Medicine and Health Sciences Commons^™

Completion Of Preventive Health Care Actions By Older Women With Hiv/Aids, Patricia Kay Correll

Walden Dissertations and Doctoral Studies

The widespread use of highly active antiretroviral therapy (HAART) has resulted in longer lifespans for HIV seropositive women in the United States, during which preventive health care is recommended. Failing to complete recommended cancer screening tests can result in cancer being diagnosed at a later stage with a poorer prognosis. The purpose of the study, based on the ecosocial theory, was to describe the sociodemographic and clinical variables of HIV seropositive women who failed to complete recommended screening tests for breast, cervical, and colorectal cancers, and determine if the presence of hypertension, obesity, diabetes, depression, or tobacco use impacted the …

The Effect Of A Drama On Young Adults' Attitudes About Domestic Violence, Regina Watson

Walden Dissertations and Doctoral Studies

Intimate partner abuse has been and remains a pervasive problem that has been documented in every race, religion, class, and level of education. This study presented the rationale for achieving positive social change by examining the problem through prevention rather than reaction and intervention. Although many theories of causation have been presented at various times, none has been proven or offers a complete explanation. Social ecological theory examines the interaction of individual, community, relational, and societal influences on the development of attitudes and behavior acceptance. This pre and post-survey group, quasi-experimental study examined the effects of an intervention on attitudes …

A Community Health Program To Reduce Cardiovascular Risk In Women, Xander Bacchus

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) is the leading cause of death among United States women. Regular aerobic exercise can significantly reduce CVD risk. This dissertation reflects one of the first studies of the efficacy of Community Health Programs (CHP) in promoting exercise among American women aged 25 to 65. Primary data used from a study involved a sample of 42 women aged 25 to 65 who attended a CVD and exercise-related CHP, while a 42-member control group merely received the CHP information in a printed form. A pretest was administered at the outset of the study, and a posttest was administered at …

The Healthy, Hunger-Free Kids Act And High School Obesity, Derek Grills

Walden Dissertations and Doctoral Studies

United States high school student obesity rates have doubled in the past 30 years to 13%, threatening the health of millions of adolescents. To mitigate the epidemic, Congress passed the Healthy, Hunger-Free Kids Act (HHFKA) in 2010, which mandated significant changes to school nutrition and physical education. From a public policy perspective, the HHFKA changed school nutrition and exercise policy to affect obesity rates by changing intake and energy expenditure at school, though no study using national-level data examined this relationship. As such, the purpose of the study was to examine whether HHFKA policy compliance had a statistically significant effect …

Health Education To Decrease Obesity In Adolescents With Asthma, Mitzie Eumarie Thomas

Walden Dissertations and Doctoral Studies

Obesity increases asthma severity and is costing the health care industry a significant amount of money. Decreasing adolescents' obesity will decrease the risk for chronic health problems, which can have a significant impact in adulthood. Implementing a school-based health education program can decrease the prevalence of obesity amongst adolescents. This program will be implemented by school nurses in the after-school program at Public School 59 (P.S) in New York City. The purpose of this project is to develop adolescents' school-based obesity prevention policies and documentation which will focus on increasing their nutrition education, increasing physical activities, and providing skills to …

Crash Risk Associated With Cellular Phone Use While Driving, Tiffani Ann Fordyce

Walden Dissertations and Doctoral Studies

There are inconsistencies in the published literature on the effect of cellular phone use while driving. The objective of this study was to estimate an adjusted nationwide crash rate associated with cell phone use while driving and to compare statewide crash rates prior to and following the implementation of legislation banning cell phone use while driving. Crash rates in nationally representative databases were calculated based on imputed values for cell phone use using the propensity score method. The imputed nationwide crash rate for fatal crashes (1.61 per 100 fatal crashes) and all crashes (1.409 per 100 crashes) represented a 2 …

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 …

Self Esteem, Locus Of Control, And The Relationship With Registered Nurses' Experience With Workplace Incivility, Elizabeth Anne Berry

Walden Dissertations and Doctoral Studies

The study's purpose is evaluating the relationship between locus of control and selfesteem

in relation to the registered nurse's experience and perception with lateral and

vertical incivility. There is a lack of research concerning nurse-to-nurse incivility within

the nursing profession. The hypothesis examined whether dynamics of locus of control

and self-esteem could provide insight into the personality dynamics influencing incivility

in the workplace. This non-experimental quantitative study used 2 self-evaluation tools

and 1 demographic survey tool to collect data via Survey Monkey, a commercial data

collection company. Participants were 65 randomly selected faculty (n = 36) and

graduate students (n …

Teachers' Perceptions Of Multimodal Literacies In Middle School Health Literacy Programs, Cynthia Darlene Jackson-Howard

Walden Dissertations and Doctoral Studies

Health literacy, defined as the ability to understand and use health information to make informed decisions, is critical to maintaining health; however, not all U.S. states mandate strategies to improve adolescents' health literacy. Moreover, many middle school teachers are often unaware of how their roles could improve the health literacy of their students. Multimodal literacies help students to create meaning through viewing print-based resources and using digital technologies. The purpose of this study was to investigate teachers' perceptions of the effectiveness of multimodal literacies on adolescents' overall health literacy via the introduction of health literacy programs into the curriculum. This …

Preventative Strategies To Improve Birth Outcomes Among African American Women In Rhode Island, Yvonne Michele Heredia

Walden Dissertations and Doctoral Studies

Despite increased access to prenatal care, birth outcomes continue to be a major source of disparity among women in the United States. The focus on lifestyle choices and negative behaviors prior to a pregnancy to reduce adverse birth outcomes has become a well-documented strategy. The purpose of this study was to determine if preparing for a pregnancy in advance improves birth outcomes for African American women of childbearing age between the ages of 12 and 45 years in the State of Rhode Island (RI). The theoretical foundation for this study was based on Prochaska's model of change, which is also …

The Role Of Sociodemographic Characteristics And Antiretroviral Prophylaxis On Risky Sexual Behavior Among Men Who Have Sex With Men, Leonard Obodo

Walden Dissertations and Doctoral Studies

Recent multicenter, randomized, double blind clinical trials have shown no association between HIV preexposure prophylaxis (PrEP) and increased sexual risk behavior among high-risk men who have sex with men (MSM). However, little research has been conducted under natural conditions devoid of clinical trial controlled environment to confirm the lack of association between PrEP and increased sexual risk behavior. Also, research has shown conflicting associations between sociodemographic characteristics and sexual risk behavior among MSM. In this cross-sectional, web-based, primary data analysis, MSM who reside in United States of America (USA) and who make use of PrEP for HIV prevention were examined …

Physician Assistants' Preventive Medicine Practices And Related Habits, Attitudes, And Beliefs, Judia Yael Malachi

Walden Dissertations and Doctoral Studies

Physician assistants play a pivotal role in expanding access to care, yet research on their preventive medicine practices is limited. Guided by Lewis's conceptual model for predicting counseling practices, this cross-sectional study examined the relationship between physician assistants' preventive medicine practices, personal health habits, prevention and counseling attitudes, and perceived barriers to the delivery of clinical preventive services. A 104-item self-administered survey was used to collect data from 314 physician assistants attending the American Academy of Physician Assistants' 42nd Annual Conference. Data were analyzed using descriptive statistics, Pearson's correlation, and stepwise multiple regression. Results indicated that physician assistants engaged in …

School Administrator And Staff Member Perceptions Of A Teenage Pregnancy Prevention Program, Sharon Lacretia Mcconnell-Smith

Walden Dissertations and Doctoral Studies

Mississippi is among the states with the highest teenage pregnancy rates, and the study site is among the high schools with the highest teenage pregnancy rates in the state. The purpose of this qualitative case study was to identify successful practices and areas for improvement in the implementation of a teenage pregnancy prevention program (TPPP) at the study site based on the perspectives of school administrators and staff members. Bandura's social cognitive theory provided a conceptual framework for considering behaviors and the social contexts in which they occur. Twelve participants were interviewed, including 3 administrators and 9 staff members. Data …

Relationship Between Modality And The Degree Of Knowledge Retention In Bioterrorism Training, Gaylon Rashun Crawford

Walden Dissertations and Doctoral Studies

A public health workforce must be trained to react quickly, especially in the case of terrorist attack. Political leaders and emergency management experts have often cited inadequate emergency training as a contributing factor in the public health system's failed preparations for a bioterrorist event. As a result of these failures, billions of dollars have been allocated towards correcting infrastructure deficiencies including training for public health nurses (PHNs), who are critical to a communitywide medical response. This quantitative study used Pearson's correlation and a multivariate regression analysis to evaluate the most effective modality of bioterrorism training (BTT) for PHNs working in …

The Association Of Lead With Cataracts And Vision-Related Problems In Perimenopausal Women, Imogene Drakes

Walden Dissertations and Doctoral Studies

Around the world, women are subject to an earlier incidence of cataracts, have a higher risk for cataracts, and also have a higher risk for other vision-related problems than men. Previous research has indicated an association between endogenous lead stored in long bones and cataracts in men over 60 years of age; however, a similar study in women did not reveal an association. This case control study was conducted to investigate whether perimenopausal mobilization of endogenous lead serves as a possible causative factor for women's generalized vision issues and cataract incidence in particular. Secondary data were gathered from 1,416 women …

Barriers To The Influenza Vaccination In Veterans, Zina Floyd

Walden Dissertations and Doctoral Studies

Influenza is the eighth leading cause of death in the United States, accounting for 56,000 deaths annually and leading to an average of more than 200,000 hospitalizations every year. Adults 65 years of age and older account for 50% to 60% of influenza-related hospital admissions and an estimated 90% of influenza-associated deaths occur in people age 65 and older. During the 2011 to 2012 influenza season, approximately 50 % of veterans between 45 and 70 years of age refused the influenza vaccine within the metro-area outpatient Veteran Administration (VA) facility in Atlanta, Georgia. The aim of this project was to …

Post Hysterectomy Discharge Destination And Risk Of Hospital Readmission In Elderly Women, Ruth Ann Churley-Strom

Walden Dissertations and Doctoral Studies

In elderly women, discharge after gynecologic surgery is often associated with increased morbidity. Little information exists about elderly women's discharge destination after gynecologic surgery and the outcome of early hospital readmission. The purpose of this study, conceptualized using the quality health outcomes model, was to examine whether post hysterectomy discharge destination is an independent predictor of 30-day hospital readmission in women age 65 and older. Examination of covariates included patient age, race, medical comorbidity and complications of care, as well as surgical anatomic approach and operative technique. This study involved use of a retrospective cohort design and data from 10,598 …

Food Policy: Urban Farming As A Supplemental Food Source, Bessie Didomenica

Walden Dissertations and Doctoral Studies

The distance between farms and cities and the limited access that some residents have to fresh foods can be detrimental to a city's capacity to feed people over time. This study addressed the under-studied topic of urban farming as a secondary food source, specifically by exploring the opportunities and limitations of urban farming in a large Northeastern city. Brundtland's food policy was the pivotal theory supporting food production to end global starvation, and was the link between environmental conservation and human survival. The research question for this study examined the potential food policy opportunities and limitations that assist urban farms …

Third-Degree Family Health History And Perception Of Disease Risk, Liana Carrasco Romero

Walden Dissertations and Doctoral Studies

Chronic diseases are a significant cause of illness and mortality in the United States. Hereditary predisposition to chronic diseases is a useful indicator for identifying people at risk for disease development. An ideal tool for determining this predisposition is the CDC, NIH, and AAFP recommended third-degree family health history (FHH). The aim of this quantitative, cross-sectional study, based on the theoretical frameworks of social constructivism and the health belief model, was to assess the possible influence between the completed third-degree FHH and the participant's perception of disease risk. Two-hundred seventy-three participants were recruited from health care facilities and from the …

Depression And Hiv Risk Among African American Men Who Have Sex With Men, Sonya Anyaka

Walden Dissertations and Doctoral Studies

African American men who have sex with men (AAMSM) are at a greater risk of contracting HIV than any other ethnic group, subpopulation, or race. Personal, environmental, and social variables can affect risk behavior. Driven by Beck's cognitive theory of depression, this quantitative study examined the relationship between depression and HIV risk behaviors in a sample of AAMSM (n = 108). Data was gathered via the Beck Depression Inventory and the HIV Risk Behavior Questionnaire. Simple and multiple linear regression analysis were conducted to analyze the data to determine the correlation between HIV risk behavior and depression. According to study …

The Association Of Gender And Socioeconomic Position With Cardiorespiratory Fitness In Adolescents, Quentin Oliphant

Walden Dissertations and Doctoral Studies

This meta-analysis investigated the association of gender and socioeconomic position with cardiorespiratory fitness in adolescents. Public health professionals know the importance of physical activity level as a modifiable behavior; however, the literature has revealed that more research is needed on the association of sociodemographic variables like gender and socioeconomic position with cardiorespiratory fitness in adolescents. Using the physical fitness and health outcomes conceptual model as a guide, the overall effect sizes across studies were assessed as well as the moderators of study design, sample size, age, and country. A systematic review of literature identified a total of 18 peer-reviewed studies …

Quantitative Study Of Clostridium Difficile Incidence Related To Influenza And Antimicrobial Use, Eileen M. Yaeger

Walden Dissertations and Doctoral Studies

In the United States, influenza causes approximately 36,000 deaths and over 200,000 hospitalizations each year with elderly most often affected. Clostridium difficile infection (CDI) is another major health care challenge and pressing public health issue associated with 14,000 deaths and over 335,000 hospitalizations annually. The use of antibiotics has been implicated in the development of CDI. This study's purpose was to test the relationship of seasonal influenza incidence and antiviral/antibiotic use in CDI development among hospitalized patients. Grounded in the epidemiologic wheel model of man-environment interactions, this retrospective observational study described and analyzed data from a proprietary, laboratory, and pharmacy-based …

An Assessment Of Sexually Transmitted Disease Knowledge Among 7th Grade Students, Racquel D. Weaver

Walden Dissertations and Doctoral Studies

Sexually transmitted diseases (STDs) continue to remain a public health concern in the United States, especially among young people. Levels of knowledge with regard to STDs have been investigated in prior research; however, these investigations have been limited primarily to older adolescents and young adults. Grounded in the social cognitive and subjective culture theories, this quantitative, cross-sectional study assessed STD knowledge (other than HIV/AIDS) among 7th grade students attending a public middle school in the United States. Demographic differences (age, gender, and ethnicity) in STD knowledge were examined to determine if these demographic variables predict STD knowledge scores and if …

Caregiver Status And Self-Reported Health Status Among African American, Phanta Soko Sackor

Walden Dissertations and Doctoral Studies

African American women (AAW) are at a high risk for type 2 diabetes, a debilitating and potentially fatal disease for which there is no cure. The purpose of this study was to extend the research of Mosca et al. (2012) by examining the relationship between caregiver status and self-reported health status for AAW 18 years or older diagnosed with type 2 diabetes. The chronic care model (CCM) provided the theoretical framework for this study. The CCM promoted routine care for patients with chronic illnesses to migrate from acute care to proactive, planned, and risk-based protocols. A binomial logistic regression investigated …

Electronic Benefit Transfer: Food Choices, Food Insecurity, And Type 2 Diabetes, Diana Louise Malkin-Washeim

Walden Dissertations and Doctoral Studies

The purpose of this research was to examine food security for people with prediabetes participating in the Supplemental Nutrition Assistance Program (SNAP), focusing on their food choice decisions and coping strategies over a 30-day benefit cycle that potentially increases the risk of Type 2 diabetes. A cross-sectional, quantitative design based on food choice process model constructs was used. SNAP participants (n = 36) with prediabetes, aged 21-70 years, were recruited as outpatients from Bronx Lebanon Hospital and completed self-reported questionnaires on demographics and health, food security, and food frequency. Descriptive statistics, Pearson chi square tests, and regression analysis were performed …

Association Between Psychological Trauma From Assault In Childhood And Metabolic Syndrome, W Sumner Davis

Walden Dissertations and Doctoral Studies

Metabolic syndrome and its component conditions of hypertension, obesity, and insulin resistance are on the increase in United States. Metabolic syndrome substantially increases the risk of cardiovascular disease and type 2 diabetes (T2D). To date, no published study has examined the relationship between psychological traumas from physical and/or sexual assault in childhood and metabolic syndrome or its components. This study, using the psychoneuroimmunology (PNI) model, investigated associations between psychological trauma (physical/sexual abuse) in childhood and metabolic syndrome in adulthood using data from the Midlife in the United States II (MIDUS-II) study. This research was undertaken to investigate whether a history …

Risk Factors And Food-Borne Illness: An Analysis Of Restaurant Violations In Georgia, Jovan Harris

Walden Dissertations and Doctoral Studies

Restaurant managers complete certification in food safety in order to ensure that food is handled and prepared in a manner that decreases risk factors associated with food-borne illness. However, the literature has been inconclusive concerning the connection between manager certification and the incidence of critical food-safety violations. The purpose of this quantitative study was to examine the relationship between the presence or absence of a certified food safety manager (CFSM) and the number of risk factors cited on food inspection reports and the food safety score. In addition, this study was designed to determine whether operation type (i.e., chain vs. …

Understanding Health Literacy Skills Of Patients With Cardiovascular Disease And Diabetes, Patrick J. Dunn

Walden Dissertations and Doctoral Studies

Health literacy is the ability to understand and act on health information and is linked to health outcomes. It is unclear how health literacy skills are developed in patients with complex conditions, such as cardiovascular disease and diabetes. The purpose of this grounded theory study was to gain perspectives of both patients and healthcare professionals on how health literacy skills were developed in patients with cardiovascular disease or diabetes. The research questions addressed how knowledge and skills were acquired, the role of digital tools, instructional strategies used by healthcare professionals, and how the instructional strategies of the healthcare professionals matched …

Planning For A Community Supported Farmers Market In A Rural Usda Food Desert, Carrie Lynn Engelbright

Walden Dissertations and Doctoral Studies

A community initiative to develop and sustain a farmer's market can address insufficient access to fresh and affordable fruits and vegetables for individuals working and residing in a United States Department of Agriculture (USDA) designated food desert. This project addressed a particular USDA food desert in South Wood County, Wisconsin. The purpose of this project was to develop and plan for implementation and evaluation of a community-supported farmers market in South Wood County, with the goal to increase access to fruits and vegetables. Project objectives included development of a sustainable community infrastructure to support the market, development of policies and …

Laying The Foundation For New Approaches In Evidence-Based Sex Education Curriculum Programs: A Family Life Policy Change, Rina Marie Prosser

Walden Dissertations and Doctoral Studies

The teen pregnancy rate in Henry County, Tennessee has increased over the years. The purpose of this project was to develop an evidence-based family life education policy for possible adoption by the board of education to address the persistent high teen pregnancy rate for girls aged 15-17 in the county. This present study resulted in a revised policy that was based on a comprehensive policy termed Abstinence-Centered Plus Contraception. An 18-member collaborative, organizational, and community project team, made up of community leaders, nurses, counselors, teachers, and students, assisted in the development and adoption of the policy, practice guidelines, and the …