Black women remain acutely underrepresented in senior leadership roles within higher education, often experiencing precarious appointments during times of institutional instability—a phenomenon known as the “glass cliff.” While existing research addresses the barriers to leadership access, limited scholarship explores what happens once Black women assume these high-risk roles. This study asks, “What are the lived experiences of Black women in high-level leadership roles in higher education, and how do they describe navigating workplace cultures shaped by the intersections of race and gender?” Using narrative inquiry, the researchers conducted semi-structured interviews with five Black women who have held high-level academic leadership positions. Participants were recruited through purposive and snowball sampling. Data were thematically analyzed using a five-step coding process, with multivocality and researcher reflexivity employed to ensure rigor. Findings revealed eight interrelated themes, including the impact of racial and gender identity on professional trajectories, limited mentorship and sponsorship, inequitable compensation, and persistent organizational cultures reflective of glass cliff conditions. Participants described feeling devalued, under-supported, and excluded from critical decision-making spaces. Despite these challenges, they demonstrated resilience and emphasized the importance of culturally affirming support systems, intentional recruitment practices, and transparent institutional cultures. This study contributes to higher education leadership literature by demonstrating how misogynoir and racialized organizational risk shape Black women’s leadership experiences post-appointment. The findings call for urgent structural reforms in recruitment, support, and retention strategies to ensure that Black women not only access leadership roles but are positioned to thrive within them.
This editorial is the first in a series of editorials exploring the future of engineering design from the perspective of thought-leaders within the engineering design community. Five early- and mid-career researchers were invited to present their perspectives at a meeting of the Design Society in March 2025 on the campus of the Georgia Institute of Technology. Jessica Menold focused on teaming and collaboration in the context of artificial intelligence (AI); Kosa Goucher-Lambert on design cognition; Astrid Layton on sustainable and resilient design; Mohsen Moghaddam on virtual reality (VR)/augmented reality (AR)/extended reality (XR) in engineering design; and Zhenghui Sha on the design of complex sociotechnical systems. Each presentation was followed by roundtable discussions of the challenges and opportunities posed by the speaker. The presentations and audience discussions are summarized in this editorial, along with a brief overview of some of the opportunities for further work. The goal of this editorial series is to inform the broader community of the progress, challenges, and opportunities associated with important themes within our research community and to offer a starting point for those who seek to investigate these topics and continue to advance the state-of-the-art in our field.
Introduction and Objective: Most published studies have demonstrated the value of continuous glucose monitors (CGM) in type 1 diabetes. Type 2 diabetes involves more varied management approaches, ranging from oral medications to insulin therapy. Significant disparities exist in CGM adoption among people with type 2 diabetes (PwT2D). Non-Hispanic Black and Hispanic PwT2D, those with lower household income, or public insurance, are less likely to be on a CGM. The aim of this study is to highlight strategies that effectively increase CGM adoption equitably. Methods: Three centers in the T1D Exchange Quality Improvement Collaborative used the 10-step equity framework, including the Ishikawa diagram, process map, effort/impact matrix tool, and PDSA cycles to test interventions in their centers to increase CGM use among all PwT2D. The coordinating center used statistical process control charts to evaluate the effectiveness of the interventions. Results: Participating centers improved their CGM adoption, equitably, by 11% over 20 months impacting 3219 PwT2D (Figure 1). Successful strategies highlighted include redesigning of CGM prescription workflows, use of technology navigators, audio- visual educational materials in multiple languages, use of electronic health records to screen for CGM use and to track CGM use. Conclusion: This project demonstrates that cross-learning and the use of QI and health equity principles can increase CGM use for all PwT2D. T.R. Bol: None. O. Odugbesan: None. T. Wright: None. N. Rioles: None. K. Fantasia: Stock/Shareholder; Eli Lilly and Company. M. Zupa: None. J. Haw: None. O. Ebekozien: Research Support; Abbott. Advisory Panel; Sanofi. Research Support; Sanofi, Lilly Diabetes, Medtronic. The Leona M. and Harry B. Helmsley Charitable Trust
Introduction and Objective: Low-income populations often use public transit to access healthcare. We hypothesized transit access impacts diabetic foot ulcer (DFU) outcomes as limb salvage requires frequent outpatient visits. We investigated the association between public transit availability and amputation-free survival after DFU hospitalizations. Methods: All patients residing in metropolitan Atlanta and admitted with a DFU to four Atlanta hospitals between 2016-21 were included. We calculated post-hospitalization amputation-free survival to estimate amputation hazard ratio (HR) with death as a competing risk. Census tract per square mile and per capita public transit frequency were the independent variables, and we calculated adjusted HRs (aHR) for age, sex, race, PAD, and ESRD. Results: Among 2864 patients, 949 (33%) died or had an amputation post-hospital discharge (table). For every 0.1 additional transit opportunities per capita, the amputation aHR was 0.969 (95%CI 0.939-0.999, p=.03). For every 100 additional transit opportunities per square mile, the amputation aHR was 1.008 (95%CI 1.006-1.177, p=0.4). Conclusion: Public transit frequency per capita protected against limb loss, but the frequency per square mile had an adverse impact on limb loss. Patient-centric data on transit barriers and use of transit for healthcare access is needed to explain these apparently contradictory census tract level findings. M. Schechter: None. J.W. Wei: None. R.R. DSouza: None. H. Zhang: None. M.K. Ali: Advisory Panel; Eli Lilly and Company. L.A. Waller: None. H.H. Chang: None. This study was supported by the National Institute on Minority Health and Health Disparities (R21MD017943) and the Emory University Woodruff Health Sciences Center Synergy Award
Introduction and Objective: Diabetic foot ulcers (DFUs) are a common complication of diabetes, presenting in patients with T1D and T2D. We aimed to compare DFU characteristics and outcomes stratified by T1 vs T2DM. Methods: All patients with a DFU hospitalized in an Atlanta Hospital between 01/2019 - 12/2021 were included. T1D and T2D status were determined using manual chart review. Diabetes due to pancreatic insufficiency or pancreatitis were excluded. The primary outcome was a composite of either major or minor amputation or death. Results: Among 696 patients, 33 (5%) had T1D and 663 (95%) had T2D. Eight (24%) patients with T1D and 135 (20%) patients with T2D experienced the primary outcome (p=0.35). Patients with T1D were significantly younger and had a higher HbA1c than those with T2D. Moreover, patients with T1D seldom had PAD or ESRD at the time of DFU-related hospitalization or when they experienced limb loss or death. Conclusion: We observed no difference in the risk of experiencing amputation or death in patients with T1D and T2D. In our study sample, patients with T1D had higher HbA1c than those with T2D and experienced amputation or death approximately 10 years before those with T2D. J.E. Tyrrell: None. M.C. Schechter: None. R.R. DSouza: None. H.H. Chang: None. M. Fayfman: Research Support; Abbott, Dexcom, Inc. National Institute of Diabetes and Digestive and Kidney Disease (5R21MD017943-02)
