Public Health Commons^™

Sex Bias In The Diagnosis Of Chronic Obstructive Pulmonary Disease, Olga Ivan Belitchenko Ryan

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, disability, and cost globally and in the United States. Various sources point to women experiencing greater morbidity, increased health care resource use and higher incidence of mortality resultant from COPD. While exact causality is not fully understood, it is possible that social bias towards COPD in women impacting screening and timely diagnosis may be a contributing factor. This current investigation involved the social ecological model. In this cross-sectional secondary analysis of Behavioral Risk Factor Surveillance System, 2017 data, differences in screening through use of breathing testing among 6334 …

Interprofessional Teams As A Strategy To Address Physician Shortages In North Dakota, Judy Ann Solberg

Walden Dissertations and Doctoral Studies

North Dakota health care and political leaders are facing pressure to revise health care delivery in the state. A chronic shortage of health care providers, retention issues, an aging population, and a recent population burst, as well as an abnormally high rate of physician retirement, have made health care access problematic for residents of the rural state. The purpose of this study was to explore and understand the main inhibitors and facilitators of employing interprofessional teams as a strategy to address rural physician shortages in North Dakota. Bandura’s social cognitive theory provided the framework for this phenomenological study of issues …

Motivators And Barriers Affecting Physical Activity Participation In Online Graduate Students, Gloria Christine Bales

Walden Dissertations and Doctoral Studies

Physical inactivity is a major contributor to chronic diseases, especially coronary heart disease. The American College Health Association’s National College Health Assessment II showed that only 47.4% of college students are meeting suggested physical activity requirements. As the nontraditional student population increases, research is needed to identify motivators and barriers specifically for online graduate students. The purpose of this case study was to examine the relationships of barriers and motivators for physical activity in online graduate students at Walden University. The study addressed research questions on what physical activity barriers existed in this study sample, (b) what intrinsic motivators and …

Medical Skepticism And Diabetes Management In African Americans, Pamela Bouyer

Walden Dissertations and Doctoral Studies

Type 2 diabetes (T2DM) in African Americans is a manageable disease, and self-management interventions reduce complications and hospital stays. However, in the African American population, traditional T2DM self-management interventions do not produce long-term effects on lifestyle and behavior changes. Researchers have analyzed the barriers and interventions associated with the disease, but the problem still exists. Medical skepticism may influence T2DM management and health outcomes in African Americans. However, there is scarce literature addressing the relationship between medical skepticism and health outcomes (eye and kidney problems). The purpose of the study is to assess the relationship between medical skepticism and outcomes …

Predictors Of Larc Use In High School Adolescent Females In The Unitedstates, Gloria J. Mabry

Walden Dissertations and Doctoral Studies

Teen pregnancy is a major public health problem in the United States of America. Among many contraceptive methods, long acting reversible contraception (LARC) is popular and effective. However, there was no adequate research study performed to show if minority teenagers are less likely to use LARC. The purpose of this study was to explore the relationship between adolescent sexual behavior and activity and the use of LARC in females, ages 14 to 19, in high schools across the United States. The theoretical framework used for this study was the health belief model. The study population was 1,496 White, Black/African American, …

Childhood Obesity: The Healthy, Hunger-Free Kids Act And School-Aged Children, Frankie Jean Alstin-Brooks

Walden Dissertations and Doctoral Studies

Obesity among children in America is at an all time high, 57.3% of the nation’s children will be obese by the age of 35. The purpose of this study was to examine the effectiveness of the Healthy, Hunger-Free Kids Act (HHFKA) policy. The HHFKA modified the nutritional and physical policies in order to reduce the obesity rates by changing their expenditures. Schools in all 50 states that are subject to federal, state and local nutrition regulations were researched. This was a quantitative, non-experimental, correlation study that measured state compliance with the USDA guidelines and tested for an association between compliance …

Suicidal Ideation, Suicidality, And Hiv/Aids Infection Or Diagnosis Among Asian American Sexual Minorities, Francis Azih Ngene

Walden Dissertations and Doctoral Studies

Asian American men who have sex with men (MSM) are an understudied minority. They are particularly affected by HIV/AIDS and are also impacted by psychosocial and mental health factors of depression, substance use, drug use, and alcohol use/abuse, any of which may lead to suicidal ideation and suicidality. These associations have not been widely studied in this population. The purpose of this quantitative study was to use the 2015 National Survey on Drug Use and Health data to examine these psychosocial and mental health issues and their association with suicidal ideation, suicidality, and HIV/AIDS infection or diagnosis among Asian American …

Racial Differences In Hospital Readmission And Reimbursement Rates For Patients With Congestive Heart Failure, Catherine Talongwa

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is associated with a significant economic burden that includes frequent emergency department visits, hospitalizations, and readmissions. The purpose of this study was to examine the differences, if any, between hospital readmission rates and insurance reimbursement rates for non-Hispanic Black and White CHF patients in California. The theoretical framework was Bandura's social cognitive theory. Secondary data for this quantitative study were obtained from the Office of Statewide Health Planning and Development and State Inpatient Databases from Healthcare Cost and Utilization for calendar year 2014-2016. A t-test and Levene's test for equality of variance were conducted on a …

The Perception Of Men's Preferred Female Body Size And Weight Control Behaviors Of Afro-Caribbean Women In The United States Virgin Islands, Alice Victoria Henry

Walden Dissertations and Doctoral Studies

The prevalence of obesity among Afro-Caribbean women living in the United States Virgin Islands (USVI) is a health care issue that can have detrimental effects on society. To reverse the spread of this disease, factors contributing to its prevalence must be understood so that they can be addressed. The purpose of this cross-sectional study was to examine Afro-Caribbean women's perception of the female body size preferred by Afro-Caribbean men and the influence of that perception on the women's weight control behaviors of diet and physical activity. The reasoned action approach was the basis for the theoretical foundation. The research problem …

The Caregiver Advise Record And Enable (Care) Act And Compassion Fatigue In The United States, Karen Marie Johnson

Walden Dissertations and Doctoral Studies

The transition from hospital to home can be complicated, leaving family caregivers in stressful situations that they may not know how to handle. The burden that is placed on these individuals has led researchers to focus on the public health implications of caregiving in hopes of identifying at-risk caregivers. This quantitative analysis identified what relationships exist between caregiver compassion fatigue among family caregivers and training or education received per the Caregiver Advise Record and Enable (CARE) Act and if education influences readmission rates. A purposive sample of 385 family caregivers participated in this study. The Care Transitions Measure (CTM-15), the …

Tracking Multimorbidity Changes In Diverse Racial/Ethnic Populations Over Time: Issues And Considerations, Ana R. Quiñones, Heather G. Allore, Anda Botoseneanu, Jason T. Newsom, Corey L. Nagel, David A. Dorr

OHSU-PSU School of Public Health Faculty Publications and Presentations

Multimorbidity is widely recognized as having adverse effects on health and wellbeing and may threaten the ability of older adults to live independently. Much of what is known about multimorbidity rests on research that has largely focused on one point in time, or from a static perspective. Given that there remains a lack of agreement in the field on how to standardize multimorbidity definitions and measurement, it is not surprising that analyzing and predicting multimorbidity development, progression over time, and its impact are still largely unaddressed. As a result, there are important gaps and challenges to measuring and studying multimorbidity …

Challenging Aggressive Behaviors Experienced By Personal Support Workers In Comparison To Home Care Workers: Relationships Between Caregiver Experiences And Psychological Health, Kelsey N. Womack, Teala W. Alvord, Caitlyn F. Trullinger-Dwyer, Sean P.M. Rice, Ryan Olson

OHSU-PSU School of Public Health Faculty Publications and Presentations

Personal support workers (PSW) are caregivers for children and adults with intellectual and developmental disabilities (IDDs) or adults experiencing mental illness or other behavioral health conditions. The work can be very meaningful, but many PSWs must prepare for, monitor, and manage challenging behaviors, including aggression. This study was designed to estimate the prevalence of aggression experienced by PSWs in Oregon, and compare it to a previous sample of Oregon home care workers (HCWs). This comparison included an analysis of relationships between exposures to aggression and psychological health factors. PSWs in Oregon (N = 240) were surveyed electronically at a single …

Changes In Operating Performance In Rural Hospitals From 2012 To 2019, Oluwaseyi Tami Young-Harry

Walden Dissertations and Doctoral Studies

Rural hospitals treat patients while dealing with the challenges of an inadequate workforce, limited financial resources, and an isolated geographic location, leading to difficulties in achieving financial viability. The purpose of this quantitative study was to analyze the operating performance of rural, general, medical and surgical hospitals in the United States and to determine if performance had changed from 2012 to 2019. Guided by x-efficiency theory, this study addressed whether hospital ownership explained variation in performance and if performance had changed from 2012 to 2019. A random sample of 394 rural hospitals was used, with data drawn from the American …

Recovering Illicit Substance Users' Perspective About Mandatory Drug Testing In Schools, Julie Bowser

Walden Dissertations and Doctoral Studies

The purpose of this exploratory qualitative study was to examine recovering substance

abusers' perceptions about the usefulness of mandatory drug testing in schools for adolescent substance abuse. Illegal substance abuse has reached epidemic proportions as more than half of U.S. adolescents, aged 12 to 17 years, have engaged in illicit drug use. Substance abuse information has been a part of school health education programs since the United States Drug Free Schools and Communities Act of 1986. Despite substance abuse education and school programs about the effects of drug use, many high school students abuse illicit drugs. Face-to-face interviews were conducted …

The Impact Of Dietary Intake On Mortality Risk In Colorectal Cancer Survivors, Ellen Chow

Walden Dissertations and Doctoral Studies

The colorectal cancer (CRC) survivor population is increasing in the United States. The lack of effective dietary recommendations in recurrence prevention undermines the health-related quality of life of survivors. Grounded in the socioecological model, dietary behavior is a personal-level risk factor that individuals may control. This study investigated the CRC-specific mortality risk as predicted by diet quality, dietary fiber intake, and dietary fat intake in hope of contributing to future dietary recommendations. A secondary analysis using data from 1,166 CRC survivors in the Multiethnic Cohort Study was analyzed via Cox proportional hazard regression models to estimate mortality risk. Results from …

Use Of Managerial Epidemiology By Healthcare Leaders In Ambulatory Settings, Chantelle Schenning

Walden Dissertations and Doctoral Studies

Despite many health reforms, the United States continues to struggle with limited healthcare access, exponential healthcare costs, and poor quality of care. Overcoming these challenges requires healthcare leaders’ effective navigation of industry transformation towards population health and a shift in patient volume to ambulatory healthcare settings. Research has demonstrated that the use of managerial epidemiology, an application of epidemiology tools and principles to management decision-making within healthcare organizations, can better serve the health of the population and could improve the triple aim of inadequate access, high costs, and poor quality. However, the adoption of this practice is weak and its …

Socio-Economic Determinants Of Risky Sexual Behavior In Sub-Saharan Africa, Frida Tende

Walden Dissertations and Doctoral Studies

Risky sexual behavior (RSB) is a major public health concern due to health outcomes, such as HIV/AIDS, sexually transmitted infections, and unwanted pregnancies. RSB has been identified as 1 of the main components contributing to the high HIV incidence rate in sub-Saharan Africa. The purpose of the current research was to investigate RSB and its association with education and economic status among men and women in 3 sub-Saharan African countries (i.e., Rwanda, Zimbabwe, and Cameroon) while controlling for gender, age, religion, and place of residence. The social cognitive theory provided the framework for this cross-sectional study that included data from …

Evaluation Of A Concussion Management And Discharge Education Training Module For Emergency Department Nurses, Carmen Frede

DNP Projects

Purpose: The purpose of this project was to improve the Emergency Department (ED) nurses’ knowledge on identifying patients at risk for concussions and delivering effective concussion discharge education using an educational training intervention.

Methods: This project used a descriptive, non-randomized pre-post survey design. Participation involved three stages: a pre-education survey to assess baseline concussion education knowledge, an educational intervention consisting of a narrated PowerPoint presentation, and a post-education survey to evaluate knowledge on concussion discharge education. The intervention was delivered online via the UK Canvas educational platform.

Results: The majority of nursing staff participants were female (97%) and had a …

Evaluating Providers’ Perceptions On Preconception Care For Women With Sud, Corinna Hughes

DNP Projects

Background: Substance use disorders (SUDs) has become an epidemic. Women of reproductive age with SUDs have particularly complex healthcare needs including an increased risk of having an unintended pregnancy and associated sequela of negative birth outcomes (NBO). Little is known about how medication assisted treatment (MAT) providers are adequately addressing their unique needs. Identifying provider barriers and tools to address the reproductive needs of women with SUDs can optimize their health outcomes and prevent NBOs.

Purpose: The purpose of this study was to evaluate MAT Nurse Practitioners’ (NPs) knowledge and perceptions of providing preconception care to women with …

Improving First Dose Administration Of The Hpv Vaccine For Adolescents In A Pediatric Primary Care Clinic, Scarlett Mikesell-Pierce

DNP Projects

BACKGROUND: Nationwide more than 90% of cervical cancer cases are caused by the human papilloma virus (HPV). Cervical cancer can be largely prevented by administration of the HPV vaccine for children before becoming sexually active. However, vaccination rates in the United States, remain low at 60%, and only 39.7% through series of completion, despite the strong evidence to support the effectiveness of the HPV vaccine. Research indicates a clinician’s recommendation, providing information and opportunity for discussion about the vaccine are strong motivators for parents to vaccinate their children, regardless of ethnicity. This study addresses the barriers to parent/caregiver intent to …