Medicine and Health Sciences Commons^™

Postcolonialism And The Marshallese Diaspora: Structural Violence And Health In The Marshallese Community In Springdale, Arkansas, Alexander J. Hirata

Master's Theses

Despite moving to the United States for better healthcare, among other benefits, Marshallese Compact of Free Association (COFA) migrants residing in Springdale, Arkansas continue to face similar acute health problems as Marshallese living in the Republic of the Marshall Islands (RMI), and often without access to health services. These problems include high rates of noncommunicable diseases, such as type 2 diabetes and thyroid cancer, as well as rare conditions such as Hansen’s Disease.

To research this, I studied the limited texts surrounding the Marshallese diaspora, as well as relevant bodies of literature: postcolonialism, Pacific migration theory, and global health and …

The Effect Of The Patient Protection And Affordable Care Act On The Medicare Part D Coverage Gap As Reflected In Diabetes Medication Adherence., Jennifer A. Forristal

Electronic Theses and Dissertations

This dissertation involves an evaluation of the effect of the Patient Protection and Affordable Care Act (ACA) on diabetic medication adherence for mail order utilizers over 6 years as the Medicare Part D coverage gap begins to close. The study had 3 objectives: 1) to evaluate diabetes medication adherence of health plan members before they reach the coverage gap and then while they are in the coverage gap, 2) to compare diabetes medication adherence between two similar groups with differing benefit structures, one group with a gap in coverage as opposed to a group with no benefit changes within the …

Diabetes Training For Community Health Workers, Judith Aponte

Publications and Research

Background: A 2.5-month diabetes education training for community health workers (CHWs) was developed, implemented, and evaluated.

Methods: Training methods used included case studies, role-playing, and lectures. Exams were used throughout the training for its evaluation. Teaching was delivered by different ways: a one day American Diabetes Association (ADA) course; a five day Diabetes Self-Management Program (DSMP); Conversation Maps; and a series of seven National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) diabetes education booklets.

Results: Qualitative and quantitative evaluative methods were used during and after the training. The CHWs' diabetes knowledge was evaluated by a pre- and post-test …

The Comparative Impact Of Different Patient-Centered Medical Home Domains On Satisfaction Among Individuals Living With Type Ii Diabetes, Jon Mills, Allyson Hall, Rebecca Tanner, Jeffrey Harman, David L. Wood, Charles Lorbeer

Patient Experience Journal

Chronic illnesses like type 2 diabetes are costly and difficult to treat. Patient-centered medical homes (PCMH) have the potential to improve patient satisfaction in this population. However, which domains have the most impact on patient satisfaction has not been established. The aim of this study was to assess the relative strength of association between seven PCMH domains and two measures of satisfaction. Cross-sectional data were used in this observational study collected from a random sample of adults aged 18-89 with type 2 diabetes (n=1301) seen at 4 PCMHs. The Ambulatory Care Experiences Survey instrument was used to assess all measures. …

Knowledge, Attitudes, Beliefs And Behaviors (Kabb) Of Diabetes Among Afro-Caribbeans Near Brooklyn, New York, Sophia Allen

Sophia I. Allen, Ph.D.

Diabetes is an epidemic in the U.S. that unduly affects minority groups. African Americans are more than two times as likely to die from diabetes than whites. Literature previously established that some population groups have a negative perception toward medical professionals and visiting a doctor's office and/or hospital when a health problem occurs. In New York City, where a large group of Afro-Caribbeans live, diabetes prevalence more than doubled over the past 10 years with over half a million adults diagnosed. Due to a gap in literature in the U.S. on type 2 diabetes among English-speaking Afro-Caribbeans, this study recruited …

Blood Inorganic Mercury Is Directly Associated With Glucose Levels In The Human Population And May Be Linked To Processed Food Intake, Renee Dufault, Zara Berg, Raquel Crider, Roseanne Schnoll, Larry Wetsit, Wayne Two Bulls, Steven G. Gilbert, H.M. “Skip” Kingston, Mesay Mulugeta Wolle, G.M. Mizanur Rahman, Dan R. Laks

Publications and Research

Background: The goals of the study were (1) to determine the impact of inorganic mercury exposure on glucose homeostasis; and (2) to evaluate the effectiveness of two community-based interventions in promoting dietary changes among American Indian college students to reduce risk factors for Type-2 Diabetes including fasting glucose, insulin, and mercury levels, weight, and body mass index.

Methods: To accomplish goal one, the National Health and Nutrition Examination Survey (NHANES) dataset was analyzed using a previously published method to determine if there is a relationship between inorganic blood mercury and fasting glucose. To accomplish goal two, ten college students were …

Risk Perception Of Developing Type 2 Diabetes Mellitus In Healthcare Related Majors At The University Of Rhode Island, Iman Aberra

Senior Honors Projects

Objective: To determine risk perception of developing type 2 diabetes mellitus in health orientated majors at the University of Rhode Island and if perceived risk is significantly different in those who have trouble affording nutritious foods.

Methods: An email was sent to an academic advisor for the doctorate of pharmacy, nursing, physical therapy, kinesiology, pre-professional health studies, nutrition, and health studies programs at the University of Rhode Island. Pre-pharmacy was included in pre-professional health studies. An additional email was sent to a professor in the nutrition department. The advisors and the nutrition professor then sent out an email with the …

Impact Of The Heart Watch Program On Patients At Risk Of Developing Metabolic Syndrome, Prediabetes Or Cardiovascular Disease, Jennifer T. Fink, Kathryn K. Havens, Julia A. Schumacher, Renee E. Walker, George L. Morris Iii, David A. Nelson, Maharaj Singh, Ron A. Cisler

Journal of Patient-Centered Research and Reviews

Purpose

Metabolic syndrome is a set of metabolic risk factors associated with increased risk of developing cardiovascular disease and type 2 diabetes mellitus. We retrospectively evaluated the effectiveness of a lifestyle modification program (Heart WATCH) geared toward reducing development of chronic disease in women deemed at risk for metabolic syndrome, prediabetes and/or cardiovascular disease.

Methods

Our institution’s Heart WATCH program consists of screening sessions with a multidisciplinary team (physician/nurse, nutritionist and psychologist), a minimum of three visits with a nurse practitioner and weekly follow-up phone calls for a 14-week period. Sociodemographic variables were obtained at initial visit. Biometric testing indices …

Considering Shared Power And Responsibility: Diabetic Patients’ Experience With The Pcmh Care Model, Olena Mazurenko Md, Phd, Sheila Bock Phd, Catherine Prato, Margarita Bondarenko

Patient Experience Journal

The patient-centered medical home (PCMH), an innovative primary care model that fosters a stronger, more personal patient-doctor relationship than traditional health care models, should be particularly well suited for the treatment of chronic conditions such as diabetes that require ongoing management by both patients and providers. Despite growing research on the effectiveness of PCMHs in diabetes care, relatively little attention has been given to diabetic patients’ experiences. This qualitative study examines diabetic patients’ experiences at one PCMH setting, using in-depth interviews to understand patients’ perspectives of the shared power and responsibility between patient and provider in their diabetes care. Our …

Supporting Practices To Adopt Registry-Based Care (Sparc): Protocol For A Randomized Controlled Trial, Rebeccar S. Etz, Rosalind E. Keith, Anna M. Matemick, Karen L. Stein, Roy T. Sabo, Melissa S. Hayes, Purvi Sevak, John Holland, Jesse C. Crosson

Publications and Research

Background: Diabetes is predicted to increase in incidence by 42% from 1995 to 2025. Although most adults with diabetes seek care from primary care practices, adherence to treatment guidelines in these settings is not optimal. Many practices lack the infrastructure to monitor patient adherence to recommended treatment and are slow to implement changes critical for effective management of patients with chronic conditions. Supporting Practices to Adopt Registry-Based Care (SPARC) will evaluate effectiveness and sustainability of a low-cost intervention designed to support work process change in primary care practices and enhance focus on population-based care through implementation of a diabetes …

Epid 7131 - Epidemiology Of Chronic Disease, Jian Zhang

Jiann-Ping Hsu College of Public Health Syllabi

This course is designed to introduce the student to the ever-expanding area of chronic disease epidemiology. Students will be introduced to the current status of chronic disease and control programs, methods used in chronic disease surveillance, intervention methods, and modifiable risk factors. Some of the major chronic diseases such as cancer, cardiovascular disease, chronic lung disease, diabetes and arthritis will be discussed in detail.

Pubh 3131 - Chronic Disease: A Modern Epidemic, Deshannon Antoine-Hardy

Jiann-Ping Hsu College of Public Health Syllabi

Chronic conditions (e.g. diabetes, cardiovascular disease, renal disease, obesity) are currently responsible for 60% of the global burden of disease and the World Health Organization predicts this to rise to 80% by the year 2020. This is one of the greatest challenges facing health care systems throughout the world and it places long-term health and economic demands on health care systems as the population ages. This course will provide students with the opportunity to study specific issues related to chronic disease epidemiology and management and their links to practice.

Shining The Spotlight On Diabetes, Rodney Richmond

College of Pharmacy Faculty Research ​and Publications

No abstract provided.

Television Watching, Diet Quality, And Physical Activity And Diabetes Among Three Ethnicities In The United States, Fatma G. Huffman, Joan A. Vaccaro, Joel C. Exebio, Gustavo C. Zarini, Timothy Katz, Zisca Dixon

Joan A. Vaccaro

Diabetes is a world-wide epidemic associated with multiple environmental factors. Prolonged television viewing (TV) time has been related to increased risk of obesity and type 2 diabetes in several studies. TV viewing has been positively associated with cardiovascular disease risk factors, lower energy expenditure, over-eating high-calorie and high-fat foods. The objective of this study was to assess the associations of hours of TV viewing with dietary quality, obesity and physical activity for three ethnic minorities with and without type 2 diabetes. Diet quality and physical activity were inversely related to prolonged TV viewing. African Americans and participants with type 2 …

Healthy Eating Index And Alternate Healthy Eating Index Among Haitian Americans And African Americans With And Without Type 2 Diabetes, Fatma G. Huffman, Mauricio De La Cera, Joan A. Vaccaro, Gustavo C. Zarini, Joel C. Exebio, Deva Gundupalli, Lamya Shaban

Joan A. Vaccaro

Ethnicities within Black populations have not been distinguished in most nutrition studies. We sought to examine dietary differences between African Americans (AA) and Haitian Americans (HA) with and without type 2 diabetes using the Healthy Eating Index, 2005 (HEI-05), and the Alternate Healthy Eating Index (AHEI). The design was cross-sectional (225 AA, 246 HA) and recruitment was by community outreach. The eating indices were calculated from data collected with the Harvard food-frequency questionnaire. African Americans had lower HEI-05 scores (−8.67, 13.1); , than HA. Haitian American females and AA males had higher AHEI than AA females and HA males, respectively, …

Medical Advice And Diabetes Self-Management Reported By Mexican-American, Black- And White-Non-Hispanic Adults Across The United States, Joan A. Vaccaro, Daniel J. Feaster, Sandra L. Lobar, Marianna K. Baum, Marcia Magnus, Fatma G. Huffman

Joan A. Vaccaro

Background

Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and …

Genetic Vulnerability To Diabetes And Obesity: Does Education Offset The Risk?, Sze Yan Liu, Stefan Walter, Jessica Daniel, David H. Rehkopf, Laura E. Kubzansky, M Maria Glymour

Department of Public Health Scholarship and Creative Works

The prevalence of type 2 diabetes (T2D) and obesity has recently increased dramatically. These common diseases are likely to arise from the interaction of multiple genetic, socio-demographic and environmental risk factors. While previous research has found genetic risk and education to be strong predictors of these diseases, few studies to date have examined their joint effects. This study investigates whether education modifies the association between genetic background and risk for type 2 diabetes (T2D) and obesity. Using data from non-Hispanic Whites in the Health and Retirement Study (HRS, n = 8398), we tested whether education modifies genetic risk for obesity …

Effective Smoking Cessation Methods Among Smokers With Diabetes In Nv, Salome Kapella-Mshigeni, Eunice Kimunai, Peter Anderson, Elizabeth Fildes, Tam Villar

Nevada Journal of Public Health

Smoking and diabetes could both be prevented if individuals would abstain from smoking, eat healthy, and exercise regularly. Smokers with diabetes have an increased risk of serious health outcomes, hence effective smoking cessation interventions are critical. The transtheoretical model was used in this quantitative study analyzing secondary data from the state of Nevada Quitline to examine the relationships between smoking cessation method (counseling versus counseling and medication) and quitting smoking for 720 smokers with/without diabetes. Participants were Nevada residents, ages 18+, men and women, English or Spanish speakers. Descriptive statistics, logistic regression, and a test of two proportions were conducted. …

Geographic Variation In Antidiabetic Agent Adherence And Glycemic Control Among Patients With Type 2 Diabetes, Eleanora Tan, Wenya Yang, Bo Pang, Mingliang Dai, F. Ellen Loh, Paul Hogan

Touro College of Pharmacy (New York) Publications and Research

BACKGROUND: Medication nonadherence is an imperative public health concern. Among patients with type 2 diabetes mellitus (T2DM), poor adherence to antidiabetic agents is strongly associated with suboptimal glycemic control. Poor adherence and hyperglycemia greatly increase diabetes-related morbidity and mortality. At a national level, diabetes drug adherence using average proportion of days covered (PDC) is estimated to range between 36% and 81%, with an estimated range for diabetes control between 38% and 47%. At a state level no such studies exist.

OBJECTIVE: To estimate the level of medication adherence to antidiabetic agents and of diabetes control, and their association among patients …

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 …

The Sweet Taste Of Health: A Positive Deviance Inquiry Into Communicative Acts That Lead To Effective Management Of Diabetes Among Hispanics, Claudia Martinez Boyd

Open Access Theses & Dissertations

ABSTRACT

Diabetes is among the fastest growing diseases in the world. In the U.S., Hispanics are the third most affected population. Nonetheless, there are Hispanics diagnosed with diabetes who have, against all odds, found solutions to manage their disease. This study focused on the intrapersonal and interpersonal acts and behaviors of "positive deviant" Hispanics living on the U.S. - Mexico border that effectively managed their diabetes. They are referred to as "positive deviants" because they accrue "positive" outcomes and "deviants" because they are not the norm.

A PD inquiry was conducted and twelve PD respondents between the ages of 20 …

Inflammatory Markers Associated With Disease Progression Of Cardiorenal Syndrome, Srikanta Banerjee

Walden Dissertations and Doctoral Studies

An increase in cellular inflammatory biomarkers directly increases the risk of cardiovascular disease (CVD). Using the social ecological and biomedical theories, the study examined quantitatively how specific inflammatory biomarkers are associated with cardiorenal syndrome (CRS), a potential complication of hypertension and diabetes, and how sociodemographic factors modify this association in the U.S. adult population. A retrospective secondary data analysis of the data collected from National Health and Nutrition Examination Survey (NHANES) 1999-2010 was utilized to evaluate these hypotheses. High sensitivity C-reactive protein, homocysteine (hcy), and fibrinogen had a modifying effect on Type 4 (chronic reno-cardiac etiology), Type 2 CRS (chronic …

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 …

A Staff Development Program: Diabetes And Tb Education And Screening, Relyndo Manalo Salcedo

Walden Dissertations and Doctoral Studies

There is a growing body of evidence on the positive association between diabetes and tuberculosis (TB), especially in populations with low socioeconomic status. According to the CDC and the WHO, diabetes is increasingly seen as a global epidemic, one that poses a threat to global TB control. The goal of this DNP project was to develop a program to educate clinical staff on the importance of early identification of diabetic and TB patients. The logic model was chosen as the framework for this project because it allows the planner to rationally observe each stage of a project's development. The program …

Differentiating Demographic Factors In Latino Patients With Type 2 Diabetes, Carol Lynne Manning

Walden Dissertations and Doctoral Studies

The American Diabetes Association (ADA) data suggest that Latinos share a greater burden of disease than do non-Latino Whites with type 2 diabetes. As a result of poor glycemic control, Latinos also suffer consequences such as blindness, kidney disease, and limb amputation more often than do other ethnic groups. The purpose of this study was to compare demographic factors of Latinos with well-controlled type 2 diabetes, as measured by a HgbA1c of 7 or less (n = 118) to Latinos not well controlled (n = 105). This cross sectional study used a secondary data set with a sample selected from …

Awareness Of Diabetes Risk Associated With Individuals 18 And Older, Rebecca Jane Boone

Walden Dissertations and Doctoral Studies

The risk of developing Type 2 diabetes is increasing at epidemic proportions, and is 12-17% higher in Marion County Florida than it is across the state, based on Florida Department of Health statistics. The purpose of this DNP project was to determine if awareness of individual risk of developing Type 2 diabetes through a questionnaire would result in high-risk participants agreeing to attend a diabetes prevention program (DPP) at a local medical clinic. The health belief model and Rosswurm and Larrabee's model for change were used as frameworks. The review of the literature showed that prevention programs were highly effective …

Knowledge, Attitudes, Beliefs, And Behaviors Of Diabetes Among Afro-Caribbeans Near Brooklyn, Sophia I. Allen

Walden Dissertations and Doctoral Studies

Literature has found that some minority groups with diabetes have a negative perception of medical professionals when a health problem occurs. This trend is particularly problematic with the diabetes epidemic in the United States. African Americans are more than 2 times as likely to die from diabetes than are Whites, and diabetes prevalence has increased exponentially in New York City where a majority of Afro-Caribbeans live. To address this problem, a cross-sectional design was used to recruit Afro-Caribbeans diagnosed with type 2 diabetes across 7 churches to examine whether shared knowledge, attitudes, beliefs, and behaviors about diabetes screening and its …

The Association Between Dietary Patterns And Diabetes Status Among U.S. Adults, Latonia Richardson

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus, or T2DM, is a leading cause of preventable death in the United States. Multiple studies have found that certain dietary patterns can significantly influence the risk of T2DM. The purpose of this study was to understand the dietary patterns associated with diabetes by comparing the relative adherence to these dietary patterns by individuals in 5 stages of diabetes: no diabetes, undiagnosed prediabetes, diagnosed prediabetes, undiagnosed diabetes, and diagnosed diabetes. Using the health belief model as the theoretical foundation, the primary research question examined whether adherence to specific dietary patterns significantly differed between individuals in different stages …

Diabetes Among Hispanic Immigrants: The Impact Of Age At Migration, Nancy Hahn

Walden Dissertations and Doctoral Studies

Diabetes is a disease that affects the Hispanic population in disproportionate numbers. With larger numbers of immigrants coming to the United States who are of Hispanic origin, the individual risk and health burden of this disease will have a major impact on the quality of life and the health care system. Research into the influence of the timing of changes in lifestyle suggested an association between specific levels of socioecological exposures and certain health conditions. This study examined that possibility. The use of the National Health Interview Survey, 2005-2011, provided adequate data for examining whether age at migration was associated …

Predictors Of Knowledge Of Stroke And Intent To Call 911 Among African Americans, Hyacinth Idu Hyacinth

Walden Dissertations and Doctoral Studies

Stroke is associated with significant health disparity and predominantly affects the elderly. Stroke outcome is significantly improved if an individual is able to get "clot-bursting" medication. A significant predictor of an on-time arrival to the emergency room for treatment in the event of a stroke is the ability to accurately recognize stroke signs and symptoms. The purpose of this study was to determine the factors (demographic, socioeconomic, and educational) that predict the knowledge of stroke signs/symptoms and intent to call 911 in the event of a stroke. The study was grounded in the social ecological theoretical model and analyzed archived …