Digital Commons Network^™

Effects On Adherence And Comprehension With Video Demonstration Support Versus Traditional Home Exercise Programs: Culminating Project, Emily E. Morales

Department of Occupational Therapy Entry-Level Capstone Projects

This culminating project examines the need for video-supported home exercise programs (HEP) in outpatient hand therapy clinics in South Jersey by developing a YouTube channel. This YouTube channel will consist of HEPs for common upper extremity diagnoses including proper demonstration of each exercise and clear concise written instructions within a playlist correlating to diagnosis. Advance clinical skill in hand therapy is the main goal for this capstone project. An analysis was completed evaluating adherence and comprehension when clients are prescribed traditional HEP to HEP supported by a video demonstration. The ultimate goal of this project was to establish an easily …

Social Support Of Mexican Immigrant Women With Gestational Diabetes Mellitus: A Constructivist Grounded Theory Study, Angela Sojobi

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to explore the perception of social support among Mexican immigrant women with gestational diabetes mellitus (GDM) within the context of their culture and discern the process through which social support can influence their adherence to the GDM management protocols. The incidence of GDM is highest in low-income, ethnic minority communities such as the Mexican immigrant community. Adhering to the GDM management protocols may prove challenging for some women, especially if social support is lacking. If uncontrolled, GDM can result in adverse maternal-fetal outcomes. Among Mexican immigrant women, the incidence of poor glycemic control and …

Improving Hand Hygiene In A Rural Critical Access Hospital, Katherine H. Miller

Doctor of Nursing Practice Scholarly Projects

Hand hygiene adherence is the single most important infection control practice among healthcare workers in United States hospitals. Hand hygiene is cost effective and adherence to protocols can reduce hospital acquired infections and employee illness. While hand hygiene adherence has been shown through research to improve patient safety and reduce hospital acquired infections, adherence to hand hygiene protocols among healthcare workers is poor and improvement efforts lack sustainability. A potential barrier to performing hand hygiene includes failure of healthcare workers to realize they are carrying microbes on their hands and what proper hand hygiene is, whether using soap and water …

Evaluation And Implementation Of A Video Intervention To Increase Adherence In A Rural Phase Ii Cardiac Rehabilitation Program., Holly Yahyawi

Doctor of Nursing Practice Papers

Background: In the U.S., heart disease affects over 30 million adults and is the leading cause of death. Cardiac rehabilitation (CR) decreases cardiac hospital readmissions, decreases the risk of additional cardiac events, and increases life expectancy. Environment: This project was implemented at a CR program which serves rural Indiana and Kentucky counties. Purpose: This QI project uses a Plan-Study-Do-Act framework to evaluate patient adherence to a rural CR program, implement a video intervention for patients, and measure patient’s perceptions. Procedures: CR patients watched four videos describing what CR is, what to expect at CR, CR benefits, and a patient CR …

Anxiety, Depression, And Perceived Barriers To Adherence Among Parents Of Pediatric Transplant Patients, Alice Marie Wille

Dissertations

Before being listed for an organ transplant, pediatric patients and families undergo a psychosocial pre-transplant evaluation to determine familial strengths and risk factors that may impact the success of transplant. Adherence is considered to be one of the primary factors in the survival of the transplanted organ and existing research has suggested a link between parental functioning and post-transplant adherence. To better understand the relationship between parental mental health and perceived barriers to adherence, this study examined whether parental symptoms of anxiety and depression significantly predicted parent and patient perceived barriers to adherence in the pre-transplant phase (n=65 parents and …

The Efficacy Of Brief Attitudinal Familism And Body Image Interventions On Diet And Exercise Self-Monitoring Adherence In Hispanic/Latinx Women, Kelsey Nicole Serier

Psychology ETDs

Addressing health disparities in overweight/obesity is a key public health issue. Research supports the efficacy of behavioral weight loss (BWL) interventions, however, adherence to these interventions is often low, which negatively impacts outcomes. The efficacy of BWL interventions is consistently lower among communities of color. Thus, there is a strong need to design and test interventions that are culturally sensitive and address predictors of BWL adherence in diverse groups. Previous research suggests that for Hispanic/Latinx women with overweight/obesity, attitudinal familism (“family comes first”) and body dissatisfaction were informative in predicting BWL adherence. The current study builds on this previous research …

Applying Health Stigma Framework To Examine The Mechanisms Of Hiv-Related Stigma On Clinical Outcomes, Chengbo Zeng

Theses and Dissertations

Background: HIV clinical outcomes including CD4 count, viral suppression, and health-related quality of life (HRQoL), are important indicators reflecting immunologic functioning, treatment efficacy, and overall health quality. However, due, in part, to HIV-related stigma, many people living with HIV (PLWH) experience suboptimal clinical outcomes. The Health Stigma Framework introduced the potentially distinct mechanisms underlying internalized, anticipated, enacted stigma and health outcomes through psycho-behavioral pathways. Based on this framework, this dissertation investigated the impacts and mechanisms of HIV-related stigma on clinical outcomes among PLWH in Guangxi, China from a longitudinal perspective. Methods: Data at baseline, 6-, 12-, 18- month follow-ups …

Attitudes Toward Mindfulness And Adherence In Chronic Pain Management, Sarah Johnson

Global Honors Theses

Chronic pain is a global public health problem, affecting 10-25% of the population. Mindfulness is an effective treatment but requires consistency. Because of its benefit, it is important to examine obstacles to mindfulness practice. In order to determine if negative attitudes toward mindfulness are related to non-adherence, 748 adults with chronic pain were recruited to fill out a series of questionnaires assessing treatment adherence and attitudes toward mindfulness. We found that positive attitudes toward mindfulness predicted reduced adherence. However, those who had more positive feelings toward mindfulness made more attempts at the therapy. Upper and middle-class participants had more positive …

Perceived Health Status, Adherence To Disease Modifying Therapy And Religious Coping In Adults With Multiple Sclerosis, Marcia P. Jones George

Dissertations, Theses, and Capstone Projects

Purpose: People living with MS need to employ both problem and emotion-focused coping strategies to maintain optimal health. Specifically, with one’s Perceived Health Status as an indicator of optimal health, treatment adherence and religious coping are indicators of problem and emotion-focused coping, respectively. This study aimed to examine the relations between Perceived Health Status, the dependent variable, and the independent variables Adherence to DMT and Religious Coping. Based on the Neuman Systems Model (Neuman & Fawcett, 2011) and Pargament's Theory of Religious Coping (1997), it was proposed that Adherence to DMT and Religious Coping are respectively one's physiological and spiritual …

Barriers And Solutions Correlated With The Implementation Of Correct Sports Nutrition Practices At A Public Ncaa Division Ii University In The Midwest., Andrew Graber

Leadership Education Capstones

Sports nutrition guidelines are an integral part of athlete performance. The guidelines are established through the American College of Sports Medicine to best guide student athletes for their specific sport. However, even with the guidelines established there are low adherence rates among student athletes who face unique barriers and therefore require solutions to increase adherence to the guidelines. The study aims to identify specific barriers that student athletes face based on their perspectives and opinions. Once the barriers are identified the study provides potential areas of focus to increase adherence rates through the provision of solutions.

To gain insight into …

Voice Therapy: Racial Disparities In Adherence And Clinically Significant Outcomes, Amber D. Burks

LSU Master's Theses

Voice therapy is evidence-based, behavioral intervention that can reduce functional and organic voice disorders. Despite its proven effectiveness, non-adherence to voice therapy is still an issue. Research shows that an estimated 65% of patients who initiate voice therapy drop out before reaching therapeutic goals. Voice therapy outcomes are largely dependent on patients’ adherence to treatment regimens, but there is limited information concerning factors that may be associated with voice therapy adherence and therapeutic outcomes for patients who successfully complete voice therapy.

The purpose of this study was to investigate which demographic factors could be associated with higher adherence rates to …

Adherence To A Mindfulness App For College Students With Depression: Patterns, Predictors, And Outcomes, Brynn Marie Huguenel

Dissertations

National trends indicate that mental health concerns, particularly rates of depression, continue to rise on college campuses; however, treatment utilization remains low. Technology-based mental health interventions, such as mental health apps (MHapps), are a promising means of overcoming treatment barriers. MHapps are effective in improving psychological outcomes, but low rates of adherence are a noted limitation. The current study explored patterns of adherence to a MHapp, investigated the bidirectional relation between adherence and depression, and identified motivational predictors of adherence rates. Undergraduate students (N= 66) reporting clinically-elevated depressive symptoms completed a three-month trial using Headspace, a mindfulness MHapp. Patterns of …

Exploring Motivation To Adhere Among Crossfit Exercise Participants, Lauren Elizabeth Falgout

Walden Dissertations and Doctoral Studies

Lack of exercise and obesity are prominent social problems in the U.S. population. Therefore, understanding the experiences that promote or hinder motivation and exercise adherence is important. A total of 15 adult participants who engaged in CrossFit for a minimum of 6 months were recruited for this generic qualitative study using purposeful sampling methods. They responded to an invitation on a social media page for CrossFit participants. They shared their exercise adherence experiences and motivation through semi-structured qualitative interviews. Trustworthiness procedures included reflexive journaling, and member checking. Data analysis proceeded from transcript reading to working with broad themes and phrases …

Changes In Patient Knowledge And Adherence To Glaucoma Treatment After Educational Intervention, Stella Stempel

Walden Dissertations and Doctoral Studies

Primary open-angle glaucoma is the most common form of glaucoma and the second-leading cause of preventable blindness worldwide. Although timely diagnosis and proper adherence to therapeutic regimen prevent blindness, patient nonadherence continues to be the greatest challenge to effective treatment. Preliminary research suggested that culturally interactive education delivery may increase patient adherence. However, this education intervention had not occurred with glaucoma treatment. The transtheoretical model of behavior change served as the framework for this study. The research questions addressed the effect that glaucoma education provided by a culturally competent patient navigator had on patient knowledge of glaucoma, adherence to medication …

Decision-Making Involvement, Social Support For Healthy Behaviors, And Nutritional Adherence In Adolescents With Cystic Fibrosis, Jennifer Kelleher

Graduate Theses, Dissertations, and Problem Reports

Background: Adolescents with cystic fibrosis (awCF) exhibit suboptimal adherence to dietary and enzyme recommendations despite the fact that eating a high calorie diet with enzymes significantly improves lung functioning. Furthermore, during adolescence teens and their caregivers begin to negotiate treatment responsibility, shifting treatment tasks to the youth. As such, it is important to understand which aspects of the complex decision-making process (e.g., expressing an opinion, asking for information from parents/adults, making joint decisions with parents) relate to better dietary adherence in adolescents with CF and how parents can best support these healthy behaviors. Thus, this study aimed to identify how …

Explanatory Necropolitics: Physicians’ Perspectives On Compliance, Culture, And Competence In The Management Of Chronic Disease, Rithvik Ramesh

Senior Honors Papers / Undergraduate Theses

In this thesis, I explore physicians’ conceptions of culture in the management of chronic diseases like diabetes and hypertension. Physicians whom I interviewed deconstructed the challenges of compliance into coded components of knowing, wanting, and doing. This pattern creates a new form of adherent autonomy, which offers the freedom to choose as much as it surveils, expects, and moralizes “good” choices in the pursuit of good care. Consequently, adherent autonomy deprives patients of practical sovereignty and continues to objectify individuals in more indirect and ostensibly acceptable forms. While physicians’ definitions for culture ranged in scope and content, they prominently framed …

The Adherence To Group B Streptococcus Screening Guidelines Amongst Pregnant Women In Western Australia – A Quantitative Descriptive Analysis, Sabine Pangerl

Theses: Doctorates and Masters

Colonisation with Group B Streptococci (GBS) is a major risk factor for neonatal infection acquired via vertical transmission during pregnancy, labour, or birth, potentially resulting in significant morbidity and mortality. Universal screening at 35 – 37 weeks gestation for maternal GBS colonisation and the use of intrapartum antibiotic prophylaxis has resulted in substantial reductions in the burden of neonatal Early-Onset GBS Disease (EOGBSD). Women in Western Australia (WA) are offered GBS screening in pregnancy and intrapartum antibiotic prophylaxis. Anecdotal evidence suggests variations in viewpoints and thus low adherence to relevant clinical guidelines amongst midwives and pregnant women in the midwifery …

Patterns Of Medication Adherence In Glaucoma, Shervonne Poleon

All ETDs from UAB

Over 60 million persons globally are affected by primary open angle glaucoma (POAG)—an optic neuropathy characterized by distinctive patterns of vision loss. Glaucoma is a leading cause of irreversible blindness worldwide, and eye drops that delay vision loss are a common treatment modality. In glaucoma, the proportion of patients with good adherence to recommended therapy is reported to be low. High treatment cost, forgetfulness, and regimen complexity have been identified as key determinants of poor adherence. However, addressing these factors in the clinic is not as simple, as patient and provider values and priorities may differ. Without concordance, it can …

Characterizing Patterns Of Adherence To Physical Activity Goals In Behavioral Weight Control, Melissa Lee Stansbury

Theses and Dissertations

Introduction: Many individuals fall short of the physical activity (PA) goals provided during lifestyle programs, and there is considerable variability in weight loss response and adherence to recommendations for behavior change. Weight loss response within the early weeks of program initiation predicts future weight loss success; however, little is known about what distinguishes those who respond well to treatment from those who fail to respond. Exposing the behavioral patterns which underlie weight loss response may point towards targets for treatment optimization. The purpose of this study was to (1) characterize individuals with distinct patterns of adherence to PA goals during …

Examining Geographic And Social Barriers To Hiv Treatment Adherence In Kampala, Uganda, Gabrielle Bruser

Electronic Thesis and Dissertation Repository

With the rapid expansion of HIV treatment programs across sub-Saharan Africa, substantial progress has been made towards universal treatment accessibility in Uganda; however, new healthcare challenges have been emerging, such as the development of drug-resistant HIV, which threaten to undermine achievements made thus far. In order for HIV treatment to be effective, people living with HIV (PLWH) must be highly adherent without missing a single dose, which can be challenging for those also facing difficulties such as financial insecurity. In the context of Kampala, Uganda’s urban capital, it has been suggested that healthcare accessibility is made difficult by several physical …

Strategies And Characteristics Of Young African American Women Who Maintain Physical Activity, Chloe Jones

Masters Theses

African American (AA) women have a disproportionately higher prevalence of obesity and physical inactivity compared to their gender and racial counterparts. Young AA women experience the largest increases in weight gain between 20-30 years of age, yet are underrepresented in current literature surrounding leisure-time physical activity (LTPA) promotion. Examining young AA women who successfully maintain LTPA participation may provide insight into their methods for doing so. The purpose of this study was to explore strategies used by active young AA women that support their LTPA maintenance, and identify various characteristics of these women.

A multimethod approach (qualitative and quantitative) was …

Multidisciplinary Team Approach Effect On Pediatric Severe Asthma, Lila Kertz

Dissertations

Problem. Children with severe asthma are more likely to be non-adherent with their prescribed medications, often related to barriers. A holistic assessment of these patients has been suggested, but is not typically performed in most pediatric asthma clinics. The purpose of this project was to evaluate the effects of severe pediatric asthma clinic services designed to perform holistic assessments and provide comprehensive care.

Methods. An observational, descriptive design was used to evaluate the Severe Asthma Clinic for Kids (SACK) created in 2013 using a retrospective database review. A convenience sample of data collected on all children treated in the clinic …

Exploring The Relationship Between Dietary Self-Monitoring With A Mobile App And Weight Change, Jason Payne

Electronic Theses and Dissertations

Background: Approximately 70% of the adult population in the United States has overweight or obesity and increased risk for developing chronic diseases. Dietary self-monitoring adherence using a paper diary is associated with weight loss; however, few studies have examined this association with dietary self-monitoring apps. Objectives: 1) explore if an association exists between app-based dietary self-monitoring and weight change among adults with overweight or obesity and 2) explore the relationships between the frequency, consistency, and completeness of self-monitoring and weight change. Methods: Participants self-monitored dietary intake for 8 weeks using the app Calorie Counter by FatSecret. Participants were assigned …

Executive Functioning And Adherence To Antihypertensive Medications Among A Sample Of Older Adults, Lauren Strainge

Doctoral Dissertations

Objective: Consistent medication adherence is critical for the effective management of hypertension among the elderly. Executive functioning (EF), higher-order cognitive abilities that include set-shifting, information updating, and inhibition, have been associated with medication adherence among other populations, but the role of these processes in adherence to medications in older adults with hypertension is unknown. A conceptual model of the ways in which specific executive processes could impact adherence is presented, and specific executive processes and broad EF were examined as predictors of adherence to antihypertensive medication over a 3-month study of hypertension and cognition in the elderly.

Method: 76 adults …

Physical Therapists Perceptions Of Patient Adherence And Strategies For Facilitating Motivation, Teadora Markovski

Theses and Dissertations

Physical therapists (PTs) are professionally required to undertake a comprehensive examination of their patients and provide consultation within their expertise, yet also have the task to motivate patients to adhere to therapy. Self-determined motivation, as a positive predictor of treatment adherence, can be facilitated by promoting patient autonomy, competence and relatedness. However, a greater understanding is needed of the context specific strategies PT’s can use to facilitate motivation. The purpose of this study is to explore physical therapists’ (PT)s perceptions of the factors affecting patient motivation, strategies and methods to facilitate adherence, and strategies used to satisfy patients basic needs …

Healthcare Provider Overlap On Evidenced-Based Practice In Intubated Patients Using The Theoretical Domain Framework: A Case Study, Katie Bull

CUP Ed.D. Dissertations

Intubation by endotracheal or tracheostomy means is a common life-saving intervention bearing significant, yet preventable risk. Evidence-based practice (EBP), intended to mitigate risk, is often inconsistently adhered to by healthcare providers (HCPs) due to a variety of factors, leaving patients vulnerable to adverse outcomes such as ventilator-associated pneumonia or tracheostomy-related stenosis. A review of the literature identified socially related barriers resulting from overlapping roles and expectations of primary HCPs. Little research has been conducted to understand the impact of overlap on EBP adherence. Using the Theoretical Domains Framework (TDF), this case study explored HCP overlap in one critical care unit …

Faith, Medication Adherence, And Cardiovascular Disease Among African American Churchgoers, Linett Lorain Brice

Walden Dissertations and Doctoral Studies

Getting African Americans to adhere to medical management strategies to reduce negative health outcomes of cardiovascular disease (CVD) and CVD risk factors may be challenging. The purpose of this cross-sectional quantitative study was to examine whether levels of faith in God's healing, when it comes to taking medications, was associated with medication adherence to hypertension and/or diabetes mellitus type 2 (DMII) medications, and whether those factors were associated with prevalence of CVD and uncontrolled symptoms of CVD risk factors, namely hypertension and DMII. Social cognitive theory provided the framework for the study. Data were collected from surveys completed by 102 …

Socioeconomic Status, Benzathine Penicillin Prophylaxis, And Clinical Outcomes In Patients With Rheumatic Heart Disease, Christopher Sabo Yilgwan

Walden Dissertations and Doctoral Studies

Rheumatic heart disease (RHD) is the major cause of acquired heart disease and death for children and young adults in developing countries. Poverty and social disadvantage are thought to influence the clinical outcomes in RHD patients. Guided by the health lifestyle theory, this study assessed the relationship between socioeconomic status and clinical outcomes (heart failure events and mortality) in patients with RHD. It also examined how adherence to penicillin prophylaxis mediates the effect of socioeconomic status (SES) on clinical outcomes. Using the Nigerian database of the REMEDY study, this study was conducted with 243 participants using Poisson regression and logistic …

Increasing Adherence To A Light Sedation Protocol By Increasing Nurses’ Knowledge And Confidence, Katie Rust

DNP Projects

Abstract

BACKGROUND: Oversedation in the mechanically ventilated patient can cause long- and short-term adverse side effects. Light sedation practices provide patients with relief from agitation and pain and still allows them to actively participate in care. A light sedation protocol was introduced to bedside ICU registered nurses (RNs) at the University of Kentucky Medical Center (UKMC), but deep sedation is still commonplace. Reeducating bedside RNs and increasing their knowledge and confidence is a proposed strategy for increasing adherence to light sedation protocols.

PURPOSE: The purpose of this quality improvement project was to gain understanding of bedside RNs knowledge and perceived …

Physical And Occupational Therapy For Young Children With Delayed Motor Development: Exploring Current Practices, Challenges, And Families’ Implementation Of Home Activities In Early Intervention, Afnan Gmmash

Theses and Dissertations--Rehabilitation Sciences

The literature supports the use of family-centered early intervention(EI) for young children with or at risk for cerebral palsy (CP) to promote the children’s motor development. Young children with or at risk for delayed motor development in their first three years of life are entitled to EI under Part C of The Individuals with Disabilities Education Improvement Act. Identifying current EI provided for young children with delayed motor development is essential to detect possible gaps and factors that could prevent therapists from providing the best EI. Understanding the parent’s perspective on the implementation of activities outside therapy to maximize the …