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Disparate Access To Medical Coverage Associated With Type 2 Diabetes Care In Low-Income And Rural Communities In Georgia, Crystal Alexis Symone Edwards

Walden Dissertations and Doctoral Studies

Disparate access to diabetes care in rural and low-income communities among older adults has been an ongoing issue among Americans. Type 2 diabetes in low-income and rural communities has continuously burdened many residents due to age, costs of care, income, geographic location, and education levels. Researchers have demonstrated that providing resources and tools to rural and low-income communities would assist in decreasing type 2 diabetes and increase education and awareness. The purpose of this quantitative cross-sectional study using secondary data was to examine the relationship between health insurance status and lack of access to health care resources and delay of …

Effects Of Social Determinants On Access To Care Among Patients With Diabetes In Florida, Nekeisha Latoya Walker

Walden Dissertations and Doctoral Studies

Diabetes imposes a major burden on society, especially in the state of Florida, in the form of increased medical costs, lost productivity, early mortality, and intangible costs in the form of diminished quality of life. Access to diabetic care affects health administration in Florida by impacting the overall cost of treating the condition. Limited access to care can lead to an increased risk of complications resulting in a higher cost of treatment. The purpose of this quantitative study was to determine whether access to care dependent variables (access to doctors and length of time since last routine checkup) were associated …

Relationship Between Childhood Trauma, ,Adverse Childhood Experiences, And Self-Management Of Type 1 And Type 2 Diabetes, Deserie J. Otoole

Walden Dissertations and Doctoral Studies

AbstractPoorly controlled diabetes is the result of lack of self-care, which contributes to complications, ill quality in life, the rise in health care costs, and early death. The purpose of this quantitative, nonexperimental study was to examine the extent to which diabetes type (Type 1 and Type 2), childhood trauma, and adverse childhood experiences predict diabetes self-management (glucose management, dietary control, physical activity, health care use, total self-management). Contemporary trauma theory suggests that early childhood trauma results in negative health-related consequences in adulthood. Standard multiple regression analyses showed that (a) higher levels of physical neglect and emotional abuse predicted poorer …

Providing Diabetes Education To Improve Staff Nurses' Knowledge, Marcia A. Patterson

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a chronic metabolic disease that affects over 34.2 million or 10.5% of the U.S. population and ranks as the seventh leading cause of death. Tennessee's diabetes prevalence rate is ranked 45th overall in the nation, with 14.9% of the population affected, and in the local area for this project, the rate is greater than 15%, creating a public health concern. Despite its prevalence, there is still a wide gap in knowledge among nurses on diabetes management. The practice-focused question for this project addressed whether a staff education program would improve nurses' knowledge regarding diabetes. The significant gap …

Risk Factors Associated With The Development Of Type Ii Diabetes-Related Complications, Jessica Danielle Lucas Williams

Walden Dissertations and Doctoral Studies

By 2040, it is estimated that 642 million people ages 20 to 79 will have Type II diabetes, thereby making it a heavily studied topic among scholars. As more people are diagnosed with Type II diabetes each year, the literature is slowly shifting to long-term complications. However, the many risk and protective factors that exist have created gaps in the literature. The purpose of this study was to determine the relationship between participation in diabetes self-management classes, mental health, physical health, BMI, smoking status, exercise, and possible diabetes complications (diabetes-related retinopathy and diabetes-related kidney disease). The gap in the literature …

Disparate Access To Medical Coverage Associated With Type 2 Diabetes Care In Low-Income And Rural Communities In Georgia, Crystal Alexis Symone Edwards

Walden Dissertations and Doctoral Studies

Disparate access to diabetes care in rural and low-income communities among older adults has been an ongoing issue among Americans. Type 2 diabetes in low-income and rural communities has continuously burdened many residents due to age, costs of care, income, geographic location, and education levels. Researchers have demonstrated that providing resources and tools to rural and low-income communities would assist in decreasing type 2 diabetes and increase education and awareness. The purpose of this quantitative cross-sectional study using secondary data was to examine the relationship between health insurance status and lack of access to health care resources and delay of …

Effects Of Social Determinants On Access To Care Among Patients With Diabetes In Florida, Nekeisha Latoya Walker

Walden Dissertations and Doctoral Studies

Diabetes imposes a major burden on society, especially in the state of Florida, in the form of increased medical costs, lost productivity, early mortality, and intangible costs in the form of diminished quality of life. Access to diabetic care affects health administration in Florida by impacting the overall cost of treating the condition. Limited access to care can lead to an increased risk of complications resulting in a higher cost of treatment. The purpose of this quantitative study was to determine whether access to care dependent variables (access to doctors and length of time since last routine checkup) were associated …

Association Of Myplate Diet And Exercise With Diabetes In African American Women, Brandi Jones

Walden Dissertations and Doctoral Studies

Lifestyle choices such as diet and physical activity have been described as significant predictors of preventable disease, such as Type 2 diabetes mellitus. African American women disproportionately develop Type 2 diabetes and are at greater risk, compared to Caucasian/European Americans. The purpose of this study was to examine the association of physical activity and adherence to the MyPlate diet plan with the occurrence of Type 2 diabetes among African American women. The health belief model was the theoretical foundation for this study. Research questions were designed to examine the extent to which diet and physical activity predict Type 2 diabetes. …

Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo

Walden Dissertations and Doctoral Studies

Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …

Adverse Childhood Events And Protective Health Behaviors Among Adults With Diabetes Or Diabetes With Comorbid Heart Disease, Ciara Michelle Rukse

Walden Dissertations and Doctoral Studies

Diabetes is a prevalent and costly chronic condition that can lead to other comorbid conditions such as heart disease. Disease management is essential but can be stressful and complicated, especially for individuals who have developed maladaptive behaviors in response to exposure to adverse childhood events (ACEs), which are chronic stressors that impact physiological and psychological development. There is limited research on the potential relationship between childhood adversity and engagement in protective health behaviors among U.S. populations with diabetes or diabetes with comorbid heart disease. The ACEs pyramid was the theoretical framework of this quantitative cross-sectional study concerning morbidity and early …

Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo

Walden Dissertations and Doctoral Studies

Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …

The Importance Of Staff Education About Implementing Ketogenic Diet In Prediabetic Patients, Clarissa L. Dorsey

Walden Dissertations and Doctoral Studies

Diabetes, a chronic disease that can lead to many complications, is one of the leading causes of death. Obesity tends to increase the risk of diabetes. Nutritional therapy can not only control diabetes but also prevent it in some cases by decreasing weight. The ketogenic diet is a low-carbohydrate, high-fat diet that can prevent and control diabetes. The purpose of this study was to examine the recommendations of medical providers before and after the presentation of educational content on the ketogenic diet as nutritional therapy in prediabetic and diabetic patients. The practice-focused question addressed whether educating medical staff at a …

Analysis Of Hba1c, Medication Compliance, Income Subsidies, And Comorbidity In Medicare Type 2 Diabetics, Robert E. Lazarchik

Walden Dissertations and Doctoral Studies

Diabetes is one of America’s leading chronic diseases with comorbidities contributing to lower health statuses and increased health care costs. While it is known that lowering HbA1c reduces the deleterious effects of diabetes, the capability to identify people with diabetes at risk for uncontrolled HbA1c levels or developing comorbidities based on the compliance rates for different oral antihyperglycemic medication classes (OAMCs) and financial assistance programs does not yet exist. These quantitative longitudinal retrospective studies examined the association between medication compliance, using Proportion of Days Covered (PDC), by OAMC and Medicare financial aid programs, on predicting HbA1c levels and comorbidities in …

Language Acculturation Effect On Diabetes Prevalence And Self-Care Skills In Puerto Ricans, Gerardo Lazaro

Walden Dissertations and Doctoral Studies

Diabetes, a silent, chronic disease that involves demanding long-term self-care skills, affects adult Puerto Ricans disproportionately. Based on the health belief model, a theory that predicts health behavior, and the theory of language barriers, which predicts the effects of language on beliefs and behavior, this quantitative nonexperimental study analyzed the relationship of the preference of Puerto Ricans in Boston to use and speak Spanish (language acculturation) to diabetes prevalence and 4 diabetes self-care skills (healthy eating, being active, taking medication, and healthy coping). Data on 1,506 initial participants in the Boston Puerto Rican Health Study were used from 3 study …

Examining Clinicians' Perspectives Screening For Depression In Patients With Type 2 Diabetes Mellitus, Vickie Lavette Bland

Walden Dissertations and Doctoral Studies

The United States has a significant diabetes problem. This chronic disease affects the body physically and mentally. One of the emotional effects of diabetes is depression. Depression is often present in individuals with diabetes, chiefly in those with type 2 diabetes mellitus (T2DM). While depression is common in T2DM and can interfere with treatment adherence, clinician screening for depression in T2DM patients is low. The purpose of this study was to examine clinicians' attitudes, behaviors, and perceptions concerning screening patients with T2DM for depression. Through a qualitative case study approach centered on reasoned action theory, 3 physicians and 5 nurse …

Social Determinants Of Health And Type 2 Diabetes Among Enrollees Of California Children’S Services Program In Fresno County, California, Daniela Marie Aghadjanian

Walden Dissertations and Doctoral Studies

Despite extensive study in adults, Type 2 diabetes (T2D) has been the subject of little research concerning young adults or children. Doctors believed T2D to develop only in a person’s later years until health care providers found younger individuals developing this disease. The purpose of this cross-sectional quantitative analysis was to determine correlations between T2D and social determinants of health in Fresno County, California, based on children and adolescents. The 2017-19 data came from the Fresno County Department of Public Health. The theoretical foundation for the study was the socio-ecological framework focusing on individuals’ traits having a bidirectional impact on …

Inhaled Insulin, Afrezza, Educational Module For Health Care Providers, Sara Lynn Doolin-Thompson

Walden Dissertations and Doctoral Studies

Abstract Inhaled Insulin, Afrezza, Educational Module for Health Care Providers

bySara Doolin-Thompson

MSN, Walden University, 2014 BSN, University of Phoenix, 2004 ASN, Kentucky Wesleyan College, 1994

Project Submitted in Partial Fulfillmentof the Requirements for the Degree of Doctor of Nursing Practice

Walden University August 2021 Abstract Diabetes is on a global rise and there is a definite gap in providing care for the diabetic population. Two of the largest contributors to this gap in care are the lack of collaboration between health care professionals and the lack of education for health care providers on the evolution of diabetes treatment plans. …

Relationship Among Health Literacy Superstitious Beliefs And Self-Care Among Diabetic Patients In Warri, Nigeria, Nkemakolam Simpson Ukpabi

Walden Dissertations and Doctoral Studies

AbstractDiabetes imposes significant burdens in medical expenditures, medication use, outpatient visits, and treatment of its chronic complications. Self-care behaviors such as medication adherence and foot care have been shown to reduce hospitalizations and complications, and high health literacy levels have been positively associated with self-care adoption. However, the effect of superstition on this relationship has not been studied among diabetic patients in Warri, Nigeria. This study was conducted to determine the moderating effects of superstitious or cultural beliefs on the relationship between health literacy and self-care adoption among diabetes patients in Warri, Nigeria. A quantitative, observational, cross-sectional design guided this …

Access To Preventive Health Care Services And Effects On Health Outcomes For Hispanic Older Adults With Type 2 Diabetes, Shafa Al-Showk

Walden Dissertations and Doctoral Studies

Despite elevated prevalence of diabetes among Hispanic, Hispanic older adults face challenges in self-control and management of their glucose levels, and they have less access to preventive health care services. The purpose of this retrospective quantitative cross-sectional study was to examine the associations between access to preventive health care services and Type 2 diabetes outcomes among Hispanic adults aged 65 years and older. The social-ecological model provided the framework for the study. The research question for this study examined the extent to which doctor visits, diabetes education and blood sugar checks correlate with HbA1c levels. Data were collected from 566 …

Type 2 Diabetes And Pesticide Exposure Among U.S. Hispanic Migrant Farmworkers, Judith Faustin-Gabriel

Walden Dissertations and Doctoral Studies

AbstractHispanic migrant farmworkers provide indispensable services to the United States, yet they are low-paid, uninsured employees working in extremely hazardous conditions. Public health and other healthcare professionals have worked to address the impact of pesticide exposure in the Hispanic migrant population. Although pesticides have been associated with various chronic diseases, limited evidence and studies have established an association between pesticide exposure and Diabetes Type 2 (DT2) among Hispanic migrant farmworkers. Guided by fundamental causes theory, this study addressed whether there is a relationship between agricultural pesticide exposure and DT2 among Hispanic migrant farmworkers in the United States who participated in …

Association Between Modifiable Risk Factors And Stroke Among Hispanics, Shanice Williams

Walden Dissertations and Doctoral Studies

Stroke is a significant public health issue that impacts the health of Hispanic adults. Understanding the multiple risk factors of stroke is an essential strategy to control the disease among this population. The purpose of this study was to examine the association between modifiable risk factors and stroke among Hispanics. The public health prevention framework guided this study. The research questions were designed to determine whether an association exists between modifiable risk factors for stroke among Hispanics. A quantitative, cross-sectional research design was used to conduct secondary analysis of the pooled 2017–2019 Behavioral Risk Factor Surveillance System annual surveys. The …

Adult Canadian Disordered Gambling And Poor Physical Or Mental Health, Pilar Lane

Walden Dissertations and Doctoral Studies

Disordered gambling has become the first recognized nonsubstance addiction. Low- and moderate-level gamblers have been found to be more likely to suffer health consequences. The purpose of this quantitative, cross-sectional, comparative study was to explore whether and to what extent being a disordered gambler in Canada increases the likelihood of having a concurrent physical or mental health problems (i.e., heart disease, diabetes and/or suicidal ideation or attempts). The research questions were whether there was a significant difference in having heart disease, diabetes, or suicidal ideations or attempts between Canadian adults who are and who are not disordered gamblers. The theoretical …

Relationship Of Complementary Modes Of Agency In The Self-Management Of Diabetes, Andrew Romo

Walden Dissertations and Doctoral Studies

Effective control of type-2 diabetes mellitus (DM2) is essential for minimizing the likelihood of developing comorbidities that result from poor glycemic control. Extensive self-management considerations are required of people with DM because they must actively participate in their own care and engage with other socially-based sources of self-management support. The purposes of this quantitative study were to determine if there is an association between (a) the extent that the individual mode of human agency is employed and quality of diabetes control among adults who have been diagnosed with DM2 for at least one year and (b) the extent that the …

Microvascular Disease And Chronic Kidney Disease In Persons With Diabetes In Grenada, Jennifer Elizabeth Lewis

Walden Dissertations and Doctoral Studies

Chronic kidney disease (CKD) is a set of pathophysiological reactions that impact the functionality of the kidney. The association between microvascular disease (MVD) and CKD as it relates to diabetes is important to the evaluation of organizational effectiveness in-hospital services planning as well as improving health outcomes. The purpose of this quantitative, cross-sectional study was to determine if there is an association between MVD and CKD severity in persons with diabetes. Using the socioecological model, the association between gender, age group, cigarette smoke, cigarette smoke frequency, alcoholic drink, alcoholic drink frequency, hypertension, albumin-to-creatinine ratio (ACR) severity, cholesterol, sickling (i.e. persons …

Environmental Barriers To Accessing Tertiary Prevention Among Hispanics Diagnosed With Type 2 Diabetes, Stella B. Biira

Walden Dissertations and Doctoral Studies

In the United States, Hispanics diagnosed with type 2 diabetes (T2DM) have not accessed tertiary level prevention, which is critical in diabetes management and the prevention of further complications. The purpose of this quantitative study was to examine the association between neighborhood crime, the absence of community health centers, the lack of culturally competent providers, the lack of public transportation, the residential setting, the distance to T2DM education classes, and access to tertiary prevention among Hispanics diagnosed with T2DM. The research was guided by the Andersen behavioral model. A sample size of N = 4,977 was used in the study, …

Effects Of Depression And Health Habits On Diabetes Outcomes, Yvonne Marie Chapa

Walden Dissertations and Doctoral Studies

Diabetes mellitus outcomes are intensified by the lack of screening and awareness for depressive symptoms, alcohol consumption, cigarette use, and gender difference. The purpose of this quantitative survey study, grounded in biopsychosocial theory, was to investigate the best predictor (alcohol consumption, cigarette use, and the exploratory variable gender) of diabetes outcome in a Mexican American population. Data were collected using the Patient Health Questionnaire-9 with 120 Mexican American patients from a diabetic clinic in Southern Texas. Results from a multiple regression analysis indicated that gender was the best predictor. A series of Pearson correlations revealed a significant positive relationship between …

Education To Improve Health For Rural Africa American Women With Diabetes, Monique Deidre Pendleton

Walden Dissertations and Doctoral Studies

Diabetes (DM) is the 7th leading cause of death in the United States. Minorities like Hispanics and African Americans (AA) are at greater risk of developing DM. The prevalence and outcomes affecting diabetes are attributed to socioeconomic status, sex differences, ethnic, cultural, and religious status. Diabetes-related mortality is a major health problem in AA in rural America. The focus for this project was to identify the best evidence regarding educational counseling on lifestyle modifications that positively impact adult AA women with diabetes living in Rural America. The social-ecological theory and health belief model informed this project because these models incorporate …

Health Literacy And Diabetes Among Refugee Women Residing In Arizona, Aline Nina Indatwa

Walden Dissertations and Doctoral Studies

There is limited research available linking health literacy and diabetes knowledge to poor health outcomes among refugees. The aim of this study was to determine the levels of health literacy and diabetes knowledge and examine whether different factors (age, education, employment status, number of years lived with diabetes and length of stay since resettlement) are associated with health literacy and diabetes knowledge. A cross-sectional study was performed among 82 refugee women with a known diagnosis of diabetes and residing in Maricopa County, Arizona. A modified two part questionnaire (self-reported health literacy extracted from the European Health Literacy Questionnaire [HLS-EU-Q16] and …

Perspectives Of African Americans Diagnosed With End Stage Renal Disease And Their Perceptions Regarding Accessibility Of Care, Toya Williams

Walden Dissertations and Doctoral Studies

End stage renal disease (ESRD) is the final phase of kidney disease. African Americans make up 35% of all ESRD cases, which is rising. They lead all other racial groups and are 3 times more likely to be diagnosed with ESRD. Researchers have reported quantitative results involving this population, but none have focused on their experiences. The researcher sought to capture the experiences of these patients and their perceptions regarding access to healthcare to determine the role that access to care played in their condition. Interviews were conducted to gain an understanding of their experiences related to their use of …

Treatment Plans For Diabetes Management During Hurricane Maria In Puerto Rico, Joel De La Cruz Oller

Walden Dissertations and Doctoral Studies

The purpose of this study was to evaluate the health outcomes of diabetic patients in Puerto Rico, before, during, and after Hurricane Maria, in 2017. The Department of Health in Puerto Rico provided the secondary data for the variables low-density lipoproteins (LDL) cholesterol, hemoglobin A1C (HbA1c), mortality, and consumer price index (CPI). The inclusion criteria were participants for whom electronic data were available before, during, and after Hurricane Maria; the sample size was 450. The theoretical framework for this investigation was the health outcomes and impact assessment. The data were analyzed by univariate and analysis of variance (ANOVA) to compare …