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Treatment Adherence Among Women Infected With Human Immunodeficiency Virus With A History Of Gender-Based Violence, Olivia Mcgregor
Treatment Adherence Among Women Infected With Human Immunodeficiency Virus With A History Of Gender-Based Violence, Olivia Mcgregor
Walden Dissertations and Doctoral Studies
Women infected with Human Immunodeficiency Virus (HIV) are at high risk of myriad conditions, especially gender-based violence (GBV). GBV can be a hindrance to treatment adherence, which is pertinent to improving the health of people living with HIV. The purpose of this longitudinal research study was to assess the effects of GBV on treatment adherence among HIV infected women, with specific focus on when the violence occurred (recent or lifetime) and the stratifying type of GBV (sexual, physical, and psychological). The health belief model (HBM) served as a theoretical groundwork. Participants were selected from secondary data, collected by the Women’s …
A Model For Hiv Disclosure Of A Parent's And/Or A Child's Illness, Gary J. Burkholder Jr, Grace Gachanja
A Model For Hiv Disclosure Of A Parent's And/Or A Child's Illness, Gary J. Burkholder Jr, Grace Gachanja
Walden Faculty and Staff Publications
HIV prevalence in Kenya remains steady at 5.6% for adults 15 years and older, and 0.9% among children aged below 14 years. Parents and children are known to practice unprotected sex, which has implications for continued HIV spread within the country. Additionally, due to increased accessibility of antiretroviral therapy, more HIV-positive persons are living longer. Therefore, the need for HIV disclosure of a parent's and/or a child's HIV status within the country will continue for years to come. We conducted a qualitative phenomenological study to understand the entire process of disclosure from the time of initial HIV diagnosis of an …
Association Between Haart And Metabolic Syndrome Components Among Hiv-Positive Adults In Southeastern Nigeria, Bridget Okiemute Amechi
Association Between Haart And Metabolic Syndrome Components Among Hiv-Positive Adults In Southeastern Nigeria, Bridget Okiemute Amechi
Walden Dissertations and Doctoral Studies
Highly active antiretroviral therapy (HAART) contributes to metabolic disorders and the growing prevalence of metabolic syndrome (MetS) in human immunodeficiency virus (HIV)-infected patients. Hypertension, obesity, and hyperglycemia (components of MetS) are risk factors for cardiovascular disease. Studies have shown that HIV patients on HAART have a 2-fold risk of dying from MetS. There are no such studies in Umuahia; hence the need for this study to fill this gap. Using a sample size of 192 medical records of HIV-infected patients in Federal Medical Centre, Umuahia, and applying metabolic syndrome theory, this study examined the relationships among types of HAART regimen, …
Risk Of Alzheimer's Disease Among Older Hispanic/Latinos With Diabetes, Kathy Bianco
Risk Of Alzheimer's Disease Among Older Hispanic/Latinos With Diabetes, Kathy Bianco
Walden Dissertations and Doctoral Studies
Alzheimer's disease (AD) is the 6th leading cause of death in older Americans. Currently there is no cure for AD, and even though the specific cause is unknown, diabetes mellitus type 2 (DM2) is regarded as a risk factor. Hispanics have a higher incidence of DM2 and possibly AD. I chose a life course theoretical model for this quantitative cross-sectional study to illuminate the variables most pertinent to a pathway from good health to poor health. The variables chosen were hypertension (HTN), obesity, smoking, stroke, dyslipidemia, and lower educational attainment. The research questions were used to examine biologic, metabolic, sociologic, …
Risk Factors For Tuberculosis And Multidrug-Resistant Tuberculosis Complications Among Foreign-Born Persons In Houston, Texas, James N. Isaboke
Risk Factors For Tuberculosis And Multidrug-Resistant Tuberculosis Complications Among Foreign-Born Persons In Houston, Texas, James N. Isaboke
Walden Dissertations and Doctoral Studies
Tuberculosis (TB) is a leading public health problem across the world. For various reasons, TB and multidrug-resistant tuberculosis (MDR-TB) have increased. Clarification on TB/HIV co-infection and homelessness as risk factors for TB and MDR-TB is required to inform policy interventions to reduce TB-related morbidity, mortality, and healthcare costs. In this quantitative study, data from the Houston Health Department (N = 341) were analyzed to explore the relationship between TB and MDR-TB outcomes and TB/HIV co-infection and type of housing/homelessness. Foreign-born persons are disproportionately affected in the United States. The socio-ecological model provided a theoretical framework for the investigation. Multiple and …
Use Of Maternal Health Services And Pregnancy Outcomes In Nigeria, Abubakar Sadiq Umar
Use Of Maternal Health Services And Pregnancy Outcomes In Nigeria, Abubakar Sadiq Umar
Walden Dissertations and Doctoral Studies
Maternal health services (MHS) provide primary, secondary, and tertiary levels of prevention to achieve better pregnancy outcomes. However, use of prenatal and natal services among Nigerian women has been ranked among the lowest in the world and, consequently, the country is among the 10 countries with the highest maternal mortality ratio. Moreover, nationwide community-based studies on the use of maternal health services in Nigeria are limited. To address this gap, this quantitative, cross-sectional study analyzed the 2008 Nigerian Demographic and Health Survey (NDHS) data to identify whether Nigerian women's biological, cultural, and socioeconomic characteristics are associated with their use of …
Socioeconomic Responsibility And Its Effect On Hypertension Among West African Immigrants In The United States, Chryss Arekhandia Okonofua
Socioeconomic Responsibility And Its Effect On Hypertension Among West African Immigrants In The United States, Chryss Arekhandia Okonofua
Walden Dissertations and Doctoral Studies
Native-born African Americans (NBAA) bear a disproportionate burden of the effect of hypertension (HTN) in comparison to other racial groups in the United States. West African immigrants (Foreign-born African Americans) appear to carry a heavier burden than the NBAA in the United States. Using the social support theory as a guide, this study examined the association between the need to meet socioeconomic responsibility of financial and familial obligations (SERFFO) and perceived stress and the increased likelihood of HTN among West African immigrants, aged 25-54 years, in the United States. In this quantitative, cross-sectional design, self-reported data were collected from a …
Impact Of Pneumococcal Conjugate Vaccine Thirteen Valent On The Reduction Of Invasive Pneumococcal Disease, Aissata Coulibaly
Impact Of Pneumococcal Conjugate Vaccine Thirteen Valent On The Reduction Of Invasive Pneumococcal Disease, Aissata Coulibaly
Walden Dissertations and Doctoral Studies
Many children under the age of 5 die each year of invasive pneumococcal disease. Childhood vaccination against this disease reduces morbidity and mortality. Despite the introduction of a pneumococcal conjugate vaccine (PCV13) in a central African country in 2011, all provinces have not yet been vaccinated. The purpose of this quantitative quasi-experimental study was to determine whether there was an association between the introduction of PCV13 and new cases of pneumococcal disease in 2 provinces in central Africa. The sample size for the study was 380. The theoretical framework for this study was the epidemic model supported by the concept …
Hospital Profiling Of The Cesarean Delivery Procedure For The State Of Georgia, 2012, Denise Frances Giles
Hospital Profiling Of The Cesarean Delivery Procedure For The State Of Georgia, 2012, Denise Frances Giles
Walden Dissertations and Doctoral Studies
Approximately 35.1% of live births for the state of Georgia were delivered by the cesarean delivery procedure with significant variation among hospitals. The purpose of this research was to develop a population-based hospital profiling methodology for study of the cesarean delivery procedure. This was a retrospective, observational design, using a 2012 linked dataset that included maternity deliveries from all nonfederal hospitals. The research was guided by Robson 10 Group Classification System, propensity score methodologies, and ethical precepts, for the development of hospital profiles and the study of variations in the cesarean delivery procedure. Key research questions aimed to determine whether …
Behaviors Related To Hiv Infections In Rural Versus Urban Regions Of Nigeria, Michael Ifeanyi Okeke
Behaviors Related To Hiv Infections In Rural Versus Urban Regions Of Nigeria, Michael Ifeanyi Okeke
Walden Dissertations and Doctoral Studies
Efforts by the Federal Republic of Nigeria and international nongovernmental agencies to reduce the impact of HIV in Nigeria have not yielded the anticipated results. This study focused on the association between attitude, religious beliefs, knowledge of HIV, sexual risk behavior, and HIV epidemiology in rural and urban Nigeria. This quantitative study used social-cognitive theory and problem theory. The study was based on the Nigerian Demographic and Health Survey (NDHS) 2013 data including a sample of 33,006 participants. Specific covariates including gender, sexual partners over the past years, age at first sexual encounter, socioeconomic status, and literacy level were obtained …
Effects Of Social Support On Cardiac Recurrence Among African Americans, Yolanda Phillips
Effects Of Social Support On Cardiac Recurrence Among African Americans, Yolanda Phillips
Walden Dissertations and Doctoral Studies
Heart disease is the leading cause of death among African Americans. Despite advances in treatment modalities, based on better understanding of the disease's pathology and access to health care, African Americans continue to die from heart disease at rates significantly higher than other races. The available literature on cardiovascular disease among African Americans does not adequately explore how social support affects heart health in this group. The purpose of this study was to examine the effects of social support on cardiac recurrence among African American adults. Cohen's ISEL support system variables: tangible, appraisal, belonging, and self-esteem; and five demographic variables: …
Impact Of Medicare And Medicaid Beneficiaries With Selected Conditions On Emergency Department Utilization, John K. Amoh
Impact Of Medicare And Medicaid Beneficiaries With Selected Conditions On Emergency Department Utilization, John K. Amoh
Walden Dissertations and Doctoral Studies
Chronic Obstructive Pulmonary Disease (COPD) and Congestive Heart Failure (CHF) are conditions that represent significant and ongoing medical costs, including frequent emergency department (ED) visits, hospitalizations, work absences, and disability. This retrospective cross-sectional study, examined the effects of the frequent ED visits due to COPD and CHF on the beneficiaries of Medicare and Medicaid in Maryland. The goal was to identify the factors that led these patients to visit the ED, the impact of these visits on Medicare utilization and costs across Maryland, and preventative intervention strategies to control this population's costs of care. Secondary data were analyzed from 2010-2012 …
Interrelationships Of Colorism, Violence, And Sexual Behaviors Among Southern African American Women., Phaedra Christensen
Interrelationships Of Colorism, Violence, And Sexual Behaviors Among Southern African American Women., Phaedra Christensen
Walden Dissertations and Doctoral Studies
Two significant public health concerns that threaten both the physical and mental health of African-American women are Intimate Partner Violence (IPV) and Human Immunodeficiency Virus (HIV). African-American women (AAW) in the south carry the greatest burden of HIV and disproportionately represent the region with an incidence of 71% for new HIV infections, and elevated rates of morbidity and mortality. In 2013, the murder rate among AAW was 2.5 times higher than it was among Caucasian women. Most of the published studies that explored the association between IPV and HIV had mixed populations, did not explore topics unique to AAs, or …
Diabetes Management Regimens And Cardiovascular Disease Risk In African American Men, Joseph Garilus
Diabetes Management Regimens And Cardiovascular Disease Risk In African American Men, Joseph Garilus
Walden Dissertations and Doctoral Studies
One of the most common health complications related to diabetes is the development of cardiovascular disease (CVD). Studies addressing the association between adherence to diabetes management regimens and the risk of CVD among minority populations are limited. This cross-sectional study was conducted to examine the association between diabetes management regimens and risk of CVD among African American men. The health belief model was used to frame the study. Data were collected from the Behavioral Risk Factor Surveillance System database for the states of Missouri and Ohio. Multiple logistic regression analysis was used to assess the association between adherence to diabetes …
The Impact Of Free Healthcare On Hospital Deliveries In Sierra Leone, Salifu Salito Samura
The Impact Of Free Healthcare On Hospital Deliveries In Sierra Leone, Salifu Salito Samura
Walden Dissertations and Doctoral Studies
Improving maternal health has been a challenge for developing nations with very high rates of maternal mortality. Sub-Saharan Africa, particularly Sierra Leone, has some of the highest maternal mortality rates in the world. In an attempt to improve on this, the Sierra Leonean government enacted free maternal healthcare services in 2010. The Sierra Leone Free Healthcare Initiative (SLFHCI) provides free healthcare for pregnant women, lactating mothers, and children under 5 years old. This research explored the impact of the free healthcare on hospital deliveries. The determinant of health model was used to evaluate the effectiveness of the SLFHCI program, and …
Risk Factors For Measles Among Hiv-Infected Children In Uganda, Miriam Nanyunja
Risk Factors For Measles Among Hiv-Infected Children In Uganda, Miriam Nanyunja
Walden Dissertations and Doctoral Studies
Measles remains a major global public health problem. Attainment of high population immunity to measles through vaccination is necessary to control this disease. Children infected with HIV infection often experience secondary measles vaccine failure by 2 years of age, making them susceptible to measles. It is not clear whether HIV-infected children on Highly Active Antiretroviral Treatment (HAART), older than 2 years, have a higher risk of measles than HIV-uninfected children. This retrospective cohort study, guided by the proximate determinants framework, was conducted to compare the risk of measles between HIV-infected children on HAART (exposed) and HIV-uninfected peers (unexposed). The age …
Perceptions Of Behavioral And Lifestyle Changes Among African American Women With Type 2 Diabetes, Myriam Almonor
Perceptions Of Behavioral And Lifestyle Changes Among African American Women With Type 2 Diabetes, Myriam Almonor
Walden Dissertations and Doctoral Studies
The prevalence of type 2 diabetes (T2D) continues to rise and is predicted to increase to 30 million people by 2030 in the United Sates alone. African Americans (AA) have one of the highest prevalence rates of T2D among all ethnic groups. African American Women (AAW) are 100% more likely to develop T2D compared with their white counterparts. The aim of this study was to quantitatively investigate the relationship of the perceptions of AAW not previously identified that could lead to a reduction in risk of T2D among AAW. A cross-sectional study of 183 AAW 20 to 65 years old …
Assessment Of Her2-Neu In Breast Cancer Lines Upon Differential Exposures To Xenoestrogens, Abha Aggarwal
Assessment Of Her2-Neu In Breast Cancer Lines Upon Differential Exposures To Xenoestrogens, Abha Aggarwal
Walden Dissertations and Doctoral Studies
Synthetic xenoestrogens have differential estrogenic properties. Research has shown that exposures to xenoestrogens could promote breast cancer by disrupting normal function of the human epidermal growth factor receptor 2 (Her2) gene. Although animal models demonstrated a connection between xenoestrogen exposure and Her2 activity, no study using human cells has systematically examined their carcinogenic potential influencing the Her2 gene expression. Furthermore, breast cancer cells are phenotypically disparate (ER+, Her2+), with some phenotypes (Her2+), leading to more aggressive disease. This study aimed to dosimetrically assess the carcinogenic potential of commonly used xenoestrogens influencing Her2 gene expression, and delineate cellular phenotypes at greater …
Environmental Factors Associated With Body Mass Index Among Long Haul Truck Drivers, Charlotte Hughes Huntley
Environmental Factors Associated With Body Mass Index Among Long Haul Truck Drivers, Charlotte Hughes Huntley
Walden Dissertations and Doctoral Studies
In 2009–2010, the prevalence of obesity among U.S. adults was 40%, and the prevalence was 69% among long haul truck drivers. Researchers have not established a clear relationship between working environment and weight among truck drivers. This quantitative cross-sectional study, using an ecological framework, evaluated the relationship between the working environment (sleep performance, food choices, driving environment, and activity level) and weight severity (e.g., body mass index [BMI]) among long haul truck drivers. One hundred and twenty six adults (46 + 10, years of age), including both genders (male = 97 and females = 29) completed an online questionnaire evaluating …
Association Between Diabetes/Chronic Disease Incidence And Lifestyle Factors Among African-Born Populations, James Walakerwon Gbala
Association Between Diabetes/Chronic Disease Incidence And Lifestyle Factors Among African-Born Populations, James Walakerwon Gbala
Walden Dissertations and Doctoral Studies
Numerous studies have revealed that immigrants' health and well-being is challenged by an increased susceptibility to diabetes/chronic disease as they settle in the United States. This study investigated a potential association between the incidence of diabetes/chronic disease and various lifestyles factors among Sub-Saharan African immigrants and refugees. The lifestyle factors studied were sociodemographics, food practices and dietary habits, access to healthcare and insurance, acculturation, and the length of stay in the United States among these immigrants and refugees residing in Minnesota. The health belief and the socioecological models guided this study to improve understanding of Sub-Saharan African's health behavior and …
Symptom Presentation Frequency And Severity Associated With Adult Lyme Disease By Ross Scale Review, Vicki A. Stanavitch
Symptom Presentation Frequency And Severity Associated With Adult Lyme Disease By Ross Scale Review, Vicki A. Stanavitch
Walden Dissertations and Doctoral Studies
Although Lyme disease is the most frequently reported vector-borne illness in the United States, recent evidence from the CDC suggests that Lyme disease incidence in the United States may be much higher than reported. Lyme disease symptoms can be mistaken for a wide variety of diseases, which can complicate the diagnosis. To date, no diagnostic criteria analysis has been conducted examining the association between sociodemographic variables (sex and age) and seasonality of infection with the severity and symptomology found in Lyme disease cases. Using the CDC's outbreak investigation model, a primary case/control study was conducted using the ROSS Scale to …
Evaluation Of Active And Passive Neonatal Tetanus Surveillance Systems In Katsina State, Nigeria, Shafique Sani Nass
Evaluation Of Active And Passive Neonatal Tetanus Surveillance Systems In Katsina State, Nigeria, Shafique Sani Nass
Walden Dissertations and Doctoral Studies
The incidence and mortality rates of neonatal tetanus (NNT) remain underreported in Nigeria. This cross-sectional study was guided by the Mosley and Chen's model for the elements of child survival in developing countries. The goals of the study were twofold: (a) to compare the NNT prevalence and the mortality rates from the existing surveillance system and active surveillance of health facility records in 7 selected health facilities from 2010 to 2014 in Katsina state, Nigeria and (b) to assess the associations between selected NNT risk factors, number of maternal tetanus toxoid injections, frequency of antenatal visits, place of delivery, and …
Associations Between Healthcare Facility Types And Healthcare-Associated Infections, Aretha D. Miller
Associations Between Healthcare Facility Types And Healthcare-Associated Infections, Aretha D. Miller
Walden Dissertations and Doctoral Studies
Healthcare-Associated Infections (HAIs) continue to be an epidemiological issue burdening patients and public health systems worldwide. The purpose of this study was to determine if specific healthcare facility types (Acute Care Hospitals, Long Term Acute Care Hospitals, and Inpatient Rehabilitation Facilities) were associated with particular categories of HAIs: Ventilator-Associated Pneumonias (VAPs), Central Line-Associated Bloodstream Infections (CLABSIs), and Catheter-Associated Urinary Tract Infections (CAUTIs). The theoretical framework for this study was the environmental determinants of infectious disease framework. A single research question focused on whether an association existed among the specified health care facility types and HAIs. Three independent categorical variables were …
Incidence Of And Risk Factors For Thromboembolic Events In Elderly Medicare Patients With Kidney Cancer, Monica Kobayashi
Incidence Of And Risk Factors For Thromboembolic Events In Elderly Medicare Patients With Kidney Cancer, Monica Kobayashi
Walden Dissertations and Doctoral Studies
The incidence of venous and arterial thromboembolic events (VTEs/ATEs) varies greatly by cancer type and age, with increased risk in the elderly. Very little research has been reported specific to elderly kidney cancer patients. Retrospective cohort analyses of Medicare patients, 11,463 with and 11,463 without kidney cancer, between 2003 and 2010 were conducted to compare incidence rates of VTEs/ATEs in cancer patients with matched noncancer patients and to assess independent risk factors for VTEs in cancer patients. The advanced epidemiology triangle was the theoretical framework used to interpret the association between incident events and other factors. Using Cox proportional hazard …
Risk Factors And Outcomes For Bloodstream Infections Among Patients With Skin Infections, Michael Rybak Rybak
Risk Factors And Outcomes For Bloodstream Infections Among Patients With Skin Infections, Michael Rybak Rybak
Walden Dissertations and Doctoral Studies
Acute bacterial skin and skin structure infections (ABSSSI) are common infections within the local community, and they result in higher morbidity and health care costs. While risk factors for skin and soft tissue infections have been previously evaluated, risk factors associated with secondary bloodstream infections (BSI) has not been investigated, especially in an intercity patient population with limited health care resources. In this case control investigation, 392 patients consisting of 196 cases (ABSSSI + BSI) and 196 controls (ABSSSI) were investigated to determine risk for BSI. Both sociodemographic and underlying conditions were evaluated. According to bivariate analysis of cases and …
Community And Patient-Centered Medical Home In The Care Of Chronically Ill Patients, Victor A. Carrillo
Community And Patient-Centered Medical Home In The Care Of Chronically Ill Patients, Victor A. Carrillo
Walden Dissertations and Doctoral Studies
Large portions of the US population live in poor inner-city communities. Health needs assessment data have shown that these communities have disproportionately high rates of chronic illnesses. The patient-centered medical home (PCMH) model was developed to address the gaps that exist in the primary care system, and emphasizes a redesign of primary care that is patient centered, utilizes multiple levels of healthcare professionals, information technology, and care coordination. However, little evidence exists on the value of this model which may explain why it has not gained wide acceptance by primary care providers. Therefore, this study was designed to examine the …
Transcriptome Analysis Of Vaccine Responses To Francisella Tularensis Or Venezuelan Equine Encephalitis Virus, Rebecca Ann Erwin-Cohen
Transcriptome Analysis Of Vaccine Responses To Francisella Tularensis Or Venezuelan Equine Encephalitis Virus, Rebecca Ann Erwin-Cohen
Walden Dissertations and Doctoral Studies
The lack of vaccines for emerging and re-emerging diseases highlights technical gaps and indicates a need for innovative approaches to produce new vaccines. Vaccines may be improved by knowledge of host responses to vaccination, disease pathogenesis, and the effect of age and genetics on vaccine outcome. This study's purpose was to quantitatively assess the molecular epidemiology of Francisella tularensis (Ft) and Venezuelan Equine Encephalitis Virus (VEEV). Study results support the Epidemiology Nexus model which holds that association of changes in gene expression to vaccination facilitate understanding the mechanisms of immune development and link public health and disease epidemiology. My research …
Differences In Treatment-Seeking And Treatment-Adherence Factors For Tuberculosis In Armenian Versus Non-Armenian Populations Of Los Angeles County, Tanya Marie Ferguson
Differences In Treatment-Seeking And Treatment-Adherence Factors For Tuberculosis In Armenian Versus Non-Armenian Populations Of Los Angeles County, Tanya Marie Ferguson
Walden Dissertations and Doctoral Studies
Tuberculosis (TB) is a deadly, yet curable, infectious disease that continues to be a global health threat. Armenia suffers from rising TB incidence and mortality rates. Armenians living in Los Angeles (LA) County, where TB incidence is higher than national averages, is the second largest Armenian community in the world; therefore implications are that many TB cases are attributed to this group. Using the social ecological model as a theoretical framework, this concurrent, mixed-methods study compared Armenians to non-Armenians in LA County about their knowledge of TB and perceived barriers to seeking and adhering to treatment. Bivariate chi-square analysis from …
Hiv-Positive Status Disclosure Barriers In Stable Heterosexual Partners In Warri, Nigeria., Edith Nkechinyere Ogbozor
Hiv-Positive Status Disclosure Barriers In Stable Heterosexual Partners In Warri, Nigeria., Edith Nkechinyere Ogbozor
Walden Dissertations and Doctoral Studies
Nondisclosure of positive status drives the secondary transmission of human immunodeficiency virus (HIV) infection. This cross sectional quantitative survey study grounded by the consequence theory evaluates fear of stigma, lack of social support, and level of HIV-related knowledge as barriers to self-disclosure of HIV-positive status to stable heterosexual partners. A sample of 303 HIV-infected respondents (111 men and 192 women) accessing antiretroviral therapy at 4 designated centers in Warri, Nigeria, completed the self-administered questionnaires. Logistic regression analysis was used to assess the association between these factors and spousal HIV-positive status disclosure. Results demonstrated: (a) social support availability significantly predicted HIV …
The Association Between Osteoporosis And Early Menopause Following Hysterectomy, Mia Meeyaong-Won Botkin
The Association Between Osteoporosis And Early Menopause Following Hysterectomy, Mia Meeyaong-Won Botkin
Walden Dissertations and Doctoral Studies
Osteoporosis is considered to be the most adverse public health disease associated with substantial mortality among postmenopausal women. Hysterectomy, surgically induced menopause, contributes to the early onset of menopause. However, there was no evidence of an association between early menopause following hysterectomy and osteoporosis among postmenopausal women. The purpose of this quantitative study was to examine the association between demographic and behavioral factors and the prevalence of osteoporosis among hysterectomized postmenopausal women. The integrated theory of health behavior change theoretical framework guided study. Cross-sectional secondary data from the 2009-2010 National Health and Nutrition Examination Survey were used. Multiple logistic regression …