Medicine and Health Sciences Commons^™

Risk Factors For Hypertension Among African-Born Immigrants In The United States, John Ojih

Walden Dissertations and Doctoral Studies

Essential hypertension (HTN) has been and continues to be a serious public health problem across the globe, particularly among Black races, with an estimated morbidity rate of over 1 billion people and an estimated mortality rate of 9.4 million people worldwide. Essential HTN can lead to a host of chronic diseases including cardiovascular disease (CVD), stroke, myocardial infarction, brain damage, kidney failure, and retinopathy. The main purpose of this quantitative, descriptive, nonexperimental study was to investigate the association of physical inactivity, length of stay in the United States, immigrants' health status, and food security as risk indicators in the development …

The Experience Of Survivorship: Quality Of Life For African American Breast Cancer Survivors, Angela L. Grimmett

Walden Dissertations and Doctoral Studies

African American breast cancer survivors are at a greater risk of experiencing disparities in mortality, treatment, and quality of life. The purpose of this phenomenological study was to explore the impact that breast cancer had on the quality of life of African American breast cancer survivors from a psychosocial, physical, spiritual, and economic perspective. Face-to-face, in-depth interviews were conducted with 9 volunteers who met the eligibility criteria of being breast cancer survivors of African American decent. The sample of survivors ranged in ages 45 to 80 and was between 6 to 30 years postdiagnosis. Giorgi's phenomenological method was used to …

A Curriculum On Culturally Competent Practices To Prevent Retraumatization In Diverse Survivors, Luana Rodriguez

Walden Dissertations and Doctoral Studies

This DNP project addresses the healthcare issue of intimate partner, domestic, and sexual violence (IPDSV), its impact on survivors, and reducing the potential for retraumatization by those who care for them in the clinical, behavioral, and social settings. Trauma-informed care interventions are designed to address the sequelae of trauma, promote recovery, and support resilience. Since IPDSV is a global health issue, supporting cultural needs of all clients is an essential aspect of trauma-informed care. This project was guided by a central research question that examined if trauma-informed, culturally competent curriculum be viewed by community stakeholders as an appropriate intervention for …

A Phenomenological Inquiry Into The Low Rates Of Influenza Vaccination Among Older African Americans, Delia Roxanne Howson-Santana

Walden Dissertations and Doctoral Studies

Influenza vaccination is recommended for persons with high-risk health conditions such as chronic diseases to prevent flu-related complications and death. African Americans 65 years and older have consistently been reported to have the lowest influenza vaccination rates compared to all other racial groups, despite having higher rates of chronic diseases. A review of the literature indicated that there is a dearth of qualitative studies examining the grounds for these low rates. In this study, 15 African Americans 65 years and older were interviewed to explore the factors that contribute to low rates of flu vaccination among this racial group. Research …

Factors Relating To Underrepresentation Of Black American Women In Health Care Administration, Alquietta Lavayle Brown

Walden Dissertations and Doctoral Studies

There is a low representation of Black American women (BAW) in health care senior leadership. With the high level of health problems found among the Black community, diversifying the executive leadership with BAW may be instrumental in increasing provider trust and reducing discriminatory action. Using critical race theory as the conceptual framework, this study examined the experiences, perceptions, and influential or deterrent factors inhibiting advancement of BAW in the health care field. Inquiry centered on factors related to lack of advancement, experiences at different stages of career progression, and strategies impacting career advancement. A qualitative research design using a transcendental …

Obesity And Workplace Injury In Hazardous Occupations Among The Hispanic/Latino Population, Barbara Klyde

Walden Dissertations and Doctoral Studies

Over the past 20 years, adult obesity has increased in the United States, especially among the Hispanic/Latino population. In 2010, the Occupational Safety and Health Administration Environmental and Safety News, reported that younger workers, ages 18 to19 years of age, worked in the most high-risk occupations such as agriculture, construction, fishing, and manufacturing. The reported fatality rates for these occupations were 5.6 times greater for Hispanic workers compared to other race/ethnicity groups reported by the Bureau of Labor Statistics in 2013. This study determined whether obesity contributed to workplace injury or mortality in hazardous occupations, using federal, state, and independent …

Primary Factors Affecting Breastfeeding In African American Communities, Lowest Jefferson

Walden Dissertations and Doctoral Studies

Prior research has shown that African Americans are less likely than are Hispanics and Whites to breastfeed their children. Compounding this problem is the scarcity of research that examines African American's culture, perceptions, and beliefs about breastfeeding. This study was conducted to gain a greater understanding of the phenomenon of breastfeeding through the perspectives of African American mothers. Guided by the theories of reasoned action and planned behavior, this ethnographic study elicited African American mothers' perspectives on breastfeeding by examining what influenced their decision to breastfeed or not. This study took place in Washington State. Ten women recruited through purposeful …

The Effects Of Buddhist Psychological Practices On The Mental Health And Social Attitudes Of Lesbian, Gay, And Bisexual People, Jessica Lynn Fritzges

Walden Dissertations and Doctoral Studies

This non-experimental, quantitative study explored the effects of the Buddhist-derived practices of mindfulness and loving-kindness meditations on the wellness of lesbian, gay, and bisexual (LGB) people. LGB people are at higher risk of mental illness and increased social isolation due to minority stress; Buddhist-derived mindfulness practices mediate these effects in other groups. Lazarus and Folkman's transactional model of stress and coping was the theoretical model explaining how positive cognitive appraisal induced by meditation can mediate effects of stress. This study examined whether mental health scores on the Emotional Symptoms Checklist (ESC), social attitudes measured on the Unjust World Views Scale, …

A Qualitative Analysis Of Migrant Women Farmworkers' A Qualit Ative Analysis Of Migrant Women Farmworkers’ Perceptions Of Maternal Care Management, Stacey A. Pilling

Walden Dissertations and Doctoral Studies

The purpose of this phenomenological study was to examine migrant women farmworkers' views of perinatal care management while working in the fields. Like men, women migrant farmworkers are exposed to many physical, chemical, and biological hazards that pose human health risks. However, women of childbearing age are at an increased risk of having reproductive health difficulties and adverse pregnancy outcomes, and the infant mortality rate among migrant farmworkers is estimated to be twice the national average. Perinatal care is a critical factor in reducing adverse outcomes for perinatal and newborn mortality. Face-to-face interviews were conducted with 15 migrant women farmworkers …

A Case Study Of Respect Among Young Urban African American Men, Morgan Zenobia London

Walden Dissertations and Doctoral Studies

Many young adult African American men living in urban areas adopt a style of self-presentation known as the gangsta image in an attempt to earn and maintain what they may perceive to be respect, self-esteem, and social status. While these young men succeed in earning the respect of their peers, they also may jeopardize their chances of succeeding in mainstream society by engaging in an alienating lifestyle related to their alternative form of status. The purpose of this case study was to explore the concepts of respect and self-esteem as defined by a culture-sharing group of young African American men …

Success Experiences Of Hispanic Nursing Students Who Persisted And Graduated After Academic Failure, Barbara Ninan

Walden Dissertations and Doctoral Studies

Twenty percent of Hispanic nursing students at a west coast university are being dismissed from the nursing program due to repeated failures in nursing courses. The purpose of this study was to gain a better understanding of Hispanic nursing students' experiences of successfully completing a nursing program, earning a baccalaureate of science degree, and passing the state licensing examination for registered nurses despite having failed a nursing course and having been placed on academic probation. Guided by Tinto's theory of academic integration, a descriptive phenomenological design was used to explore Hispanic nursing graduates' success experiences. Purposive sampling was used to …

Racism Vs. Social Capital: A Case Study Of Two Majority Black Communities, Bruce W. Strouble

Walden Dissertations and Doctoral Studies

Several researchers have identified social capital as a means to improve the social sustainability of communities. While there have been many studies investigating the benefits of social capital in homogeneous White communities, few have examined it in Black homogeneous communities. Also, there has been limited research on the influence of racism on social capital in African American communities. In this dissertation a comparative case study was used within a critical race theory framework. The purpose was to explore the role of racial oppression in shaping social capital in majority African American communities. Data were collected from 2 majority Black communities …

Women And Thyroid Disease: Treatment Experiences And The Doctor-Patient Relationship, Laura J. Mccormick

Walden Dissertations and Doctoral Studies

Thyroid disease, a chronic illness, affects nearly 200 million people worldwide and is more common among women than in men. Numerous factors make diagnosing and treating thyroid disease in women challenging. The standard blood test for diagnosing thyroid disease and determining treatment effectiveness is inconsistent in its accuracy. Many women with thyroid disease are misdiagnosed or struggle with symptoms even once receiving treatment. Although thyroid disease is highly prevalent among women and the doctor-patient relationship is known to influence treatment outcomes, there is a gap in the literature regarding the treatment experiences of women with thyroid disease and the doctor-patient …

Assessing Spirituality Among Hospice Patients: A Phenomenological Study Of Hospice Nurses, Isabel Esther Kaufman

Walden Dissertations and Doctoral Studies

The shift in health care and nursing philosophy and practice from a holistic approach to a highly technological, cure-oriented approach has been attributed to effective pharmaceuticals made to prolong life. Recently medical professionals have shifted their focus to a combination of spiritual healing and medicine. Hospice care in particular have taken a key interest in integrating spirituality within their health care. The problem is that due to the complications in defining spirituality and appropriate training and education of spirituality within nursing curriculum, assessing patients' spiritual distress may be difficult for many hospice nurses which may be at a loss when …

A Mixed Method Study Of Diagnostic And Adaptive Functioning Challenges In African American Preschool-Aged Children With Autism Spectrum Disorders, Douglene Jackson

Walden Dissertations and Doctoral Studies

Children with Autism Spectrum Disorder (ASD) are known to experience performance and participation challenges, with early diagnosis being critical for improved outcomes. Children from ethnic minority backgrounds tend to receive their diagnoses later, even when symptomatology is similar. This mixed methods study explored symptom severity, functional difficulties, and age at diagnosis for ASD and to describe the functional challenges encountered by preschool-aged children with ASD of African American descent. The International Classification of Functioning, Disability, and Health along with the Model of Human Occupation were the theories used for this study to conceptualize functional challenges and other potential factors. Research …

Cultural Beliefs And Experiences Of Formal Caregivers Providing Dementia Care To American Indians, Damon Grew Syphers

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is a significant public health concern for all elders in the United States. It is a particular concern for the American Indian (AI) population, which is one of the fastest-aging populations in the United States and the smallest, most underrecognized, and most culturally-diverse group in the country. A formal caregiver understanding of AD in the AI population is scarce. This phenomenological study was designed to discern what is known about AD in the AI population by exploring the cultural beliefs and experiences of formal caregivers who provide care for AI dementia patients. Specifically, this study sought to …

A Comparative Study Of Compliance Among Patients Attending An Opiate Outpatient Treatment Center In Rural Appalachia, Jerry Russell Morris

Walden Dissertations and Doctoral Studies

Adults with an opiate addiction have a higher rate of noncompliance with treatment, which limits its effectiveness and increases the burden of care for society. Effective treatment decreases emergency room visits, and overdoses. The tristate area of Kentucky, West Virginia, and Ohio has experienced increased opiate-related arrests and deaths. This study sought to measure the extent to which treatment type (medical treatment (MS) or faith-based component of service (FBS)) predicts compliance when measured by number of clean urine drug screens (UDSs) and number of kept pill count, over and above dual diagnosis, college education, and income. The on-site records of …

Health Care Seeking Behavior And Provider Responses For Hcv-Positive African Americans, Kathleen Susanna Bailey

Walden Dissertations and Doctoral Studies

Of the 3.5 million persons infected with chronic HCV in the United States, the African American population is the largest racial group with chronic HCV. Disparities in access to care and treatment involve a complex set of individual, interpersonal, socioeconomic, and environmental factors that influence the course of HCV infection in the African American population, resulting in poorer outcomes and survival. Drawing upon both the theory of reasoned action and the theory of planned behavior, this study was conducted to determine whether the seeking of health care by HCV-positive African Americans and the responses of health care providers to HCV-positive …

The Impact Of Self-Imposed Barriers On African Americans Successes, Pennie L. Murray

Walden Dissertations and Doctoral Studies

Researchers and economists have argued that the economic and social stagnation of African Americans is the result of their lack of self-confidence, initiative, and commitment toward their own advancement. This qualitative study examined whether historical conditioning and personal experiences have created a hypersensitivity in this population to events triggering behaviors that mirror the success fearing personality when seeking social, economic, and political advancement. It used Zuckerman and Allison's fear of success scale to identify the range of success fearing in 30 African American men and women aged 35 years or more; this group was also interviewed regarding their lived experiences …

Women's Perspectives On Adequacy Of Screening And Treatment For Postpartum Depression, Gloria Marcia Watson

Walden Dissertations and Doctoral Studies

Postpartum depression affects some 10% to 20% of mothers. Its impact on the health and well-being of mothers and their infants is well documented. If not identified and addressed early, it can result in emotional burden, costly hospitalization and treatment, and, at worst, suicide and or infanticide. Empowerment theory was the conceptual framework for this hermeneutic phenomenological study. The purpose was to understand the lived experiences of the screening and treatment processes of 10 women from New York City experiencing postpartum depression and their perceived adequacy of the treatment received. In-depth interviews were used to investigate participants' lived experiences of …

Racial Differences In The Impact Of A Worksite Wellness Program On Cardiovascular Biomarkers, Ceabert Joseph Griffith

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) is responsible for approximately 600,000 deaths in the United States each year, with African Americans (AAs) disproportionately affected. Individual-level approaches to reducing CVD remain ineffective, mobilizing a movement that advocates for population-based solutions. Workplace wellness programs (WWPs) have gained considerable traction as a viable strategy for ameliorating CVD burden among workers in general. However, no studies have looked at the efficacy of WWPs in ameliorating CVD specifically among AA employees--a knowledge gap that this investigation aimed to close. Based on the health belief model and the social cognitive theory, this retrospective cohort study used de-identified secondary data …

Toward A Therapeutic Use Of Spirituality Among Individuals With Mild To Moderate Intellectual Disabilities, Tony Terrell Lee

Walden Dissertations and Doctoral Studies

Toward a Therapeutic Use of Spirituality among Individuals with Mild to Moderate Intellectual Disabilities

by

Tony Terrell Lee

MS, William Carey University, 2005

BS, University of Southern Mississippi, 1992

Dissertation Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Clinical Psychology

Walden University

May 2015

Research has shown that community employment, different levels of independent living, and advocacy groups are factors that influence self-esteem in individuals with mild to moderate intellectual and developmental disabilities (ID). One gap in the literature is whether there is a correlation between spirituality and self-esteem in individuals with mild to …

Attitudes And Behaviors Of South African Women And Psychosocial Determinants Of Gonorrhea, Takiyah White Ndwanya

Walden Dissertations and Doctoral Studies

The incidence of gonorrhea had declined since the HIV epidemic in the late 1980s, but is now increasing globally due to the emergence of antibiotic-resistant forms of this disease. In South Africa, the incidence of gonorrhea is highest among Black women due to their high co-infection rates with HIV and other sexually transmitted infections (STIs). This study examined the psychosocial determinants of gonorrhea among Black women aged 18 - 35 in the Langa township in Cape Town, South Africa. All participants had reported at least one sexual experience and at least one positive test for gonorrhea in the past two …

How Spiritual Values Correlate With Hospice Use For African Americans, Latrina Dion Frazier

Walden Dissertations and Doctoral Studies

End of life hospice services have consistently been underused by African Americans. This disproportionate use of hospice has contributed to poor quality of life and a lack of cost-effective care for patients with terminal illness. Driven by the theory of reasoned action, the purpose of this quantitative study was to test associations between African Americans' perceptions of hospice, decisions to use hospice, and religiosity. A convenience sample of 154 African American adults was surveyed online. The survey instrument combined the AARP End of Life survey, Perception of Hospice survey, and the Religiousness Measure survey. The results of a multiple linear …

Midcareer Women Leaving Information Technology: An Examination Of The Phenomenon, Susan F. Way

Walden Dissertations and Doctoral Studies

Midcareer women are leaving the information technology (IT) career field at a much higher rate than are men. This attrition has contributed to a decreasing percentage of women in the IT field, hindering the creativity, innovation, and productivity that can result from a diverse workforce. This phenomenological study addressed a gap in the current research by examining the lived experience of women who have left the IT field. The conceptual frameworks of the study included Rhodes and Doering's integrated career change model based on traditional turnover theory, a model of gender and power in careers by Ragins and Sundstrom, and …

The Influence Of Religion On Attitudes Toward Alcohol Use In Jewish Adolescents, Toby R. Levin

Walden Dissertations and Doctoral Studies

Historically, the Jewish faith has used alcohol in rituals and religious holidays in which adolescents are permitted to fully participate and this exposure to alcohol may influence attitudes and beliefs about underage drinking among Jewish adolescents. The purpose of this study was to determine if there was a relationship between the Jewish religion and attitudes toward alcohol among Jewish adolescents. The theoretical frameworks, on which this study was based, were the social bond theory and the social development theory. Each of these theories indicates that community is important to the individual. Using a cross sectional study design, 160 adolescents participated …

Experiences And Perceptions Of Pregnant Unmarried Adolescents In Nigeria, Priscilla Ndidi Asonye

Walden Dissertations and Doctoral Studies

Sexual activity among unmarried adolescents is a major public health problem in Nigeria, because unmarried pregnant girls are more likely to have multiple sex partners and are less likely to use contraceptives, putting them at greater risk for sexually transmitted diseases (STD), unplanned pregnancy, abortion, social isolation, and poverty. Teen pregnancy and STD rates are on the rise in Nigeria, yet few data exist on the experience of the adolescents themselves. This phenomenological study was designed to explore the in-depth experiences of 10 pregnant, unmarried adolescent girls aged 16-19, including the factors contributing to their sexual activity. An ecological model …

African American Race And Culture And Patients' Perceptions Of Diabetes Health Education, Linda Marie Keenan

Walden Dissertations and Doctoral Studies

African Americans diagnosed with diabetes are less likely to self-manage diabetes-specific modifiable risk factors. As a result, utilization of healthcare services occurs at a greater rate than other racial groups, and thereby incurs higher than expected healthcare costs. This ethnographic study explored the elements of diabetes educational material African Americans in a large city in the southern part of the United States found most useful to facilitate self-management of their disease. Bandura's self-efficacy theory provided the theoretical framework. Research questions addressed the preferred educational content, layout of material, and methods for educational delivery and caregiver support. A purposive sample of …

Factors Influencing Diabetes Self-Management Of Filipino Americans With Type 2 Diabetes Mellitus: A Holistic Approach, Jocelyn B. Sonsona

Walden Dissertations and Doctoral Studies

There is an increasing prevalence of Type 2 diabetes mellitus among Filipino Americans. However, how well Filipino Americans with diabetes self-manage their disease and what factors influence their diabetes self-management behaviors remain unknown. Based on a holistic approach, this quantitative study was designed to investigate the diabetes self-management behaviors of this population and the factors influencing their self-management behaviors. The combined roles of diabetes knowledge, diabetes self-efficacy, spirituality, and social support were examined in predicting diabetes self-care behaviors. A convenience sample of 113 Filipino Americans with Type 2 diabetes mellitus completed the Diabetes Knowledge Test, Self-Efficacy for Diabetes Test, Daily …

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 …