ScT—while exploring the historical roots of racialized practices in medicine, including the legacy of unethical experimentation and the Flexner Report (open full item for complete abstract)

Doctor of Education (Ed.D.) in Organizational Leadership , Franklin University, 2024, International Institute for Innovative Instruction

The underrepresentation of African American male teachers in K-12 education significantly impacts educational equity and student success, especially in urban areas where these students often lack relatable role models. Historically, African American males were a significant presence in teaching, but their numbers have drastically declined since the Brown v. Board of Education decision. This shortage limits cultural representation and mentorship opportunities essential for the academic and personal development of African American male students. This qualitative phenomenological study, conducted within the Columbus City Schools system, explores the motivations of African American male teachers and their impact on students. Using Social Learning Theory and Social Identity Theory, the research involved in-depth interviews revealing key themes such as the influence of positive role models, the critical need for cultural representation, and the desire to mentor and advocate for young African American males. The study highlights the importance of targeted recruitment, supportive environments, and professional development programs to attract and retain these educators. Increasing the presence of African American male teachers enhances student engagement, achievement and fosters a more inclusive and equitable educational environment.

Ph.D., Antioch University, 2022, Leadership and Change

The purpose of this qualitative participatory action research was to explore how complexity is engaged and experienced in complex regulatory systems, and to understand how cannabis might be regulated in ways that lead to socially equitable conditions. This was accomplished by studying the lived experiences of governmental leaders charged with the responsibility of establishing regulatory frameworks for legalized cannabis where none previously existed. Using the learning history methodology, the study deeply explores the ways that complex systems coexist by capturing the lived experiences of research participants and enhance theoretical understanding of complex regulatory systems. Data collection occurred through reflective interviews, followed by distillation and thematic analysis. This resulted in the creation of a data table and a learning history artifact that were validated by distribution to research participants and used as both an actionable tool for participants and an analytical tool to distill and categorize research findings. The data table and the artifact established three main findings: complexity is both a property and characteristic of systems; complexity is not a behavior, characteristic or action of “leadership” or “leaders” in complex regulatory systems; and the interplay between social justice and social equity is complex and often oversimplified. Rather than directing, participants brought about change by building interactive trust through dialogue and relationship-building in interactive spaces across and between macro, meso, and micro systems levels. Complexity arose from these participatory human relationships when both the properties and characteristics of these systems were engaged, but the theoretical construct of complexity does not explain the presence of agency within this dynamic. By recognizing agency across all systems, structural barriers may be reduced, resulting in regulatory frameworks that may lead to more socially equitable con (open full item for complete abstract)

Doctor of Philosophy, The Ohio State University, 2020, Political Science

Do fluctuations in climate spur violence? Across a variety of stakeholders, there is an intuitive expectation that climate factors influence conflict in vulnerable areas. While existing research suggests that there might be a relationship between climate and conflict, the exact linkage between the two remains an open question. Contemporary research in this area suffers from three main gaps: it often uses incomplete measures for climate that generate unreliable results; many studies employ statistical methods that do not accurately model the underlying data structure of the conflict outcome; and most studies use theoretical models of conflict participation that cannot account for variation at the micro-level. To address these gaps, this dissertation leverages spatially disaggregated climate data, original data collected during fieldwork in Uganda, and improved modeling strategies to explore the links between climate and conflict at the macro, meso, and micro levels. I propose a coherent theoretical framework through which we can understand how climate volatility impacts individual decision-making and drive violence. I argue that climate volatility heightens feelings of uncertainty among small-holder farmers; discomfort with feelings of uncertainty pushes individuals to try and seek certainty in a variety of ways. One way to find certainty, although not the only one, is to align with social groups that can offer psycho-social and economic benefits to membership. Armed groups and micro-finance social groups are examples of social groups that benefit from this certainty seeking behavior. Individual efforts to reduce uncertainty results in a larger pool of potential supporters and recruits for social groups, which can lead to the occurrence of violence. As the pace of anthropogenic climate change accelerates and uncertainty increases, a nuanced understanding of the climate-conflict relationship is critical for protecting those most at risk. Clarifying the links between (open full item for complete abstract)

Master of Science, The Ohio State University, 2020, Environment and Natural Resources

Harmful algal blooms (HABs), have been a growing issue in Lake Erie since the 1990s. The blooms, composed of toxin-producing cyanobacteria, are primarily caused by nutrient runoff in the form of phosphorus and nitrogen from agricultural lands around the Lake. HABs in Lake Erie have become an especially salient issue after the August 2014 Toledo Water Crisis, in which 500,000 people in the Toledo Metropolitan Area were deprived of the use of their tap water due to a `do not drink' advisory prompted by toxins in the water originating from a HAB. In drawing an explosion of attention to HABs, the 2014 algal bloom functioned as a focusing event. A focusing event is an event, concentrated in a particular geographical area, that causes harm or reveals the potential for harm to human communities. To understand how the 2014 Toledo Water Crisis affected policy change processes implicated in managing Lake Erie, I investigate two issues pertaining to how this attention changed HAB management: first, the ways the crisis changed the social networks of the stakeholders involved in water quality management; and second, the ways that the crisis altered narratives about HABs. To address HABs, coordination across jurisdictions and the various levels of government is essential. Actors faced with these fragmentations of management built into government face a collective action problem and must coordinate their actions to compensate for this fragmentation. Understanding how the 2014 algal bloom as a focusing event altered social networks associated with water quality management in Lake Erie will help reveal the conditions under which coordination and collective action may arise. As a part of this process of addressing HABs, narrative will also be an important aspect. Policy debates are fought using narrative, and narrative affects the policy process. Understanding the narratives actors employ at a moment in which quickly mobilizing resources and people is essential can elucidate how acto (open full item for complete abstract)

Doctor of Philosophy, The Ohio State University, 2018, Political Science

Since the 1980s, Asia has witnessed constant social policy expansion. Newly democratized countries show resemblance in terms of the route of coverage expansion. Due to authoritarian legacies, these countries undertook reform by expanding the already-existing Bismarckian-style contributory programs, most of which feature insurance rather than redistributive goals. Public sector workers have already been protected under these programs, so coverage reform mainly targeted private sector workers to close the protection gap. However, de jure coverage reform does not lead to de facto coverage expansion on the ground. Huge gaps between institutional designs and praxis exist across countries. What explains the mismatch? The mismatch between de jure institutional design and de facto implementation is partially due to the non-compliance behavior, which is the focus of the dissertation. I argue that the social foundation for Bismarckian-style social security programs no longer exists in Asia. The key reason is that the inter-temporal feature between contribution and benefit embedded in the Bismarckian-style contributory programs does not work well with flexible labor market structures, limiting the number of citizens participating in such programs. More specifically, I argue that labor market flexibility is conducive to workers' new career profiles, which are characterized by unstable earning patterns. Unstable income truncates citizens' time horizons and acts as a disincentive for contributing to social programs in which benefits can only be realized in the long run. Under the theoretical framework, several observable implications and sub-arguments are derived. First, people with unstable income are, in general, less likely to think about retirement due to their truncated time horizon. Second, unstable income should make people not participate in Bismarckian-style social programs, even if they are mandated to do so. Third, income level moderates the impact (open full item for complete abstract)

Doctor of Philosophy, Case Western Reserve University, 2018, History

The Civil Rights Act and the expansion of Title IV of the Social Security Act in 1962 vastly increased the number of children and families eligible for child welfare services in the 1960s. States and counties were able to offer a significant and sustained increase in government support for expanding existing institutional child welfare programs and creating new community based programs. The combination of increased demand and increased funding resulted in the transformation of children's institutions from mostly custodial and residential charitable organizations to mostly therapeutic and community-based government-subsidized nonprofit organizations. This dissertation examines the history of three children's homes affiliated with the National Benevolent Association of the Disciples of Christ from their founding around the turn of the twentieth century to the passage of the Child Abuse Protection and Treatment Act in 1974. These case studies demonstrate how federal legislation, state regulation, and the work of a national accreditation organization, The Child Welfare League of America, influenced the creation of modern child welfare agencies.

Doctor of Philosophy (PhD), Ohio University, 2017, Instructional Technology (Education)

Social Media has been a worldwide phenomenon for the last ten years. This phenomenon became an important component of many people's daily lives. Social media has also been a vital tool for several governmental institutions and business organizations. However, the higher education industry is believed to have remained behind as far as the fast evolution of social media. This study aims to address the utilization of social media technology in higher education teaching and learning. This qualitative research has been conducted to obtain the understanding and perception of utilizing social media in higher education teaching and learning by faculty members at Ohio University's Patton College of Education (PCOE). The results of this research present a clearer picture of the current status of social media utilization from the PCOE's faculty member's perspectives based on the Technology Acceptance Model (TAM), Unified Theory of Acceptance and Use of Technology (UTAUT), and the constructivist learning theory. The results of this research, based on the analysis of semi-structured interviews with ten faculty members, demonstrate that the advantages of using social in higher education teaching and learning outweigh the disadvantages. The findings also show the urgent need for the development of all-inclusive social media policies at the institutional level.

Doctor of Philosophy, The Ohio State University, 2016, Sociology

For decades the study of unemployment has been dominated by psychologists and economists and has largely been overlooked by sociologists. When the world economy entered a period of prolonged economic decline in the fall of 2007, this began to change. During this period many workers found themselves facing extreme economic hardship as they were involuntarily unemployed for extended periods of time. Yet even as the Great Recession forced sociologists to rediscover the topic of unemployment, most of this research followed the traditions set forth by economists and psychologists by focusing on macro-level factors associated with the decline or the psychological responses of unemployed workers. While this research is important, it provides little insight into the lived experiences of unemployed workers and their families. In the following paper I begin addressing this gap by utilizing qualitative methods to explore the lived experiences of unemployed and underemployed workers during two of the most devastating economic collapses in U.S. history: the Great Depression and the Great Recession. Data on the experiences of workers during the Great Recession come from eighty-four semi-structured interviews with displaced workers in Columbus, OH conducted between 2012 and 2013. In contrast, the experiences of unemployed workers during the Great Depression are explored using research conducted by E. Wight Bakke and his team during the 1930s. The current analysis focuses primarily on the material responses of workers during both periods. Material responses are conceptualized as the strategies individuals and families employ in order to maintain their standard of living in the face of economic hardship. Given the substantial technological, industrial, and institutional changes that have occurred since the start of the Great Depression, one would expect there to be significant differences in the material responses of workers during both periods. Yet, the current analysis discovers t (open full item for complete abstract)

Doctor of Philosophy, The Ohio State University, 2015, Rural Sociology

An assumption exists in the public discourse regarding the future of agriculture at the Rural Urban Interface (RUI) that decline is all but inevitable. Yet, agriculture at the RUI continues to persist and in some cases thrive. Policy relating to land use and economic development has been the primary source of intervention in attempts to protect and bolster RUI agriculture. This research explores the hypothesis that communities with stronger network relationships, a concept I call agricultural social infrastructure (ASI), will be more likely to have land use and economic development policies in place and in such perform better in relation to maintaining or growing agriculture in there respective counties than counties without strong ASI and policy. Additionally, this work looks to incorporate a holistic model of county structural impact on agricultural outcomes. The primary addition to this model is the inclusion the national commodity crop productivity index (NCCPI) and rating of prime farmland. Each of these measures serves to capture the inherent production capacity of agricultural lands. This research is important in that it looks to fill two fundamental gaps in the literature relating to RUI agriculture. First, can we identify a path for the creation and implementation of public policy relating to the social infrastructure in a community? Second, are their particular types of agricultural lands in production in the RUI that lead to better overall success relative to income and the maintenance of farmland production? To test these hypotheses, a number of methods were used. Key informants in agriculturally important RUI counties were administered a survey to determine the extent of agricultural programming and policy in place in the county as well as to establish the strength of network relationships associated with ASI. Additionally, data was drawn from the USDA census of agriculture for 2002-2012 as well as from the NRCS- National Resources Inventory 2007 t (open full item for complete abstract)

Doctor of Philosophy in Urban Education, Cleveland State University, 2014, College of Education and Human Services

This dissertation focused on understanding high school students' perception of the goals of education as they relate to those of policymakers, as these perceptions have largely been absent in the dialogue of education reform and policy. These goals may compete with each other, as do broader educational goals, reflecting different societal views of the purpose of education. Understanding students' perception of the goals of education (as framed by the goals of policymakers) may provide greater insight into current policy, and serve as a compass in directing future reforms that is inclusive of all stakeholders involved in this complex system. Using David F. Labaree's (1997a, 1997b, 2010) construct of the competing goals of education (democratic equality, social efficiency, and social mobility) as a theoretical framework, three research questions were examined through a quantitative design: to what extent do students identify with each of the competing goals of education? to what extent do students' course of study and grade point average (GPA) relate to each of the competing goals of education? and to what extent do students' GPA and the competing goal with which students most strongly identify with predict membership in course of study? This study employed chi-square analysis, multivariate dimension reduction factor and scale reliability, multivariate analysis of covariance (MANCOVA), and multinomial logistic regression as the statistical methods. Version 22.0 of Statistical Product and Service Solutions (SPSS) was used to analyze the data. Survey results indicated that students most strongly identified with the goal of social efficiency, followed by the goals of district stakeholders, democratic equality and social mobility. There was no statistically significant relationship between students' course of study and GPA, and the competing goals of education. The results from the multinomial logistic regression suggested statistically significant predictive value (open full item for complete abstract)

Master of Arts (MA), Ohio University, 2003, History (Arts and Sciences)

This thesis discusses Michael Walzer's role as a public critic of American foreign policy from the mid-1950s to the present. The purpose of this discussion is two-fold. First, it seeks to trace out a voice on the American liberal left that does not fit the common stereotype of a negativist, ideologically rigid leftist critic. Walzer's alternative liberal vision as articulated in the course of the past four decades demonstrates the ways in which it is possible for intellectuals on the left to remain true to liberal values and put forward a highly nuanced and constructive critique of official foreign policy without succumbing to negativism or ideological dogmatism. Second, this discussion is based on the premise that Walzer's ideas can best be understood not just by analyzing them philosophically but also by considering Walzer's main intellectual influences, his personal background, and the historical context in which he is writing. Although a lot has been written on Walzer's political thought per se, there has so far been no attempt to place the public writings of this important political philosopher in the context of his times. This thesis proceeds chronologically and is divided into five chapters. Chapters I and II discuss Walzer's personal background, education, and early political writings for Dissent magazine in the 1950s. Chapters III and IV deal with Walzer's political activism in the 1960s and discuss how his opposition to the Vietnam War led him to think about the moral aspects of warfare in more systematic terms, culminating in the publication of his most significant philosophical work on foreign policy, Just and Unjust Wars, in 1977. Chapters V and VI look at Walzer's contributions to the public foreign policy debate during the presidencies of Jimmy Carter, Ronald Reagan, and Bill Clinton, and also deal with Walzer's response to the terrorist attacks of September 11, 2001. The thesis concludes with an epilogue outlining today's liberal foreign policy dilem (open full item for complete abstract)

BA, Oberlin College, 2010, Politics

The arguments presented in this paper attempt to fill particular gaps in the scholarly knowledge of the transnational solidarity movement for Palestine. Chapter One is a descriptive history of transnational solidarity for the Palestinians since the beginning of the second intifada (fall 2000). The next chapter puts the US based component of the Palestine solidarity movement in a comparison with recent US solidarity movements for East Timor and Central America. Chapter Three connects the subjective transnational framing tactics of the movement to the objective, structural conditions of the international system. Chapter Four extends the analysis in Chapter Three by examining the role of new media such as viral videos and low-budget documentaries in the construction of the solidarity movement.

Doctor of Philosophy in Urban Studies and Public Affairs, Cleveland State University, 2009, Levin College of Urban Affairs

The Republic of Korea's efforts to accelerate the development of its economy in the aftermath of an extremely destructive civil war led to the concentration of capital and activity in areas that resemble the growth poles described by Perroux (1950) and Hirschman (1958). These poles led to an extreme centralization of economic activity and people in the Seoul Metropolitan Area (SMA). More than 48 percent of the GDP, 90 percent of the headquarters of major firms, and 48 percent of the population is concentrated in 11.8 percent of the Republic's land (2006 figures). Despite the agglomeration economies, the national government has investigated policies and practices to spatially reorganize the growth-pole regions' industrial base to bring more balanced growth to other parts of the country. These efforts have been mostly unsuccessful. To better understand factors that could be undermining efforts to decentralize and enhance the distribution of economic activity this study looks at the relationship between social linkages among power elites and the concentration of economic activity. After assessing the existence of growth poles and their dominance, this study also analyzes the consequences of the concentration of capital into two regions. The third and main part of the study uses social network analysis (SNA) to identify the existence of a powerful social system that sustains these growth-pole regions and impede meaningful change. The data analysis strongly suggests that changes in the ‘creative destruction' of social patterns at a minimum must occur at the same time that efforts are made to alter path-dependent economic patterns. The final section of the dissertation presents some recommendations to achieve the needed reforms in social networks that must precede any change in the concentration of economic activity.

Master of Arts (MA), Ohio University, 2013, International Development Studies (International Studies)

The objective of this research is to understand, how people in different socio-economic groups access food, the role of the state in facilitating or hindering access to food, and what constitutes the 'politics of access' to food for people. The data for this research was collected from interviews conducted among four socio-economic groups, and was analyzed using descriptive statistics and qualitative analysis. This research identified market-based entitlements as the most significant form for all the groups to access food, and identified indigenous laborers as lacking access to major endowments and entitlements, amongst all the groups. Finally, this thesis points to the significance of transfer entitlements across the socio-economic groups, and in doing so details the nature of politics, especially those practiced by the state, that help people gain access to the schemes or denies access to them.

Doctor of Philosophy, Miami University, 2025, Educational Leadership

This dissertation examines educational disparities in Malawi, focusing on the role of standardized testing in shaping access to secondary education for students in rural areas. Despite the theoretical promise of education as a social equalizer, systemic inequalities disproportionately disadvantage students from marginalized backgrounds. The study investigates how standardized testing policies perpetuate disparities, limiting educational opportunities for rural students who face economic hardship, inadequate school infrastructure, and resource deficits. The research employs a multiple critical case study approach, integrating Critical Policy Analysis (CPA) and colonialism as theoretical frameworks to analyze the historical and structural factors contributing to educational inequities. Through interviews with educators and administrators, case studies of rural schools, and policy analysis, the study explores the intersection of socio-economic conditions, colonial legacies, and standardized assessment practices. Findings indicate that standardized testing, particularly the Primary School Leaving Certificate Examination (PSLCE), disproportionately disadvantages rural students due to limited access to qualified teachers, study materials, and supportive learning environments. Furthermore, the rigid nature of standardized assessments fails to account for contextual challenges such as food insecurity, long travel distances, and the prevalence of child labor in rural communities. The study also highlights the colonial roots of Malawi's education system, emphasizing how contemporary policies maintain structural inequalities established during British rule. Standardized testing, originally designed to filter students into limited secondary school spaces, continues to function as a mechanism of exclusion rather than an equitable tool for academic evaluation. The research finds that only a small percentage of rural students transition to secondary education, perpetuating cycle (open full item for complete abstract)

Psy. D., Antioch University, 2025, Antioch New England: Clinical Psychology

Young adults in college experience significant rates of mental health difficulties. The mental wellness of young adults has shown to have a substantial link to future success, health, and well-being. Individuals with marginalized sexual and gender identities (SGM) often hold additional mental health difficulties due to having identities that typically defy society's assumptions and expectations, and these assumptions/expectations are presented to youth from a young age. The distress experienced by SGM individuals can often be relational in nature due to living in and relating to a heteronormative, cisgender society that stigmatizes and oppresses SGM individuals. University Counseling Centers (UCC) typically have limited treatment approaches with stricter time-limitations as compared to other clinical settings. This provides rationale to conduct research on approaches to psychotherapy in UCCs for SGM individuals. Cultural and social contexts are crucial in understanding SGM identities, and therefore, relational cultural therapy (RCT), and its integration of interventions for multiple theories is suggested due to combining relational and cultural factors. However, this dissertation also provides a critical discussion of the use of psychotherapy approaches, regardless of theoretical orientation, in working with SGM individuals who present with distress in UCCs. The intertwining areas of social justice, diversity, intersectionality, and ethics are addressed. This is a policy position paper with reviewing, analyzing, and reporting findings from the existing research on SGM clients engaged in UCCs to provide recommendations to better inform services and American Psychological Association (APA) guidelines. This dissertation is available in open access at AURA, https://aura.antioch.edu/ and OhioLINK ETD Center, https://etd.ohiolink.edu

Doctor of Philosophy, Case Western Reserve University, 2005, Management

Strong tax base components such as payroll taxes, corporate taxes, and income taxes drive economic health. As companies grow, add jobs, and increase wages, regional economic health improves. Since regions vary in terms of industry strengths, stakeholders must understand factors driving economic growth. Not understanding these factors can lead to poor decisions, resource waste, and low performance outcomes. We identify and analyze medical device entrepreneurial ecosystems factors impacting Massachusetts, Minnesota, and Ohio through four questions. Our first research question is, “What factors explain Minnesota's medical device entrepreneurial ecosystem performance?” We found, through a series of interviews in Minnesota that policy, university engagement, entrepreneurial orientation, and social capital are all relevant. From this study, we ask, “To what extent do these factors explain medical device entrepreneurial ecosystem performance?” This second study assesses the identified factors impact and significance three regions collectively. We then research “To what extent do these factors explain medical device ecosystem performance in Massachusetts, Minnesota, and Ohio?” We found social capital impacts performance across all studies while policy has no impact. In the case of the latter, our research supports the neoclassical approach to regional economic development. Finally, we research “How do medical device ecosystem performances differ between Massachusetts, Minnesota, and Ohio?” In this final study, we found our mediation and moderation results to vary by region.