Medicine and Health Sciences Commons^™

Low Health Literacy And Hpv Vaccine Uptake Of African American And Hispanic American Women, Peter Ntiamoah

Walden Dissertations and Doctoral Studies

Cervical cancer incidence in the United States has declined for the past 40 years, yet the odds of developing cervical cancer is much higher among marginalized women, particularly African American and Hispanic American women. Although preventable through vaccination against the human papillomavirus (HPV) prior to infection, uptake and completion rates of the vaccine among African American and Hispanic American women are low. The purpose of the study was to determine if a significant relationship existed between the health literacy levels of African American and Hispanic American women, ages 18-26, and the low HPV vaccination uptake. The integrated behavioral model, which …

Cultural And Environmental Determinants Of Dental Discoloration Among School-Aged Children In Nigeria, Ogbudu Gabriel Ada

Walden Dissertations and Doctoral Studies

Dental discoloration from fluorosis is a global public health problem. In Nigeria, 11.4% of the population is impacted by this disorder. Dental discoloration is caused by successive exposures to high fluoride concentrations during tooth development in utero and it is linked to the development of a variety of psychological and physiological problems, from dental aesthetics to a reduction in intelligence and skeletal changes. The purpose of this quantitative, cross-sectional study was to examine the cultural and environmental determinants of dental fluorosis in children in a rural community in Nigeria. A multilevel theoretical model was used to develop possible fluoride exposure …

Predictive Relationship Between Treatment Adherence, Glycated Hemoglobin And Diabetic Complications Among Jamaicans, Christian Anaba Nwaukwa

Walden Dissertations and Doctoral Studies

Patient nonadherence to physicians' prescribed therapeutic regimen is the greatest challenge in the effective treatment of patients with diabetes worldwide. Scientific evidence has revealed that nonadherence to prescribed medication could result in diabetic complications such as cardiovascular disease, retinopathy, nephropathy, and neuropathic diabetic foot ulcers. The purpose of this study was to explore predictive relationships between levels of adherence to antidiabetic medications, patient HbA1c levels, and diabetic complications among Jamaicans, an understudied population. The research question that guided this study was: Do the patient level of adherence and HbA1c levels have any predictive relationship with the severity of diabetic complications …

Emergency Department Use For Nontraumatic Dental Conditions And Adult Oral Health, Cheryl Anne Lassiter-Edwards

Walden Dissertations and Doctoral Studies

Nontraumatic dental-related emergency department visits has resulted in a financial burden to hospitals across the United States. This study investigated whether there is a relationship between adult preventive dental care and emergency department visits for nontraumatic dental conditions by comparing specific states. Guided by Andersen's behavioral model of health services utilization, this retrospective quantitative study also investigated associations between state-specific community water fluoridation and dental-related emergency department visits. The population of interest was adult Medicaid enrollees who visited the emergency department for non-trauma-related dental conditions in the top 5 most populous states as identified in the 2012 NHAMCS survey. These …

Health Care Facilities As A Predictor Of Breast Cancer Survival Rates, Elizabeth Natalie Webster

Walden Dissertations and Doctoral Studies

The disparity between survival rates for Black and White women with breast cancer is well documented and has been examined in terms socioeconomics, environment, tumor type, and genetics. However, there is little examination of the role of health care facilities in cancer disparities. Health care facilities are representative of societal norms and beliefs that include location, quality of care, finance, policies, and staffing; therefore, they are a proxy for social justice and social change. The purpose of this study was to examine correlations between health care facility type; social determinants of cancer such as poverty, culture, and social justice; and …

Impact Of Violent Rapes Among Women In Eastern Democratic Republic Of Congo, Benoit Munganga Mirindi

Walden Dissertations and Doctoral Studies

For the last 22 years, systematic rapes and punitive violence against women in the Democratic Republic of Congo (DRC) were utilized as weapons of war and a control strategy. This quantitative study built upon the ecological model of impact of sexual assault on women's mental health to investigate the relationship between the health impacts and chronic pain and depression among women survivors of sexual rape in eastern DRC. The sample included 156 female rape survivors, between 18-80 years old, and raped between 2010 and 2014 while residing in the conflict area. The research questions focused on the association between fistulas, …

Influence Of Maternal Psychosocial Health On Infant Feeding Practices, Tessy Linda Aguzie

Walden Dissertations and Doctoral Studies

Choice of nutrition has a great effect on the early development of human growth. Despite increased knowledge on the benefit of breastfeeding to both mother and child, some mothers still choose to formula feed. The purpose of this study is to explain how maternal health contributes to choices. The theory of maternal role attainment and the social cognitive theory are used to evaluate these feeding choices. This study tests for the association between maternal weight status and choice of infant feeding practices, the association between postpartum depression and choice of feeding and finally, if depression mediates the relationship between maternal …

Factors Influencing Alzheimer's Disease Healthcare Utilization Patterns In Puerto Rico, Carlamarie Noboa

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is associated with substantial healthcare utilization costs, resulting in a public health priority. In this study, the relationship between the demographic characteristics of age, gender, and type of health insurance; the presence of comorbidities of older Puerto Rican residents diagnosed with AD; and their healthcare utilization patterns (i.e., medical office and emergency room visits and hospital admissions) was examined using Andersen's behavioral model. Data from the 2013 Puerto Rico Health Study was used in this retrospective cohort design study. All AD cases aged -?¥ 60 years were extracted using systematic random sampling. One-way ANOVA-WELCH, Mann-Whitney U test, …

Association Between Adaptive Sports Programs And Quality Of Life Among Amputee Veterans, Sean V. Seay

Walden Dissertations and Doctoral Studies

Adaptive sports programs (ASPs) are important for enhancing the physical, psychological, and social aspects of life for amputee combat veterans while reducing the risk of depression and anger. Although the role of ASPs in improving quality of life (QoL) has been researched in relation to amputee combat veterans of World War II, the Korean War, and the Vietnam War, there has been limited examination of the role of ASPs in improving QoL among veterans of Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation Noble Eagle (OND). Therefore, the purpose of this study was to assess the effects of …

Catheter-Associated Urinary Tract Infection In New York And North Carolina, Kehinde O. Abiodun

Walden Dissertations and Doctoral Studies

In the United States, many hospitalized patients with indwelling urinary catheters acquire catheter-associated urinary tract infections (CAUTI) during their hospital stay. CAUTI negatively affects peoples' health and quality of life and causes a financial burden to individuals and the nation. The purpose of this quantitative cross-sectional study was to explore the relationship between gender, age, and hospital types and CAUTI incidence in New York and North Carolina over a 3-year period. The theoretical framework of choice was the Donabedian model. Simple logistic regression and hierarchical multivariable logistic regression analysis were performed on archival data that was requested from Healthcare Cost …

Effects Of Micronutrients On The Status Of Hiv-Infected African American Women, Veronica Alicia Graham

Walden Dissertations and Doctoral Studies

Weight loss among HIV-infected African American women (AAW), results in the fall of the cluster of differentiation (CD4) cell count and an increase in the viral load. There are 48,126 HIV-infected AAW who reported weight loss within the first year. AAW who report more than 10% weight loss within the first year progress to AIDS due to a deficiency in micronutrients and poor linkage to care. The phenomenon that occurs with individuals living with HIV does not necessarily occur among individuals who have cancer, heart disease, or some other life-threatening illness, and this phenomenon indicates a direct threat to the …

Dissertation: Sociodemographics And Pancreatic Cancer Survival Rate, Sylvester Lewis

Walden Dissertations and Doctoral Studies

Pancreatic carcinoma or pancreatic cancer (PaCa) is an insidious disease with a prognosis of 6- to 12-month survival time for a late stage diagnosis. This problem has become crucial given that no study to date had been able to establish a definitive association between independent factors (other than a few diseases) and the survival rate of pancreatic cancer. The purpose of this quantitative, cross-sectional study was to determine whether an association exists between the independent, sociodemographic variables (marital status, age, education, income, and employment) and the outcome variable of survival rate. The social cognitive theory was the framework that provided …

The Impact Of Transmission Mode On Hiv/Aids Medication Adherence, Lindsey Wilde

Walden Dissertations and Doctoral Studies

Medication adherence amongst HIV/AIDS infected individuals can be challenging for many reasons. I examined whether there was an association between mode of HIV transmission, such as sexual intercourse, mother to child, or IV drug use, and medication adherence among HIV+ individuals 18 years and older living in New York City. The theoretical base for this study was the Social Ecological Systems Theory. Logistic regression analyses were conducted on field data obtained from the New York State Medicaid Agency from 2015. Results indicated that transmission mode, age, race, and poverty level all have statistically significant associations with the dependent variable of …

Association Between Genetic Ancestry And Body Mass Index Among A Cohort Of Hispanic American Children, Sahel Hazrati

Walden Dissertations and Doctoral Studies

Childhood obesity is disproportionately higher among children from Hispanic backgrounds. Ethnicity is a social and cultural construct and does not capture true ancestral heterogeneity. Hispanic Americans have a wide variety of genetic admixture proportions of European (EUR), Native American (AMR), and African (AFR) ancestry. The objective of this cross-sectional study was to assess the contribution of ancestral genetic composition to body mass index (BMI), and to evaluate the relationship of obesity risk factors to BMI among 154 2-year-old Hispanic American children. The theory of Evolutionary Developmental Biology was utilized to investigate the relationship between children's growth process and ancestral background. …

The Impact Of Parental Education Level, Wealth Status, And Location On Female Genital Mutilation Prevalence In Northwestern Liberia, Sando Adetunji

Walden Dissertations and Doctoral Studies

Walden University

College of Health Sciences

This is to certify that the doctoral dissertation by

Sando Adetunji

has been found to be complete and satisfactory in all respects,

and that any and all revisions required by

the review committee have been made.

Review Committee

Dr. Chinaro Kennedy, Committee Chairperson, Public Health Faculty

Dr. Adebowale Awosika-Olumo, Committee Member, Public Health Faculty

Dr. James Rohrer, University Reviewer, Public Health Faculty

Chief Academic Officer

Eric Riedel, Ph.D.

Walden University

2018

Female genital mutilation has been a public health issue in many countries. As a result, researchers across the globe have conducted numerous studies …

Physical Activity And Veteran Status In Obesity And Chronic Obstructive Pulmonary Disease, Erin Mcguire Kren

Walden Dissertations and Doctoral Studies

There are few data available regarding the relationship between physical activity and veteran status in those with combined chronic obstructive pulmonary disease (COPD) and obesity. COPD is a common illness and a leading cause of death in the United States. Veterans represent a distinct subpopulation in the United States and are more likely to have COPD, which is a disease with a high rate of comorbidities such as obesity. Physical activity can improve outcomes for those with COPD and obesity. However, recommendations for physical activity for those with COPD and obesity are vague. This study, based on the self-determination theory, …

Using Social Cognitive Theory To Predict Obesity Behaviors In Hispanic American Children, Augustina Anyikwa

Walden Dissertations and Doctoral Studies

Childhood obesity is a growing challenge in the U.S. Hispanic American population. There is a need for evidence-based approaches to combat this problem. Social Cognitive Theory (SCT) is one such approach. The purpose of this study was to examine the extent to which selected constructs of SCT (expectations, self-efficacy, self-efficacy in overcoming barriers and self-control) could predict five childhood obesity prevention behaviors, namely time spent on television watching, time spent on physical activities, water consumption, consumption of fruits and vegetables, and meal portion size among Hispanic American children. A quantitative cross-sectional research design was employed for this study. Data were …

Oral Glucose Insulin Secretion Test For Identifying Patients With Insulin Resistance, David Kershner

Walden Dissertations and Doctoral Studies

Insulin resistance is an increasing public health issue with the current literature, suggesting reduced sensitivity of insulin leads to adult onset diabetes and associated downstream pathologies that reduce life expectancy. The main objectives of this study were to evaluate the ability of the Oral Glucose Insulin Secretion Test (OGIST) to identify insulin resistance and examine differences in the insulin sensitivity based on gender, age, and ethnicity. This study was supported by the insulin resistance theory which focuses on the reduced ability of insulin to bind to the cellular insulin receptor, reducing the sensitivity of insulin. The OGIST lab results of …

Association Of Dietary Intake With Suicidal Ideation Or Suicide Attempts In Adolescents, Zenobia J. Bryant

Walden Dissertations and Doctoral Studies

Suicide is among the leading cause of adolescent deaths worldwide and thus a significant public health concern. Risk factors for suicidal behavior include drinking alcohol, smoking, and engaging in risky sexual behaviors. One area of concern is dietary patterns and their association with depressive symptoms and suicidal ideation. Bandura's social cognitive theory emphasizes the assumption that one can perform specific actions to bring about desired outcomes. The primary research questions for this quantitative, retrospective, cross-sectional study concerned whether there is a statistically significant interaction between fruit and vegetable intake and suicidal ideation or suicide attempts. Data from 71,776 adolescents in …

Factors Affecting Colorectal Cancer Screening Among African-Born Immigrants In The United States, Chidoziri Chibundu

Walden Dissertations and Doctoral Studies

Despite the evidence that colorectal cancer screening is effective in reducing the incidence of and mortality from colorectal cancer, racial and ethnic disparities in colorectal cancer screening persist in the United States. African-born immigrants in the United States have lower colorectal cancer screening rates than native-born Americans. The purpose of this quantitative, retrospective, cross-sectional study was to examine how family income, health insurance status, language of interview, length of stay in the United States, perceived health status, level of education, and having a usual place for medical care affect colorectal cancer screening among African-born immigrants in the United States. The …

Perceived Cardiovascular Risk Among West Africa Immigrants In Dekalb County, Georgia, Oluwayomi Fabayo

Walden Dissertations and Doctoral Studies

West African immigrants appear to carry a heavier burden of hypertensive heart disease than the native-born African Americans in the United States. In this study, I used the socioecological model theory as a guide to examine the association between perceived stress, length of stay in United States, smoking status, housing conditions, and the risk of hypertensive heart disease among West African immigrants, ages 18 - 54 years in DeKalb County, Georgia. In this quantitative, cross-sectional design, self-reported data were collected from a sample of West African immigrant (N=107) in the DeKalb County of Georgia, using a demographic data/screening sheet and …

Public Health Strategies For Strengthening Prehospital Injury Responses In St. Lucia, Delwin Oliver Ferguson

Walden Dissertations and Doctoral Studies

Traumatic injuries have steadily increased during the last two decades, affecting over 5.8 million persons annually and have become a global public health issue. Since 2008, 80% of all deaths from noncommunicable diseases and trauma, approximately 29 million occurred in developing countries. Sixteen thousand young adults worldwide have died due to traumatic injuries. Additionally, injuries account for over 15% of the global burden of diseases, with approximately 90% of these injuries occurring in developing countries like St. Lucia. The purpose of this qualitative descriptive study was to examine policy gaps in prehospital traumatic injury responses and explore implementing Essential Public …

Long-Term Health Impacts Of Cell Phone-Driven Radiofrequency Radiation Exposure In Humans, Ndukaku Omelu

Walden Dissertations and Doctoral Studies

Uncertainties still exist about the safety of cell phone use and the level of cell phone-driven radiation. The purpose of the current inquiry was to determine the long-term health impacts of cell phone-driven radiation via the use of cell phones. In this cross-sectional study, which was based on socio-ecological theory, secondary data from the 2012 National Health Interview Survey were analyzed to assess the difference in the prevalence of thyroid cancer, mouth/tongue/lip cancer, and heart disease between exposed and non-exposed/less exposed cell phone-driven radiation groups in the United States. Logistic regression was used to address three research questions. Findings initially …

Gender, Social Support, And Resiliency In Suicidal Ideation Among U.S. Army Soldiers, John Franklin Ambrose

Walden Dissertations and Doctoral Studies

Suicidal behaviors have continued to increase in the United States (U.S.) Army population since the beginning of the wars in Iraq and Afghanistan. Suicide rates are higher in men compared to women; yet, the rate of suicidal ideation is higher in women than men. The purpose of this study was to determine if there is a correlation between suicidal ideation and protective factors, if social support and resiliency are different for men and women within the U.S. Army population, and if gender acts as a moderating variable between suicidal ideation and protective factors. The interpersonal-psychological theory of suicidal behavior was …

How Fine Particulate Matter Modifies Preterm Birth Risks In Korea, Hyun Jin Choi

Walden Dissertations and Doctoral Studies

Despite the increasing interest in preterm birth risk associated with maternal exposure to the current level of fine particulate matter (PM2.5) in Korea, there is little information on differences in PM2.5 exposure and its impact on preterm birth. This study was designed to examine the effects of Korea's air quality on preterm birth, including the possibility of moderation and mediation. This work was also designed to investigate manipulable factors for PM2.5 exposure. The theoretical framework of this quantitative and observational study included the social ecological theory and systems theory. The conceptual framework of this partially ecologic and retrospective cohort study …

Bleach-It-Away Clostridium Difficile, Kim Ione Hecker

Walden Dissertations and Doctoral Studies

Hospital-associated infections (HAIs) are infections patients contract as a result of being hospitalized. HAI rates decreased for almost all pathogens in the past few years, with the exception of Clostridium difficile infections (CDIs), which have been steadily climbing, placing hospital-acquired CDI at the top of the HAI list. The Center for Disease Control and Prevention reported in 2010 almost a half a million people were infected with CDIs yearly in the United States, and CDIs claimed the lives of approximately 29,000 people, representing a 4-fold increase from 1993. To address the problem in the local hospital, a quality improvement initiative …

Knowledge, Perceived Barriers, And Preventive Behaviors Associated With Cardiovascular Disease Among Gallaudet University Employees, Andy Kenji Tao

Walden Dissertations and Doctoral Studies

When the Minority Health Improvement and Health Disparity Elimination Act of 2007 went into effect, there was a corresponding increase in research focused on cardiovascular disease (CVD) in underrepresented groups, except for 1: culturally Deaf Americans. Guided by the health belief model, the purpose of this study was to determine if there were significant differences in the level of knowledge, perceived barriers, and preventive behaviors associated with CVD among Deaf and hearing employees at Gallaudet University, Washington D.C. This cross-sectional quantitative research study used a survey with questions derived from 2 existing national surveys. One hundred eighty-six subjects were recruited …

Relationships Among Vitamin D Deficiency, Metabolic Syndrome, Smoking Behavior, And Physical Activity, Ethan Pham

Walden Dissertations and Doctoral Studies

Aging increases the risk of both vitamin D deficiency and metabolic syndrome. Vitamin D deficiency and metabolic syndrome may be related, although there are mixed findings. Furthermore, literature suggests other factors such as physical fitness activity and smoking behavior are associated with Vitamin D deficiency and the development of metabolic syndrome. A number of studies have documented associations between Vitamin D levels and physical fitness activities, while other studies found correlations between Vitamin D levels, metabolic syndrome, and smoking behavior. However, no previous study has examined the links between physical fitness activity, smoking behavior, Vitamin D levels, and the risks …

Knowledge, Beliefs, And Perceptions About Tuberculosis Among Haitian Immigrants And Haitian Americans Living In Miami-Dade County, Florida, Leslie Barbour

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) kills 1.7 million people each year, and 1/3rd of the world's population is estimated to have latent TB. It was once the deadliest disease in the United States but is now relatively rare and, if treated properly, it is curable. Migrants from TB-endemic countries, such as Haiti, are one source of TB transmission to the US, and the prevalence of TB remains high and is increasing in Little Haiti, Florida. Data on the knowledge and perceptions of Haitian immigrants and Haitian Americans about TB is inadequate. The purpose of this qualitative research was to study the TB-related knowledge, …

Adherence To Antiretroviral Medicines Among Adolescents And Young Adults In Benue State, Nigeria, Amom Tor-Anyiin

Walden Dissertations and Doctoral Studies

Adherence to ARV medicines is essential to halt HIV progression, increase CD4 counts, decrease virologic impact, and improve quality of life for the infected people. However, sustaining good adherence among adolescents and young adults (AYA) has been a challenge caused by various problems such as distance to clinic, improved CD4 count which lead to complacency in adherence, and the nature of the environment. This was a quantitative, retrospective, correlational, cross-sectional study anchored by the transtheoretical model, which was used to understand how adherence rate among the study population was impacted by the predictive factors. Secondary data was collected from patient's …