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Medicine and Health Sciences

Walden University

2011

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Factors Affecting Cervical Cancer Screening Among African Women Living In The United States, Mosunmola Adeyemi Jan 2011

Factors Affecting Cervical Cancer Screening Among African Women Living In The United States, Mosunmola Adeyemi

Walden Dissertations and Doctoral Studies

More than half of the incidents and mortality rates from cervical cancer occur among minority groups, including immigrant women from continental Africa living in the United States. Although researchers have examined cervical cancer screening practices among minority populations, including Black women in Africa and in the United States, there are few studies on cervical cancer screening and associated risk factors, specifically among African women living in the United States. The purpose of this study was to investigate the association between selected factors and cervical cancer screening practices among African immigrant women living in the United States. Using the behavioral model …


Understanding Psychosocial Rehabilitation Workers' Perceptions Of Difficult Psychiatric Situations, James B. Arnold Jan 2011

Understanding Psychosocial Rehabilitation Workers' Perceptions Of Difficult Psychiatric Situations, James B. Arnold

Walden Dissertations and Doctoral Studies

Psychosocial rehabilitation (PSR) is a community-based service that addresses the challenges faced by people diagnosed as having psychiatric disabilities. While working with co workers and clients, PSR workers may harbor perceptions that could lower the effectiveness of their work and hinder recovery by their clients. Although cognitive-behavioral theory has suggested an association, research has not yet connected PSR worker attitudes about psychiatric situations to their feelings and behavior. In this nonexperimental factorial design, 196 PSR workers were surveyed about the frustrations presented by stressful interpersonal job situations using the Psychiatric Situations Scale to identify whether occupation (case workers, residential workers, …


Attachment, Parentally Bereaved Adolescents, And High School Outcomes In A Large Inner-City High School, Silvana Amar Jan 2011

Attachment, Parentally Bereaved Adolescents, And High School Outcomes In A Large Inner-City High School, Silvana Amar

Walden Dissertations and Doctoral Studies

U.S. and world communities face the challenges of understanding how children grieve and of giving them sufficient social and educational support. Inner-city minority adolescents have not been represented well in the bereavement and attachment literature. The purpose of the quantitative study was to use the attachment theory to understand the impact of parental bereavement on these adolescents. Data were collected using the Adult Attachment Interview (AAI), the Piers-Harris Children's Self- Concept Scale (2nd ed.), and school records. MANOVAs were used to analyze the influence of attachment organization, bereavement status, and gender on self-concept and academic and behavioral functioning in school. …


Generational Cohort Differences In Types Of Organizational Commitment Among Nurses In Alabama, April Lavette Jones Jan 2011

Generational Cohort Differences In Types Of Organizational Commitment Among Nurses In Alabama, April Lavette Jones

Walden Dissertations and Doctoral Studies

In hospitals in the United States, the ratio of nurses to patients is declining, resulting in an increase in work demands for nurses. Consequently, organizations face challenges with nurses' organizational commitment. Studies have revealed generational differences, as determined by birth year, in employee levels of organizational commitment in a number of organizational settings. However, there is a gap in the literature regarding the impact of generational cohorts on the organizational commitment of nurses. The purpose of this quantitative, nonexperimental, cross-sectional design was to address whether generational cohorts of nurses differed in their levels of organizational commitment, and to investigate whether …


The Effect Of Phytoestrogen Chemoprevention Of Prostate Cancer, Ruel Slyfield Michelin Jan 2011

The Effect Of Phytoestrogen Chemoprevention Of Prostate Cancer, Ruel Slyfield Michelin

Walden Dissertations and Doctoral Studies

Prostate cancer (CaP) remains the most commonly diagnosed cancer and second leading cause of cancer mortality among men in several ethnic groups in the United States. Lower CaP incidence among Asian men has been attributed to increased intake of soy derived phytoestrogens (SDPs); however, its association has not been extensively explored in U.S. men. The purpose of this study was to determine the effect size of serum prostate specific antigen (sPSA) and serum estradiol (sE2) following dietary SDP intervention. The study was based on an original conceptual model that aims to avert early prostate tissue damage through identification of critical …


Religious-Base Social Relationship And The Psychological Well-Being Of The Elderly: Gender And Race Variations, Eugene C. Uche Jan 2011

Religious-Base Social Relationship And The Psychological Well-Being Of The Elderly: Gender And Race Variations, Eugene C. Uche

Walden Dissertations and Doctoral Studies

More people in the United States are approaching retirement age, a trend which has resulted in increased study on life satisfaction and psychological well-being of the elderly. Previous researchers have focused on the relationship between religious social support and life satisfaction; however, there remains a gap in the literature regarding how race and gender may influence this association. Knowledge of interactions between religiosity, gender, and race will enable counselors working with different groups of religiously inclined clients to develop and implement religious-based interventions specific to their clients. Guided by the social ecological model, the purpose of this study was to …


Gatekeeper Suicide Prevention Training And Its Impact On Attitudes Toward Help Seeking, John Angelo Cascamo Jr. Jan 2011

Gatekeeper Suicide Prevention Training And Its Impact On Attitudes Toward Help Seeking, John Angelo Cascamo Jr.

Walden Dissertations and Doctoral Studies

Gatekeeper Suicide Prevention Trainings such as Question Persuade and Refer (QPR) are used to increase suicide awareness and teach participants basic suicide intervention skills. Previous researchers showed that QPR training increases knowledge of suicide risk factors and increases participants' willingness to intervene with individuals at risk of suicide. It was hypothesized that completion of QPR would also increase positive attitudes toward the utilization of mental health services and that this outcome would be more pronounced among male participants. The examination of attitudes was rooted in the theoretical framework of Ajzen's theory of planned behavior. The Inventory of Attitudes toward Seeking …


Drills And Exercises As Interventions To Improve Public Health Emergency Response, Donna Beth Knutson Jan 2011

Drills And Exercises As Interventions To Improve Public Health Emergency Response, Donna Beth Knutson

Walden Dissertations and Doctoral Studies

The 2001 destruction of the World Trade Center and the subsequent anthrax attacks highlighted the inability of an antiquated public health system in the United States to respond effectively to emergencies. Little documentation exists to define how public health agencies can improve performance. The overarching research question was the extent to which drills and exercises improve performance in public health emergencies. Adult learning theory and deliberate practice theory were explored in this context. The research data were from 50 state public health departments, which were required to report performance information to the U.S. Centers for Disease Control and Prevention. The …


A Case Study Of Primary Healthcare Services In Isu, Nigeria, Raymond Ogu. Chimezie Jan 2011

A Case Study Of Primary Healthcare Services In Isu, Nigeria, Raymond Ogu. Chimezie

Walden Dissertations and Doctoral Studies

Access to primary medical care and prevention services in Nigeria is limited, especially in rural areas, despite national and international efforts to improve health service delivery. Using a conceptual framework developed by Penchansky and Thomas, this case study explored the perceptions of community residents and healthcare providers regarding residents' access to primary healthcare services in the rural area of Isu. Using a community-based research approach, semistructured interviews and focus groups were conducted with 27 participants, including government healthcare administrators, nurses and midwives, traditional healers, and residents. Data were analyzed using Colaizzi's 7-step method for qualitative data analysis. Key findings included …


The Relationship Between Emotional Intelligence And Literacy Achievement Of Secondary Students, David P. Jones Jan 2011

The Relationship Between Emotional Intelligence And Literacy Achievement Of Secondary Students, David P. Jones

Walden Dissertations and Doctoral Studies

Proficiency in language arts and communication skills is essential to success in the global workforce. Most states assess students in language arts literacy (LAL) through standardized tests that assess a student's ability to read, interpret literature, and write expressively. Although educational reformers strive to improve the foundations that prepare students in literacy, reforms have not fully incorporated the theory of emotional intelligence (EI), which explains a student's ability to use, understand, perceive, and manage their emotions in order to think critically, make decisions, and solve problems. Although it is not known whether EI directly correlates to literacy, emotional skills are …


Wage Equality Among Internationally Educated Nurses Working In The United States, Sat Ananda Hayden Jan 2011

Wage Equality Among Internationally Educated Nurses Working In The United States, Sat Ananda Hayden

Walden Dissertations and Doctoral Studies

Discrimination against immigrants based on country of origin, gender, or race is known to contribute to wage inequality, lower morale, and decrease worker satisfaction. Healthcare leaders are just beginning to study the impact of gender and race on the wages of internationally educated nurses (IENs). Grounded in Becker's theory of discrimination, this cross-sectional study examined nursing wages for evidence of wage inequality among IENs working in the United States using secondary data collected in the 2008 quadrennial National Sample Survey of Registered Nurses. Ordinary least square regression coupled with the Blinder-Oaxaca wage decomposition was used to analyze the wages of …


Emotional Support In Managing Cardiovascular Diseases Among Hispanic And Non- Hispanic Menopausal Women, Claudette Andrea Jan 2011

Emotional Support In Managing Cardiovascular Diseases Among Hispanic And Non- Hispanic Menopausal Women, Claudette Andrea

Walden Dissertations and Doctoral Studies

Effective recognition and proper treatment of cardiovascular diseases (CVDs) in Hispanic woman is a public health problem that needs further investigation. Guided by the stress and coping social support theory, the purpose of this cross-sectional survey study was to examine the relationship between attitudes, emotional support, and the perception of success in managing cardiovascular diseases (CVDs) in 335 Hispanic women living in Atlanta, Georgia. Correlations, independent-sample t tests, simple linear regression, and multiple linear regressions showed ethnicity as a moderating variable between the perception of success in handling CVD and emotional support, while emotional support was shown to be a …


Learning Style Needs And Effectiveness Of Adult Health Literacy Education, Leah A. Grebner Jan 2011

Learning Style Needs And Effectiveness Of Adult Health Literacy Education, Leah A. Grebner

Walden Dissertations and Doctoral Studies

Low health literacy impacts an individual's ability to comprehend communication from healthcare providers, reduces access to healthcare, and contributes to increased mortality. The purpose of this study was to evaluate the impact of learning style on adult health literacy education. The health belief model, protection motivation theory, the transtheoretical model, and social cognitive theory were used to analyze the data in this study, and to further develop effective health literacy education. The research questions addressed the effectiveness of educational intervention adjusted to their appropriate learning style in comparison to a standardized health literacy intervention and potential difference, according to type …


Leadership And Attitudes On Adopting Evidence-Based Practice For Influenza Vaccination, Pamela A. Paparone Jan 2011

Leadership And Attitudes On Adopting Evidence-Based Practice For Influenza Vaccination, Pamela A. Paparone

Walden Dissertations and Doctoral Studies

The United States has set a 90% benchmark for influenza vaccinations for healthcare personnel. Unfortunately, healthcare personnel fall far short of that mark with current rates as low as 62%. Low vaccination rates are responsible for influenza, nosocomial influenza, influenza-like illness, and mortality during influenza season. The purpose of this quantitative correlational study was to understand the relationship between leadership styles, attitudes towards evidence-based practice, and vaccination intention among New Jersey registered nurses (RNs). Diffusion of innovations theory was the theoretical foundation. The 3 instruments used were the Multifactor Leadership Questionnaire, Evidence Based Practice Attitude Scale, and Behavioral Intention Scales, …


The Impact Of Nutrition-Teaching Self-Efficacy On Daily Fruit And Vegetable Intake, Leslie E. Rawls Hoglund Jan 2011

The Impact Of Nutrition-Teaching Self-Efficacy On Daily Fruit And Vegetable Intake, Leslie E. Rawls Hoglund

Walden Dissertations and Doctoral Studies

Lack of fruit and vegetable (FV) consumption is directly linked to the prevalence of obesity and chronic disease in the United States. The USDA Fresh Fruit and Vegetable Program (FFVP) offers elementary school teachers access to healthy foods as part of the public school classroom experience. The purpose of this study---which was based on self-efficacy theory and the socio-ecological model---was to examine if an association exists between selected factors: (a) daily fruit and vegetable consumption, training status in the USDA Fresh Fruit and Vegetable Program (FFVP), and an established school nutrition policy and (b) nutrition-teaching self-efficacy (NTSE) among elementary school …


An Examination Of Awareness Of Over-The-Counter Nonsteroidal Anti-Inflammatory Drugs And Adverse Events, Michelle Popa Jan 2011

An Examination Of Awareness Of Over-The-Counter Nonsteroidal Anti-Inflammatory Drugs And Adverse Events, Michelle Popa

Walden Dissertations and Doctoral Studies

The elderly population is among the fastest growing populations in the United States. Finding and consuming medications safely and effectively are challenging endeavors for this population. Nonsteroidal anti-inflammatory drugs (NSAIDs) are a widely consumed class of medications among the elderly population, with 70% of individuals consuming over-the-counter (OTC) NSAIDs once a week and 34% using them daily. The purpose of this quantitative study was to determine whether (a) patients are aware of the risks associated with the consumption of NSAIDs, and (b) there are differences in awareness based upon specific demographic characteristics and levels of patient-physician communication. The health belief …


The Influence Of Hiv Stigma And Disclosure On Psychosocial Behavior, James Minson Jan 2011

The Influence Of Hiv Stigma And Disclosure On Psychosocial Behavior, James Minson

Walden Dissertations and Doctoral Studies

Human Immunodeficiency Virus (HIV) remains a serious public health issue, and many social factors are involved in virus transmission and treatment. The current conceptualization of how HIV status disclosure and perceived stigma of HIV diagnosis interact is undeveloped. This study was based on social cognitive theory and tested hypothesized positive relations between HIV serostatus disclosure, social support, and self-efficacy. In addition, self-rated HIV stigma was examined as a potential mediating variable. Participants were 109 HIV positive, mostly White gay men recruited via an online bulletin board. They completed the medical outcomes study social support survey, the general self-efficacy scale, the …


Barriers To Healthcare Access For Members Of The Bronx Ghanaian Immigrant Muslim Community In New York City, Adam A. Musah Jan 2011

Barriers To Healthcare Access For Members Of The Bronx Ghanaian Immigrant Muslim Community In New York City, Adam A. Musah

Walden Dissertations and Doctoral Studies

Cultural beliefs on healthcare in the 21st century by the African immigrants in the United States have contributed to the severity of illnesses in their communities. The results of this research identified the healthcare barriers experienced by members of the Bronx Ghanaian Immigrant Muslim Community (BGIMC) in New York City. The purpose of this research was to investigate the influence of education, immigration status, health insurance status, and cultural beliefs on the BGIMC members' perceived access and willingness to use healthcare services for various ailments. A sample of 156 male and female members of the BGIMC completed the survey questionnaire. …


Perspectives Of Women In Nairobi Kenya Toward Malaria Control, Catherine Kisavi-Atatah Jan 2011

Perspectives Of Women In Nairobi Kenya Toward Malaria Control, Catherine Kisavi-Atatah

Walden Dissertations and Doctoral Studies

Malaria infection has been and continues to be a serious public health concern that has mystified many in the public health care industry. One area in Sub Saharan Africa that continues to feel the devastating effects of malaria is in Nairobi, Kenya. This qualitative research study explored the attitudes of women in Nairobi, Kenya and how they view intervention measures already introduced by public health care experts in fighting malaria. The phenomenological research approach used purposeful sampling to recruit 16 women from Nairobi, Kenya to participate in semi-structured, open-ended interviews. The ecological systems theory was used as a lens of …


Factors Influencing U.S. Army Personnel Meeting Body Mass Index Standards, Salma Theus Jan 2011

Factors Influencing U.S. Army Personnel Meeting Body Mass Index Standards, Salma Theus

Walden Dissertations and Doctoral Studies

U.S. Army Regulations require soldiers to be fit, as excessive weight negatively impacts their readiness, health, and morale. A quantitative study examined if personal, behavioral, and/or environmental factors predict a soldier's self-efficacy and body mass index. Data were obtained from 117 soldiers on 6 scales: the Armed Services Vocational Aptitude Battery, the Army Physical Fitness Test, the General Self-Efficacy Scale, the Stress Management Questionnaire, the Lifestyle Assessment Inventory, and the Multifactor Leadership Questionnaire. Multiple regression analysis was used to determine if personal (intellectual capabilities and physical fitness), behavioral (lifestyle and stress management), and/or environmental (supervisor leadership) factors predict self-efficacy and …


The Relationship Between Overweight And Obesity And Acculturation Of 12- To 19-Year-Old Mexican American Children, Elsa Ramirez-Brisson Jan 2011

The Relationship Between Overweight And Obesity And Acculturation Of 12- To 19-Year-Old Mexican American Children, Elsa Ramirez-Brisson

Walden Dissertations and Doctoral Studies

Mexican Americans, one of the fastest growing segments of the population, have been identified as having above-average rates of obesity. Yet, among this group, obesity rates seem to differ by immigrant status: recent immigrants, immigrants who have lived in the United States more than 15 years, and U.S.-born Mexican Americans. Guided by the acculturation phenomenon and the social ecological model, the current study assessed all 1,732 Mexican American children 12-19 years old who participated in the National Health and Nutrition Examination Survey between 2003 and 2008 to determine the association between body mass index (BMI) and language, years living in …


Effects Of A Web-Based Decision Aid On African American Men's Prostate Screening Knowledge And Behavior, Beverly Layton Jan 2011

Effects Of A Web-Based Decision Aid On African American Men's Prostate Screening Knowledge And Behavior, Beverly Layton

Walden Dissertations and Doctoral Studies

African American men have the highest prostate cancer occurrence and deaths of any population, yet many are unaware of screening opportunities or prognoses if diagnosed with the disease. The focus of this study was to learn whether a web-based prostate health education decision aid would increase prostate cancer knowledge, declared intention to be screened, and the likelihood of scheduling a prostate-specific antigen (PSA) test. The transtheoretical model of behavior change served as the theoretical framework for the study to assess readiness to adopt new behaviors. A total of 128 African American men between the ages of 40--65 without a history …


Hardiness And Attitude On Hypertension Treatment Adherence Among Nigerian Health Care Workers, Chinwe N. Egwuagu-Ndubisi Jan 2011

Hardiness And Attitude On Hypertension Treatment Adherence Among Nigerian Health Care Workers, Chinwe N. Egwuagu-Ndubisi

Walden Dissertations and Doctoral Studies

Racial and ethnic minorities in the United States have higher rates of hypertension than European Americans. In this ethnographic study, 30 Nigerian immigrant health care workers with hypertension described their self-efficacy management of the disease to ascertain the relationship between health-related hardiness, individual attitudes on compliance, and medication adherence self-efficacy. Using a mixed methods designs comprised of survey tools and focus-group questionnaires, the research questions were focused on understanding attitudes and health practices within Nigerian culture that support self-efficacy management. The theoretical framework for this study is the social learning theory and the social cognitive theory postulated by Bandura. Content …


Assessing The Influence Of Socioeconomic Factors, Knowledge Level, Attitudes, And Practices On Malaria Prevention Among The Gusii People Of Kenya, Christopher Nyakundi Arori Jan 2011

Assessing The Influence Of Socioeconomic Factors, Knowledge Level, Attitudes, And Practices On Malaria Prevention Among The Gusii People Of Kenya, Christopher Nyakundi Arori

Walden Dissertations and Doctoral Studies

Global morbidity and mortality associated with malaria is rampant, and most of the clinical malaria cases are found in sub Saharan Africa. Previous and current research show that malaria is both preventable and treatable and that socioeconomic variables have a profound influence on how persons in rural Africa respond to malaria infections and the associated preventive strategies. This study assessed two key research questions for malaria cases in the Gusii region of Kenya regarding: First, whether a community education program on malaria has an impact in changing malaria preventive behaviors; and, second, if a relationship exists between socioeconomic factors and …


Public Sponsored Health Insurance To Improve Health Outcomes With Implications For Government Health Policy, Design, And Decision Making, Steven M. Wagner Jan 2011

Public Sponsored Health Insurance To Improve Health Outcomes With Implications For Government Health Policy, Design, And Decision Making, Steven M. Wagner

Walden Dissertations and Doctoral Studies

This research sought to ascertain the extent to which providing public sponsored health insurance (PSHI) to previously uninsured Mexican-American Hispanics improves health outcomes among those requiring ongoing treatment to control diabetes. Prior research utilizing insurance access theory; access, equity, and health outcome interrelationship theory; health affordability theory; and financial and resource burden theory suggests the uninsured receive less care than the insured, with delayed treatment, leading to chronic conditions. This research tested each of those major theoretical constructs into a blended conceptual framework based on the notion that providing health insurance helps alleviate the disabling effects of diabetes among this …


The Effects Of An Integrated Health And Physical Education Program On Student Achievement, Myralynn B. Catchings Jan 2011

The Effects Of An Integrated Health And Physical Education Program On Student Achievement, Myralynn B. Catchings

Walden Dissertations and Doctoral Studies

In recent years, several schools have addressed the No Child Left Behind (NCLB) Act of 2001 by focusing on promoting skill acquisition in reading and math, often overlooking physical education (PE) as a significant part of a child's education. The purpose of this causal-comparative study was to evaluate the effectiveness of an integrated health and physical education (HPE) program on student achievement. This study was grounded in action-based learning theories. The research question examined differences in posttest scores, adjusted for pretest differences, from 204 freshman students enrolled in a Biology-1 class at an urban high school. Students in Group A …


The Relationship Of Provider Cultural Competence And Utilization Of Prenatal Care In The Hmong Of Minnesota, Cynthia J. Larson Jan 2011

The Relationship Of Provider Cultural Competence And Utilization Of Prenatal Care In The Hmong Of Minnesota, Cynthia J. Larson

Walden Dissertations and Doctoral Studies

Experts suggest that the cultural competence of healthcare providers is a critical factor impacting healthcare services to the ethnically diverse patient populations in the U.S. and that it may play a role in improving outcomes and reducing health disparities; however, the association between cultural competence and health outcomes remains unclear. This study used a cross-sectional quantitative design grounded by cultural competency constructs and the ethnic origins theory to explore the relationships between provider cultural competence, adequacy of prenatal care, and neonatal health outcomes in Hmong women, a population whose cultural beliefs affect their use of early and adequate prenatal care. …


Differences In Breast Cancer Tumor Size, Stage, And Survival By Socioeconomic Position In Young Women, Julie Maureen Tomaska Jan 2011

Differences In Breast Cancer Tumor Size, Stage, And Survival By Socioeconomic Position In Young Women, Julie Maureen Tomaska

Walden Dissertations and Doctoral Studies

Although the incidence of breast cancer in women under 40 years of age is somewhat rare, young women tend to present with cancer that is more advanced and with poorer prognostic characteristics. This research will be important to providers, women and their families and those seeking to clarify screening guidelines. The purpose of this quantitative, retrospective, cohort study was to evaluate differences in prognostic characteristics by socioeconomic position (SIP). The cohort was comprised of females aged 18 to 39 with a primary diagnosis of breast cancer. Data were obtained from the Surveillance, Epidemiology and End Results registry for all primary …


Assessment Of Admission Criteria And Selection Process For Nurse Education Programs, Mary Ann Jarmulowicz Jan 2011

Assessment Of Admission Criteria And Selection Process For Nurse Education Programs, Mary Ann Jarmulowicz

Walden Dissertations and Doctoral Studies

Qualified student enrollment to nurse education program is limited by admission criteria predetermined by faculty; however, little is known regarding the development and consistency of selection criteria. The purpose of this study was to examine the admission requirements of nursing programs to better understand the philosophical underpinnings and complexity of selection criteria. The conceptual frameworks of teaching philosophy, complexity, and gatekeeping guided this research. This descriptive correlational study used a cross-sectional design to survey a purposeful sample of full-time faculty teaching in nurse education programs in a southeastern state. Descriptive analyses, independent t test, and a Lambda analyses were employed …


Evaluation Of Capacity For Best Practice Of Clinical Vaccine Research In Western Kenya, Sylvie Anne Kwedi Jan 2011

Evaluation Of Capacity For Best Practice Of Clinical Vaccine Research In Western Kenya, Sylvie Anne Kwedi

Walden Dissertations and Doctoral Studies

African institutions that perform health research need to continuously evaluate their practices in order to ensure compliance with international standards of good clinical practice (GCP). This mixed-methods study, undertaken at one clinical research site in Western Kenya, was an evaluation of GCP compliance at the site, research participants' satisfaction with research procedures, and research participants' comprehension of informed consent. The qualitative portion of the study involved audit of the site's compliance with GCP standards. The quantitative portion was an assessment of participant satisfaction and informed consent comprehension, undertaken through interviews with a sample of 297 participants. Thematic analysis of the …