Digital Commons Network^™

Addressing Air Quality Mitigation As A Key Factor In Asthma Management And Prevention, Julia Buckles, Jewel Radford

Doctor of Nursing Practice Projects

Asthma is the most prevalent disease in childhood and disproportionately affects African American (AA) populations in terms of prevalence and frequency of exacerbations. Air quality and environmental factors are strongly associated with the diagnosis and management of asthma and AA children are more likely to live in areas with poor air quality. An air quality flag program was implemented in a daycare located in a county with a predominantly AA population with a high prevalence of asthma diagnoses. The goal of the intervention was to increase staff awareness of air quality and the impact it can have on asthma diagnosis …

African American Women’S Perceptions Of A Group Based, Diabetic Medical Nutritional Therapy Intervention: A Qualitative Study, Megan Mcmahon, Laura Gray

DNP Scholarly Projects

Background: African American women exhibit lower rates of attaining recommended diabetes management goals such as optimal blood sugar, cholesterol, and blood pressure numbers compared to other racial and gender groups. As a result, they bear a disproportionate burden of the adverse outcomes associated with poorly managed type 2 diabetes, including increased complications and mortality rates compared to other demographic groups. Despite favorable qualitative findings regarding group-based interventions for African American women with other chronic diseases, a notable gap in the literature exists regarding the women’s perceptions of a group-based medical nutritional therapy tailored to type 2 diabetes. Purpose: This scholarly …

Diabetic Coaching Program To Improve African American Patients Glycemic Control, Shonda Moore

Student Scholarly Projects

Practice Problem: The purpose of the practice problem was to find out if, among African Americans with type II diabetes who are over 18, adopting a diabetic coaching program that emphasizes diet management can result in better glycemic control over 10 weeks than for those who do not receive coaching.

PICOT: In African Americans with type II diabetes over 18 years of age (P), does a diabetic coaching program on diet management (I), compared to no coaching program (C), improve glycemic control (O) over 10 weeks (T)?

Evidence: The evidence used to guide this project came from databases, including PubMed, …

Reducing Mortality Among African American Mothers Related To Postpartum Hemorrhage By Implementing Early Education And Risk Assessments, Don'ya Truesdale

Theses and Dissertations

African American women are at the highest risk for hemorrhaging during childbirth (Okunlola, 2022). A hemorrhage can occur among postpartum mothers for many reasons, with the main causes being uterine atony, tissue trauma, and clotting issues. However, risks for Black mothers differ. The comorbid and social factors within the Black community greatly influence the likelihood of Black mothers experiencing postpartum hemorrhage. Additionally, the lack of assessment and attention catered towards those risk factors lead to an increased mortality among African American (AA) mothers compared to Caucasian mothers and all other ethnicities. Nonetheless, as maternal risk assessments and education increase, mortality …

Church-Based Hypertension Education: An Alternative Solution To Hypertension Management In The African American Community, Nicole Tofi Rice

Doctor of Nursing Practice Final Manuscripts

Purpose: The objective of this evidence-based project is to explore a church-based hypertension education program as an alternative solution to providing hypertension education to the African American community. The desired goals of this project are: (a) to assess the current levels of adherence to antihypertensive therapy among members of a local African American church, using the Hill-Bone Compliance to High Blood Pressure Therapy Scale, and (b) to conduct a literature review exploring policy options encouraging the implementation of a church-based hypertension education program.

Background: Despite medical advances aimed towards prevention and effective treatment, the African American community remains disproportionately affected …

Management Of Stage I And Stage Ii Labor Arrest Disorder To Reduce Primary Cesarean Section Birth Rate For African American Women, Ariam Yitbarek Mha, Bsn, Rn, Nea-Bc

Doctor of Nursing Practice Projects

Background: Cesarean section delivery rate in the United States has reached an alarming rate of over 30%. African American women experience a higher cesarean birth rate compared to Caucasian Women. The repeat c-section rate for all patients is greater than 80%. These findings underscore the need for intervention to reduce primary cesarean section deliveries in African American Women.

Objective: This quality improvement project aimed to implement caregiver education on the ACOG/SMFM definition of the first and second-stage labor arrest disorder to reduce primary cesarean section birth for African American women.

Method: This pre-and post-intervention quality improvement project was conducted on …

Substance Use Disorder Treatment Among African American Men Living In The Rural South Of The United States, Serge Raoul Wandji

Theses and Dissertations

Substance use disorders (SUD) affect more than 40 million Americans. African American (AA) men are disproportionally affected by the negative health and social consequences of SUD, and men in rural areas may be particularly at risk due to disadvantaged socioeconomic conditions and persistent race-related stressors such as perceived discrimination. The overall purpose of this study is to advance the understanding of factors associated with SUD treatment acceptance and relapse potential among Southern rural AA men.

This purpose was achieved by determining differences in treatment acceptance and relapse potential by race and gender among rural residents admitted in a SUD treatment …

Clinical Vaccination Education Guideline For The African American Community, Margaret Chinedum Nwoji

Walden Dissertations and Doctoral Studies

AbstractVaccination hesitancy is high among African Americans and other people of color. The practice gap addressed in this project was the lack of a culturally sensitive clinical guideline for vaccination education relevant to the African American community. The practice-focused question was answered by developing an evidence-based Clinical Vaccination Education Guideline for the African American Community (CVEGAAC) that was validated by a group of four content experts using the Appraisal of Guidelines, Research, and Evaluation tool. The content experts scored each of the domains above 90%, implying that the CVEGAAC is of high quality and ready for implementation. The end users …

Empowering Nurses To Recognize Post-Stroke Depression In The African American Community, Deidra Frisbie, Robin Simon

Doctor of Nursing Practice Projects

African Americans (AA) have the highest prevalence of stroke and death compared to other racial groups in the United States. Post-stroke depression (PSD) affects approximately 1/3 of all stroke patients and is underdiagnosed in the African American community.

Aim: By using a mHealth mobile app and a Psychiatry provider list at discharge, PSD can be identified, and interventions initiated, thus decreasing the sequela of PSD in AA.

Methods: Nurses were provided education on PSD, expressions of depression in African-Americans, cultural humility, implicit bias, and the importance of the nurse's role in developing a therapeutic relationship.

Results: Quantitative analysis revealed the …

Addressing Culturally Congruent Care Amongst African Americans In Skilled Nursing Facility: A Systematic Review, Adekemi T. Adedipe

DNP Qualifying Manuscripts

Introduction: Healthcare disparities and mistrust of the healthcare system discourage African Americans from seeking mental health services. Healthcare providers face challenges delivering culturally appropriate care. Examining current cultural practices can inform the education needed for healthcare providers to understand cultural care and awareness. This review aimed to identify evidence available to understand the impact of a cultural training on healthcare providers in skilled nursing facilities.

Methods: APA PsycINFO, CINAHL, and PubMed, were searched for English-language studies published between January 2016 and January 2022. Healthcare cultural competency training

in any aspect of cultural care was considered. Outcomes of interest included changes …

Exploring Cultural Values, Beliefs, And Perceptions Of Human Papillomavirus Vaccine Acceptance In African American Men, Rashida Henderson

Electronic Theses and Dissertations

Introduction: African American (AA) /Black men have a higher rate of anal and rectal HPV-associated cancer, which the HPV vaccine can prevent. Purpose: This study aimed to understand the cultural values, perceptions, and beliefs of the HPV vaccine in African American/Black Men. Method: Through a focused ethnography, a semi-structured guide was utilized to interview 24 AA men. Inclusion criteria included identifying as AA/Black, aged 18-30 years, born and living in the United States, identify and born as male, and able to understand, read, and write English. Results: Through Leininger’s Four Phases of Analysis, three themes emerged: 1) lack of knowledge …

Midwifery Care's Potential To Improve Birth Outcomes And Experiences For Black Women And Infants, Neville Wintergerst-Burch

Undergraduate Theses

Black women and infants experience higher morbidity and mortality rates compared to white women and infants in the United States. Forces of systemic racism and poverty often lead to inadequate access to prenatal care for Black women, and care received is often compromised by implicit bias or barriers related to insurance coverage, impersonal provider-patient relationships, and poor healthcare literacy. Despite the rich history of Black Granny midwives in the United States, most Black women began using physicians for obstetric care in the 20th and 21st centuries. This integrative review explores how improving access to midwifery care for Black women could …

Leadership Relationships And Advancement Opportunities Among African American Female Nurses, Kendra Pitts

Walden Dissertations and Doctoral Studies

A healthy work environment for nurses is critical to staff recruitment, retention, patient safety, and the financial sustainability and viability of a healthcare organization. The specific research problem under study was whether a lack of advancement opportunity or a lack of good leadership has an impact on African American female nurses leaving the nursing profession. Researchers have investigated the impact of leadership and advancement opportunity on the general population, but there is a dearth of research specific to African American female nurses and their reason for leaving the profession. Secondary quantitative data analysis was performed using survey data from the …

Improving Medication Adherence For African American Patients With Hypertension, Kimberly Fitzgerald

Walden Dissertations and Doctoral Studies

Adherence to antihypertensive medications is essential for positive outcomes in treating hypertension (HTN). But the rate of nonadherence to antihypertensive medications among African Americans (AA) is low. The purpose of this DNP project was to develop a clinical practice guideline (CPG) that would assist in improving hypertensive medication adherence in the AA patient population as well as assess whether the CPG would be recommended by a team of content experts for use in their practice. The Hypertension Medication Adherence CPG incorporated the medication adherence model and the transtheoretical model to generate evidence-based interventions. Grading of Recommendations Assessment, Development, and Evaluation …

Family History Of Substance Problems Among African Americans: Associations With Drug Use, Drug Use Disorder, And Prescription Drug Misuse, Rebecca Mahrs-Gould

Theses and Dissertations

Background: Understanding individual risk for substance use and substance use disorders is important in the efforts of reducing risk and prevention of these problems. A family history of alcohol and/or drug problems often increases the risk for these problems, however the majority of research in this area is conducted in samples that are predominantly White. African Americans face disparate outcomes from substance use and substance use disorders, and the risks for substance problems may not be the same as for Whites. A systematic review of the literature identified nine studies that examined a family history of either substance problems or …

Exploring The Relationship Between Chronic Stressors And Protective Factors And Preterm Risk In An African American Pregnant Population, Megan Mileski

All ETDs from UAB

BACKGROUND: In the United States, infant mortality is a serious public health issue, particularly for the African American (AA) population. Despite ample research investigating explanations for the significantly higher infant mortality rate (IMR) for AA infants in the United States, the reason for the racial disparity remains unknown. Reports suggest that chronic, life-course stressors may increase risk of preterm birth (PTB), the leading contributor to the high IMR for AA infants. Adverse childhood experiences and perceived racial discrimination, experienced over the life course, have the potential to increase a stress response in AA women, leading to PTB. Psychosocial resources may …

The Psychosocial Experiences Of African American Sexual And Gender Minority Caregivers Of People With Dementia, Lakeva Harris

Doctoral Dissertations

Over 50 million people in the United States provide unpaid care to a family member or friend. One-third of these caregivers (16 million) provide care to someone with Alzheimer’s disease and related dementias (ADRD). Of these caregivers, more than 20% state caregiving has led to a decline in their health. African American caregivers are less likely to report being in very good or better health than their white caregiving peers. Similarly, lesbian, gay, bisexual, transgender, and/or queer (LGBTQ) caregivers are more likely to report fair or poor health than their heterosexual, cisgender peers. The overlap of these minoritized identities may …

Detection Of Breast Cancer In African American Women Using Walk-In Mammography, Munachi Nwosu

Dissertations

Abstract

Problem: Breast cancer is a life-threatening condition, in which the prognosis could potentially worsen with a delay in the detection and commencement of treatment. Scheduling patients for mammograms continues to allow for long wait times that exist in screening mammography. Lower rates of participation in scheduled screening mammograms contributes to the increased rate of advanced breast cancer diagnosis that exit in African American women and threatens their health outcomes. The purpose of this project was to implement walk-in mammography to increase participation for early breast cancer detection.

Methods: An observational descriptive design with a retrospective chart review. A PDSA …

A Faith-Based Approach To Promote African American Healthy Heart Behaviors, Gwendolyn Gaston

Electronic Theses and Dissertations

More than 100 million American people have some form of cardiovascular disease. African American life expectancy is 3.4 years shorter than that of Caucasians, with an estimated 32% difference in cardiovascular disease mortality between Caucasian and African American men and a 43% difference between Caucasian and African American women. The purpose of this project was to utilize a faith-based approach in developing a heart-healthy program for addressing health disparities in an African American Baptist Church. The program focused on improving cardiovascular health literacy and addressing modifiable risk factors. The results of this project revealed that African Americans need interventions to …

Developing A Lifestyle Modification Tool To Prevent And Manage Elevated Blood Pressure Among African Americans, Magdalene Oziwo

Walden Dissertations and Doctoral Studies

Hypertension is a national medical problem that has been predominantly seen amongst African Americans. Within this community, hypertension has been associated with obesity, a sedentary lifestyle, and poor nutrition. It is for this reason that lifestyle modifications can be used as applied tools in the field of nursing in the prevention and management of hypertension among African American patients. This doctoral project was conducted to address the gap in nursing practice that currently exists for the African American population with regards to hypertension. The project focused on a nursing staff education program with 10 participants to promote the implementation of …

Exploring Cultural Experiences Of African American Recipients Of Healthcare, Christopher Steven Hairfield

Walden Dissertations and Doctoral Studies

Culturally competent care is widely accepted as a strategy to address healthcare disparities based on the perceptions of the individual provider, yet this approach lacks the voice of the African American (AA) communities intended to benefit from the strategy. Individuals in AA communities have been shown to suffer higher incidence of disease, disproportionately poorer health outcomes, and inequitable healthcare treatment. Framed by Leininger’s culture care theory, the purpose of this interpretive phenomenological study was to explore the lived cultural experiences of AA recipients of care when interacting with the healthcare system in an effort to contribute evidence to improve the …

Lived Experiences Of African American Nursing Students In An Associate Degree Nursing Program, Monique Renee Merritt

Walden Dissertations and Doctoral Studies

Despite recognition of the barriers that African American nursing students encounter while pursuing nursing education, leaders of U.S. nursing programs continue to struggle to retain these students and promote their degree completion. Poor retention and lack of completion contributes to the unequal representation of African American nurses in the U.S. healthcare workforce compared to the overall population. The purpose of this qualitative study was to examine the experiences that helped to promote African American nursing students’ success or served as barriers to successful completion of an Associate Degree Nursing program. Tinto’s integration model was used as the theoretical framework. Semistructured …

Cultural Aspects Of End Of Life Advance Care Planning For African Americans: An Ethnonursing Study, John Collins

Electronic Theses and Dissertations

Introduction: Advance directive completion rates among the general population are low. Studies report even lower completion rates among African Americans are impacted by demographic variables, cultural distinctives related to patient autonomy, mistrust of the healthcare system, low health literacy, strong spiritual beliefs, desire for aggressive interventions, importance of family-communal decision making, and presence of comorbidities. End of Life (EOL) advance care planning (ACP) promotes patient and family centered care. The purpose of this study was to identify culturally based meanings, expressions, and traditions of EOL ACP and decision making among African Americans, to better understand and provide culturally congruent nursing …

The Lived Experience Of Discharged And Readmitted African Americans With Chronic Obstructive Pulmonary Disease To A Safety-Net Hospital, Kiiyonna Jones

Dissertations

Background:Chronic Obstructive Pulmonary Disease (COPD) is a debilitating respiratory disease that negatively affects the quality of life of those affected and has been a major contributor to the continuous rise in healthcare cost in the Unites States (Guarascio, Ray, Finch, & Self, 2013; National Heart Lung and Blood Institute, 2009; Shavelle, Paculdo, Kush, Mannino, & Straus, 2009; Scott, Smith, Sullivan, & Mahajan, 2001). In 2014, Centers for Medicare & Medicaid Services (CMS) identified COPD as an applicable condition to the Hospital Readmissions Reduction Program, which penalizes healthcare organizations having readmissions higher than the national average. COPD is the second …

Recommendations For African American Family Caregivers Of Adult With Congestive Heart Failure., Callista Chika Ejim

Walden Dissertations and Doctoral Studies

African Americans suffer disproportionately higher incidence of congestive heart failure (CHF) at an earlier age of onset and with more rapid progression compared to other races. Due to this escalating prevalence of CHF within the African American population and the lack of culturally responsive support for the caregiving role, African American family caregivers of adult CHF patients face greater challenges and suffer increased caregiver burden, stress, depression, and financial strain compared to European American caregivers. The purpose of this project was to conduct a systematic literature review to find the recommendations that target African American family caregivers of adult CHF …

Experiences Of African American Mothers Following Infant Death, Katina W. Jones

Nursing Theses and Dissertations

African American women have been disproportionately affected by unfavorable birth outcomes for decades. Infant mortality rates for non-Hispanic African American women have been almost twice as high as that of Caucasian women for years. The goal of this study was to: (1) understand African American mothers’ experiences with infant death and (2) discover how African American mothers manage their grief following the loss of an infant. A review of the literature revealed African American women experience infant loss at a rate of 13.31 deaths per 1,000 live births compared to 5.63 for Caucasian women and 4.75-9.22 for other racial and …

An Exploration Of Factors That Contribute To The High Attrition Rate Of African American Nursing Students, Shanell Hill

ETD Archive

Although African Americans represent the largest minority group, studies show they have the lowest success rates in nursing programs. According to the AACN (2013), “African American nursing students have the lowest graduation rate when compared to other minority groups.” The lack of minorities providing care negatively effects healthcare outcomes and accessibility. In order to increase the number of practicing African Americans nurses, it is essential to gain an understanding of the circumstances that lead to successes and failures. The purpose of this qualitative, phenomenological research study is to provide insight into the positive and negative experiences of African American nursing …

African American Caregivers’ Decision To Use Hospice Services For A Loved One: A Grounded Theory Study, Paula M. Gordon

All ETDs from UAB

This qualitative grounded theory study explored the process of decision making for African American family caregivers in the southeastern United States, as they make hospice decisions for their loved ones, Although hospice use in the United States has grown over the last decade, a disparity continues to exist between African American and Caucasian populations. African Americans represent a small percentage of hospice users in the United States, despite research that has found that patients who use hospice experience improved symptom control, fewer unmet needs, and better end of life care. Research has identified many reasons for this disparity; however, little …

Self-Care Management Of African American Men With Type 2 Diabetes, Kevin Konstantinos

Walden Dissertations and Doctoral Studies

African American men are disproportionately affected by type 2 diabetes and have a 3 times higher rate of 3 serious complications of diabetes, including blindness, amputations, and end-stage renal disease, compared to other groups. The purpose of this project was to address the gap-in-practice disparity that exists in care of African American men with diabetes by providing one-on-one self-care management education in an outpatient clinic setting. The behavior change theories that supported the project intervention were Orem's self-care theory and Bandura's self-efficacy theory. Employing a quasi-experimental design, 33 participants between the ages of 40 and 65 were divided into an …

African American Male Veterans’ Illness Representation And Reported Self-Management Practices Of High Blood Pressure, Tammie Brodie

Dissertations, Theses, and Capstone Projects

High blood pressure (HBP) is a common condition in the United States, affecting one in four American adults. Forty-one percent of African Americans have HBP compared to 27% of White Americans. African Americans develop high blood pressure at an earlier age and suffer more complications compared to other ethnic groups. Numerous studies have been conducted to find the causes and treatment for HBP in African Americans.

The purpose of this research is to explore self-management practices of African-American male veterans, who have positive HBP representation and controlled HBP. A mixed-methods approach guided the study to gain quantitative and qualitative explanatory …