About

Dan Gray is an Associate Professor Emeritus in the Department of Theatre, Film, and Media Arts at The Ohio State University. He has been a working theatre professional for more than 30 years, during which he has designed productions at numerous regional theaters including The George Street Playhouse, the Capital Repertory Theatre Company, Players Theatre Columbus, and the Delaware Theatre Company. Gray has also assisted scenic designer Michael Anania on projects for Broadway, The New York City Opera, Paper Mill Playhouse, The Alabama Shakespeare Festival, and The Minnesota Opera. His expertise encompasses director/designer collaboration, properties design and construction, scenic design, and scene painting. Throughout his career, Gray has received several awards for his designs, including multiple Best Scenic Design awards from The Columbus Dispatch and six USITT/Ohio Valley Section Peggy Ezekiel Awards for Design Excellence. His work has been recognized internationally, with his design for Ohio State's 1999 production of Feral Music being selected for the United States Exhibit at the 2003 Prague Quadrennial. Gray has also designed productions for many Central Ohio companies such as CATCO, BalletMet, Opera Columbus, Red Herring Theatre Company, Pro Musica Chamber Orchestra, The Human Race Theatre Company, Dayton Ballet, and the Columbus Zoo. He retired from the department in 2022.

Research topics

• Medicine
• Internal medicine
• Oncology
• Environmental health
• Political Science
• Sociology
• Geography
• Gerontology
• Gastroenterology
• Development economics
• Demography
• Economic growth
• Virology
• Economics
• Family medicine

Selected publications

• Whose health is impacted by income inequality? Associations between county-level income inequality and healthcare utilisation in an insured population

  Journal of Epidemiology & Community Health · 2025-12-25 · 1 citations

  article

  BACKGROUND: Many studies have detected a negative relationship between income inequality and general measures of health. However, data limitations have prevented a full understanding of whose health is impacted and in what ways. METHODS: In this study, we combined area-level census data with individual-level health claims data to estimate the cross-sectional association between county-level income inequality and healthcare utilisation across a range of member characteristics. RESULTS: We found that a 1 SD increase in the Gini coefficient was associated with about 5% higher medical and pharmacy costs and a 0.2 percentage-point increase in the probability of a hospital visit within the year. Income inequality was associated with higher medical costs primarily among adults with commercial insurance, more emergency department visits among children and Medicaid members, and more hospital visits among older adults, including Medicare members. By examining diagnoses attached to claims, we found that income inequality was associated with detrimental impacts on mental health, as indicated by higher spending for anxiety and depression and more emergency department visits for substance-use disorders. CONCLUSIONS: Income inequality was associated with worse health across a wide range of members by age, income and insurance type, and can be considered as a risk factor by policymakers and health systems.

  PublisherDOI

• Development of a Brief Online Mindfulness-Based Intervention to Reduce Patient Anxiety Before a First-Time Screening Colonoscopy

  Journal of Cancer Education · 2025-03-31 · 3 citations

  articleOpen access

  To describe the development of an online mindfulness-based intervention (MBI) to reduce anxiety before a first-time screening colonoscopy among average-risk patients. A qualitative study used an iterative process guided by health behavior and mindfulness theories and feedback from a convenience sample of patients, endoscopy medical staff, and community members. Patient and medical staff (n = 18) were included in formative interviews (30-45 min), eight helped during intervention development sessions (15-90 min), and four community members reviewed the MBI in individual sessions (60 min). Interviews and sessions were recorded, transcribed verbatim, and analyzed using NVivo qualitative data software. Two themes emerged from the study: (1) both patients and medical staff reported that average-risk patients have pre-procedural anxiety before a first-time screening colonoscopy, and (2) using stakeholder-engaged strategies in an iterative process with both patients and medical staff is important so the developed intervention is acceptable to the priority population and to ensure medical accuracy and avoid disruption of workflow. Using an iterative process with key stakeholders is essential to develop interventions that are feasible and acceptable. The MBI developed through this process is being compared to usual care in a pilot randomized controlled trial to determine intervention feasibility and patient acceptability and to collect preliminary efficacy data. If efficacious, the developed MBI has the potential to reduce pre-procedural anxiety which may improve patient behaviors (e.g., bowel prep adherence and quality), patient satisfaction, and clinic workflow by reducing cancellation/no-shows, the amount of sedation required, and procedural time.

  PublisherOA PDFDOI

• More than Just a Number: Perspectives from Black Male Participants on Community-Based Interventions and Clinical Trials to Address Cardiovascular Health Disparities

  International Journal of Environmental Research and Public Health · 2024-04-06 · 7 citations

  articleOpen access

  BACKGROUND: Black Americans remain significantly underrepresented and understudied in research. Community-based interventions have been increasingly recognized as an effective model for reckoning with clinical trial participation challenges amongst underrepresented groups, yet a paucity of studies implement this approach. The present study sought to gain insight into Black male participants' perception of clinical trials before and after participating in a community-based team lifestyle intervention in the United States. METHODS: Black Impact, a 24-week community-based lifestyle intervention, applied the American Heart Association's Life's Simple 7 (LS7) framework to assess changes in the cardiovascular health of seventy-four Black male participants partaking in weekly team-based physical activities and LS7-themed education and having their social needs addressed. A subset of twenty participants completed an exit survey via one of three semi-structured focus groups aimed at understanding the feasibility of interventions, including their perceptions of participating in clinical trials. Data were transcribed verbatim and analyzed using a content analysis, which involved systematically identifying, coding, categorizing, and interpreting the primary patterns of the data. RESULTS: The participants reported a positive change in their perceptions of clinical trials based on their experience with a community-based lifestyle intervention. Three prominent themes regarding their perceptions of clinical trials prior to the intervention were as follows: (1) History of medical abuse; (2) Lack of diversity amongst research teams and participants; and (3) A positive experience with racially concordant research teams. Three themes noted to influence changes in their perception of clinical trials based on their participation in Black Impact were as follows: (1) Building trust with the research team; (2) Increasing awareness about clinical trials; and (3) Motivating participation through community engagement efforts. CONCLUSIONS: Improved perceptions of participating in clinical trials were achieved after participation in a community-based intervention. This intervention may provide a framework by which to facilitate clinical trial participation among Black men, which must be made a priority so that Black men are "more than just a number" and no longer "receiving the short end of the stick".

  PublisherOA PDFDOI

• Association of Socioeconomic Status With Life's Essential 8 in the National Health and Nutrition Examination Survey: Effect Modification by Sex

  Journal of the American Heart Association · 2024-02-13 · 21 citations

  articleOpen access

  Background Higher scores for the American Heart Association Life's Essential 8 (LE8) metrics, blood pressure, cholesterol, glucose, body mass index, physical activity, smoking, sleep, and diet, are associated with lower risk of chronic disease. Socioeconomic status (SES; employment, insurance, education, and income) is associated with LE8 scores, but there is limited understanding of potential differences by sex. This analysis quantifies the association of SES with LE8 for each sex, within Hispanic Americans, non‐Hispanic Asian Americans, non‐Hispanic Black Americans, and non‐Hispanic White Americans. Methods and Results Using cross‐sectional data from the National Health and Nutrition Examination Survey, years 2011 to 2018, LE8 scores were calculated (range, 0–100). Age‐adjusted linear regression quantified the association of SES with LE8 score. The interaction of sex with SES in the association with LE8 score was assessed in each racial and ethnic group. The US population representatively weighted sample (13 529 observations) was aged ≥20 years (median, 48 years). The association of education and income with LE8 scores was higher in women compared with men for non‐Hispanic Black Americans and non‐Hispanic White Americans ( P for all interactions <0.05). Among non‐Hispanic Asian Americans and Hispanic Americans, the association of SES with LE8 was not different between men and women, and women had greater LE8 scores than men at all SES levels (eg, high school or less, some college, and college degree or more). Conclusions The factors that explain the sex differences among non‐Hispanic Black Americans and non‐Hispanic White Americans, but not non‐Hispanic Asian Americans and Hispanic Americans, are critical areas for further research to advance cardiovascular health equity.

  PublisherOA PDFDOI

• A Cell-free DNA Blood-Based Test for Colorectal Cancer Screening

  New England Journal of Medicine · 2024 · 358 citations

  • Medicine
  • Internal medicine
  • Oncology

  BACKGROUND: Colorectal cancer is the third most diagnosed cancer in adults in the United States. Early detection could prevent more than 90% of colorectal cancer-related deaths, yet more than one third of the screening-eligible population is not up to date with screening despite multiple available tests. A blood-based test has the potential to improve screening adherence, detect colorectal cancer earlier, and reduce colorectal cancer-related mortality. METHODS: We assessed the performance characteristics of a cell-free DNA (cfDNA) blood-based test in a population eligible for colorectal cancer screening. The coprimary outcomes were sensitivity for colorectal cancer and specificity for advanced neoplasia (colorectal cancer or advanced precancerous lesions) relative to screening colonoscopy. The secondary outcome was sensitivity to detect advanced precancerous lesions. RESULTS: The clinical validation cohort included 10,258 persons, 7861 of whom met eligibility criteria and were evaluable. A total of 83.1% of the participants with colorectal cancer detected by colonoscopy had a positive cfDNA test and 16.9% had a negative test, which indicates a sensitivity of the cfDNA test for detection of colorectal cancer of 83.1% (95% confidence interval [CI], 72.2 to 90.3). Sensitivity for stage I, II, or III colorectal cancer was 87.5% (95% CI, 75.3 to 94.1), and sensitivity for advanced precancerous lesions was 13.2% (95% CI, 11.3 to 15.3). A total of 89.6% of the participants without any advanced colorectal neoplasia (colorectal cancer or advanced precancerous lesions) identified on colonoscopy had a negative cfDNA blood-based test, whereas 10.4% had a positive cfDNA blood-based test, which indicates a specificity for any advanced neoplasia of 89.6% (95% CI, 88.8 to 90.3). Specificity for negative colonoscopy (no colorectal cancer, advanced precancerous lesions, or nonadvanced precancerous lesions) was 89.9% (95% CI, 89.0 to 90.7). CONCLUSIONS: In an average-risk screening population, this cfDNA blood-based test had 83% sensitivity for colorectal cancer, 90% specificity for advanced neoplasia, and 13% sensitivity for advanced precancerous lesions. (Funded by Guardant Health; ECLIPSE ClinicalTrials.gov number, NCT04136002.).

  PublisherDOI

• Cardiovascular Health and Colorectal Cancer Screening in Black Men: A Cross-Sectional Analysis

  American Journal of Men s Health · 2024-05-01 · 2 citations

  articleOpen access

  African American/Black (henceforth Black) men face disproportionate risks of morbidity and mortality from both cardiovascular disease (CVD) and colorectal cancer (CRC). The American Heart Association’s Life’s Simple 7 (LS7) tool was designed to examine predictors of CVD with included behaviors also linked to CRC risk (i.e., smoking status, weight, diet, and physical activity). However, no studies have combined LS7 assessment alongside CRC screening history, which serves as a proxy for assessing CRC risk, in Black men. In this study, Black men aged 45–75 participating in annual community wellness events were screened for 6 of 7 LS7 measures (excluding diet, LS6) and self-reported CRC screening. Analyses conducted using R 4.0.5. revealed that Black men ( N = 680), with an average age of 57.3 years ( SD = 7.5), reported poor (39.7%), intermediate (34.6%), or ideal (25.7%) LS6 scores with higher scores corresponding to lower risk for CVD. However, for every 1-point increase in LS6 scores (0–6), there was a 26% lower odds of reported CRC screening ( p = .001). In the fully adjusted model, men with 4+ ideal LS6 behaviors had a 60% lower odds of self-reported CRC screening compared to those with two ideal LS6 behaviors ( p < .001). These findings underscore the need for culturally relevant interventions for Black men across all levels of cardiovascular health (CVH) to increase CRC screening uptake.

  PublisherOA PDFDOI

• Improving mental health in black men through a 24-week community-based lifestyle change intervention: the black impact program

  BMC Psychiatry · 2024-01-09 · 7 citations

  articleOpen accessSenior author

  BACKGROUND: Poor mental health is a leading cause of morbidity and mortality among Black men in the United States. Efforts to improve mental health among Black men have been hampered by a lack of access and utilization of mental health services. Physical activity and social networks have been shown to improve mental health. Thus, we examined the effect of a community team-based physical activity, health education and social needs intervention among Black men on mental health over 24 weeks. METHODS: Black adult males (n = 74) from a large Midwestern city participated in Black Impact, a 24-week community-based lifestyle change program adapted from the Diabetes Prevention Program and American Heart Association's (AHA) Check, Change, Control Blood Pressure Self-Management Program, which incorporates AHA's Life's Simple 7 (LS7) framework. Measures of mental health including the Center for Epidemiological Studies Depression Scale (CES-D), Patient Health Questionnaire 2-question depression screener (PHQ-2), and Perceived Stress Scale-10 (PSS-10) were completed at baseline, 12 and 24 weeks. The change in mental health scores from baseline to 12 and 24 weeks were evaluated using linear mixed-effects models adjusting for age, education, and income. The change in cardiovascular health scores, defined as objective metrics of LS7 (LS5 [blood pressure, total cholesterol, fasting glucose, body mass index and smoking]), by baseline mental health were evaluated using linear mixed-effects models with an interaction term (time*baseline mental health variable) and a random intercept for each participant. RESULTS: Among 71 Black men (mean age 51, 85% employed) at 24 weeks, CES-D scores decreased from 10.54 to 7.90 (-2.64, 95%CI:-4.74, -0.55), PHQ-2 decreased from 1.04 to 0.63 (-0.41, 95%CI: -0.75, -0.07), and PSS-10 decreased from 14.62 to 12.91 (-1.71, 95%CI: -3.53, 0.12). A 1-unit higher CES-D at baseline was associated with less improvement in LS5 scores by -0.04 (95%CI: -0.076, -0.005) and - 0.032 (95%CI:-0.067, 0.003) units at week 12 and 24, respectively, with similar findings for PSS. CONCLUSIONS: The Black Impact community-based lifestyle program has the potential to reduce depressive symptoms and stress in Black men. There is a dire need for larger, randomized studies to test the impact of Black Impact on mental health in Black men to advance health equity. TRIAL REGISTRATION: Retrospectively Registered, ClinicalTrials.gov Identifier: NCT04787978.

  PublisherOA PDFDOI

• S224 Evaluating the Risk of Non-Colorectal Cancers in Individuals With a False Positive Blood-Based Colorectal Cancer Screening Test

  The American Journal of Gastroenterology · 2024-10-01

  article
  PublisherDOI

• Community engagement and clinical trial diversity: Navigating barriers and co-designing solutions—A report from the “Health Equity through Diversity” seminar series

  PLoS ONE · 2023-02-16 · 70 citations

  articleOpen accessCorresponding

  INTRODUCTION: In recent years, there has been increasing awareness of the lack of diversity among clinical trial participants. Equitable representation is key when testing novel therapeutic and non-therapeutic interventions to ensure safety and efficacy across populations. Unfortunately, in the United States (US), racial and ethnic minority populations continue to be underrepresented in clinical trials compared to their White counterparts. METHODS: Two webinars in a four-part series, titled "Health Equity through Diversity," were held to discuss solutions for advancing health equity through diversifying clinical trials and addressing medical mistrust in communities. Each webinar was 1.5 hours long, beginning with panelist discussions followed by breakout rooms where moderators led discussions related to health equity and scribes recorded each room's conversations. The diverse groups of panelists included community members, civic representatives, clinician-scientists, and biopharmaceutical representatives. Scribe notes from discussions were collected and thematically analyzed to uncover the central themes. RESULTS: The first two webinars were attended by 242 and 205 individuals, respectively. The attendees represented 25 US states, four countries outside the US, and shared various backgrounds including community members, clinician/researchers, government organizations, biotechnology/biopharmaceutical professionals, and others. Barriers to clinical trial participation are broadly grouped into the themes of access, awareness, discrimination and racism, and workforce diversity. Participants noted that innovative, community-engaged, co-designed solutions are essential. CONCLUSIONS: Despite racial and ethnic minority groups making up nearly half of the US population, underrepresentation in clinical trials remains a critical challenge. The community engaged co-developed solutions detailed in this report to address access, awareness, discrimination and racism, and workforce diversity are critical to advancing clinical trial diversity.

  PublisherOA PDFDOI

• Addressing non-medical health-related social needs through a community-based lifestyle intervention during the COVID-19 pandemic: The Black Impact program

  PLoS ONE · 2023-03-09 · 21 citations

  articleOpen accessCorresponding

  BACKGROUND: Non-medical health-related social needs (social needs) are major contributors to worse health outcomes and may have an adverse impact on cardiovascular risk factors and cardiovascular disease. The present study evaluated the effect of a closed-loop community-based pathway in reducing social needs among Black men in a lifestyle change program. METHODS: Black men (n = 70) from a large Midwestern city participated in Black Impact, a 24-week community-based team lifestyle change single-arm pilot trial adapted from the Diabetes Prevention Program and American Heart Association's (AHA) Check, Change, Control Blood Pressure Self-Management Program, which incorporates AHA's Life's Simple 7 (LS7) framework. Participants were screened using the Centers for Medicare and Medicaid Services (CMS) Accountable Health Communities Health-Related Social Needs Screening Tool. Participants with affirmative responses were referred to a community hub pathway to address social needs. The primary outcome for this analysis is change in social needs based on the CMS social needs survey at 12 and 24 weeks using mixed effect logistic regressions with random intercepts for each participant. Change in a LS7 score (range 0-14) from baseline to 12 and 24 weeks was evaluated using a linear mixed-effects model stratified by baseline social needs. RESULTS: Among 70 participants, the mean age of participants was 52 ±10.5 years. The men were sociodemographically diverse, with annual income ranging from <$20,000 (6%) to ≥$75,000 (23%). Forty-three percent had a college degree or higher level of education, 73% had private insurance, and 84% were employed. At baseline 57% of participants had at least one social need. Over 12 and 24 weeks, this was reduced to 37% (OR 0.33, 95%CI: 0.13, 0.85) and 44% (OR 0.50, 95%CI: 0.21, 1.16), respectively. There was no association of baseline social needs status with baseline LS7 score, and LS7 score improved over 12 and 24 weeks among men with and without social needs, with no evidence of a differential effect. CONCLUSIONS: The Black Impact lifestyle change single-arm pilot program showed that a referral to a closed-loop community-based hub reduced social needs in Black men. We found no association of social needs with baseline or change in LS7 scores. Further evaluation of community-based strategies to advance the attainment of LS7 and address social needs among Black men in larger trials is warranted.

  PublisherOA PDFDOI

Frequent coauthors

• Joshua J. Joseph

  University of Maryland, Baltimore

  35 shared

• Timiya S. Nolan

  The Ohio State University

  33 shared

• Hisham Hussan

  University of California, Davis

  27 shared

• Peter P. Stanich

  The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute

  25 shared

• Folasade P. May

  UCLA Jonsson Comprehensive Cancer Center

  24 shared

• Rachel B. Issaka

  University of Washington

  23 shared

• Alicia McKoy

  The Ohio State University

  20 shared

• John Gregory

  20 shared

Education

• MPH

  Harvard School of Public Health

  2014

• MD

  Howard University College of Medicine

  2007

Awards & honors

• Best Scenic Design from The Columbus Dispatch
• six USITT/Ohio Valley Section Peggy Ezekiel Awards for Desig…
• Design for Ohio State's 1999 production of Feral Music selec…