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Antenatal Care And Maternal Sociocultural Determinants Of Childhood Immunization In Northern Nigeria, Amaka Tonia Okafor

Walden Dissertations and Doctoral Studies

Immunization has been recognized globally as a cost-effective public health intervention. However, despite its benefits, children in northern Nigeria are still adversely affected by the negative consequences of inadequate uptake of immunization. The purpose of this study was to assess antenatal care and maternal sociocultural determinants that influence childhood immunization within 2 months of birth in northern Nigeria. Constructs of social cognitive theory were applied to this retrospective correlational cross-sectional inquiry involving women 15-49 years old in northern Nigeria. Secondary data (the 2013 Nigeria Demographic and Health Survey) were analyzed using univariate, bivariate and multivariate logistic regression. Statistically significant (p < 0.05) predictors of uptake of childhood immunization within 2 months of birth were the person who delivered antenatal care, the number of antenatal care visits, the number of tetanus injections, maternal educational level, religion, wealth index, husband/partner educational level, and the person who decides on health care. Educated Christian women from middle-class or rich homes, whose husbands/partners were also educated and who jointly decided on health care, made numerous contacts with health care professionals, and received at least one tetanus injection during antenatal care, had a higher likelihood of immunizing their children within 2 months of birth. The positive social change implications for this study include providing evidence of deterrents to childhood immunization that could lead to relevant policies and interventions leading to healthier children, communities, and society.

Impact Of Community Factors On The Donor Quality Score In Liver Transplantation, Giovanna Saracino

Walden Dissertations and Doctoral Studies

An increasing prevalence of metabolic syndrome and obesity has been linked to the rise in transplant indication for cryptogenic cirrhosis and nonalcoholic fatty liver disease (NAFLD), creating a growing challenge to public health. NAFLD liver transplant (LT) candidates are listed with low priority, and their waiting mortality is high. The impact of community/geographic factors on donor risk models is unknown. The purpose of this study was to develop a parsimonious donor risk-adjusted model tailored to NAFLD recipients by assessing the impact of donor, recipient, transplant, and external factors on graft survival. The theoretical framework was the social ecological model. Secondary …

A Conflictive Triuvirate Consruct Of Epidemiologic Systems Failure, Ngozi Lois Ulinwa

Walden Dissertations and Doctoral Studies

Epidemiologic systems failure (ESF) is a major hurdle in minimizing the spread of infectious diseases during outbreaks. The reasons for ESF include the technical limitation of personnel handling epidemic crises, strictly defined health policies that limit the actions of epidemiologists, and personal perspective's reservations towards the intentions of health agencies. The purpose of this triumvirate mixed-methods case study was to examine factors of infectious disease control mechanisms useful for determining ESF. Three juxtaposed pre-emptive factors (technical [T], organizational [O], and personal [P] perspectives were used to determine how the multiple perspectives inquiring systems and fuzzy logic revealed factors causing ESF …

Public Health Implications Of Retailer Resale Of Returned Textile Clothing Merchandise, Antonette M. A. Francis-Shearer

Walden Dissertations and Doctoral Studies

Historically, 18th century anecdotal accounts of the decimation of several tribes of U.S. of the Native American population by trading of infected textile blankets alludes to the role of retail in the transmission of infectious disease. This study explores implications of the modern day retail organization practice of reselling returned clothing textiles from a public health infectious disease perspective. A qualitative multi-case study, utilized responses from 20 open-ended, unstructured interviews of retail employees assigned to the returns process. Additionally, several informal observations of select U.S.based, top-ranked clothing retail organizations, identified by the National Retail Federation were completed. Select federal, state, …

Factors Associated With Pesticide Resistance In Culex Mosquitoes, Jude Akpan

Walden Dissertations and Doctoral Studies

In recent years mosquito-borne diseases have reemerged, largely because of pesticide resistance. The mosquitoes develop resistance to pesticides because of broad and repeated uses of pesticides. Preventing the development of pesticide resistance requires proper understanding of the environmental factors potentially associated with the development of the resistance. The purpose of this study was to investigate the environmental factors associated with the resistance to pesticides by the Culex mosquitoes. This correlational study included the analysis of archived data samples (N = 29,794) from the Field Cage Tests results conducted between 2013 and 2017 by a large county public health department. The …

The Impact Of Congressional Attention And Policy Mood On Public Health Funding, Evelyn Denise Dunn

Walden Dissertations and Doctoral Studies

Congressional appropriations for federal public health agencies are subjected to external factors throughout the congressional appropriations process, resulting in fluctuations in funding. Recent literature has focused on externals factors, such as political attention and public attitudes, that could influence government funding levels; however, the impact of these factors on federal public health funding was not addressed. The purpose of this study was to determine whether a relationship exists between these external factors and federal public health appropriations. A quantitative study was used to examine congressional attention, policy mood, and the influence on the change in the level of federal public …

African American Masculinity And Its Influence On Hypertension-Related Behaviors, Tangee Denise Thomas

Walden Dissertations and Doctoral Studies

High blood pressure (hypertension) is known to be one of the leading factors that directly contributes to heart disease and stroke, which are the first and third leading causes of disabilities and death in the general U.S. population. The prevalence of high blood pressure among African American men in the United States ranks as one of the highest in the world. Research indicates the roots of this phenomenon are found in physiological, psychosocial, cultural, and socioeconomic factors differentially affecting the African American population. The purpose of this study was to examine the interaction between African American males' masculine perspective and …

Influence Of Low Rate Of Reporting Of Adverse Events Following Immunization On Immunization Dropout, Samuel Errie Yenyi

Walden Dissertations and Doctoral Studies

Immunization protects millions of children. Yet, many children drop out of immunization in Jigawa State of north Nigeria. This cross-sectional quantitative correlational study based on the Health Belief Model was designed to determine whether the dropout from routine immunization (RI) was influenced by low rate of reporting of adverse events following immunization (AEFI) to health facilities by caregivers. Primary data was collected from 307 caregivers with dropout children using structured interviewer-administered questionnaire. The data were analyzed using logistic regression and descriptive statistics. The results showed that 61.3% of the children had AEFI and dropped out. Rate of reporting of AEFI …

Poverty, Demographics, And Hepatitis C Infection In The National Health And Nutrition Examination Survey, Wilson J. Washington Jr

Walden Dissertations and Doctoral Studies

Hepatitis (HCV) is a communicable disease that impacts many Americans. The scholarly literature lacked the knowledge pertaining to the relationships between poverty and HCV diagnosis and prescription for HCV medication. The purpose of the study was to measure the magnitude and statistical significance of these relationships, as modeled by the health belief model and public health surveillance and action framework. Specifically, the study was designed to determine whether there is a statistically significant relationship between living below the poverty line and being diagnosed with HCV, as well as living being below the poverty line and being prescribed HCV medication. A …

The Effectiveness Of Two Types Of Adjunct Acupuncture Exposures On In Vitro Fertilization Outcomes, Lindsey Vacovsky

Walden Dissertations and Doctoral Studies

One out of every 8 couples experiences infertility. Few publications exist examining the association between the addition of adjunctive therapies when applied to the in vitro fertilization (IVF) procedure and pregnancy outcome. The purpose of this study was to compare the effectiveness of 2 types of adjunct acupuncture exposures on IVF outcomes by applying the concept of the epidemiology triad. The association between the type of adjunct acupuncture exposure received (the independent variable) and pregnancy (the outcome) was determined via binary logistic regression using SPSS software. Medical records of women having received the IVF procedure along with adjunct acupuncture were …

Primary Care And Behavioral Health Services In A Federally Qualified Health Center, Svetoslav A. Arsov

Walden Dissertations and Doctoral Studies

Between 2013 and 2016, 8.1% of U.S. adults 20 years and older suffered from depression, but only 29% of them sought help. This project addressed the low depression screening rate in a Federally Qualified Health Center (FQHC) that supported integrated care. The purpose of the project was to evaluate the integration of behavioral health into primary care in an FQHC through the rate of depression screenings. Two theoretical frameworks, the find-organize-clarify-understand-select/plan-do-study-act model and the Centers for Disease Control and Prevention's framework for program evaluation in public health were combined into a list of questions and data validity tests that were …

Program Evaluation Of The Employee Health And Wellbeing Program, Alicia Carmen Marlena Perez

Walden Dissertations and Doctoral Studies

Health promotion and disease prevention are a focus of population health management. Without ongoing and rigorous evaluation, these programs may be in jeopardy of continuing. The purpose of this project was to conduct a descriptive population health- focused evaluation of a large-scale health system's employee health and wellbeing program. Guided by the Center for Disease Control and Prevention (CDC) framework for program evaluation in public health and National Center for Organization Development guidelines, a nurse-led evaluation was conducted using 5 specific data sets emphasizing organizational structure, employee health offerings, employee surveys, Pathway to Excellence survey, and program contributions. A descriptive …

Improving Disaster Preparedness And Planning For Chronic Disease Populations, Gladys N. Gichomo

Walden Dissertations and Doctoral Studies

The significant rise of both chronic diseases and disasters in the last 20 years and the healthcare outcomes of individuals with chronic diseases during and in the aftermath of disasters have raised concerns among public health practitioners, healthcare providers, the U.S government, and the general public. Researchers have indicated that during disasters, the health outcomes of individuals with chronic diseases are significantly unfavorable compared to the general public. However, there is inadequate information on the management of chronic diseases, quality of care, and resource identification and allocation by disaster responders. This qualitative, grounded theory study, explored how the study participants …

Black, Male, African Immigrants’ Perceptions Of Colorectal Cancer Screening In Baltimore, Maryland, Frant Kembou

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) represents a public health issue that may be prevented using the screening strategy. Black people in Africa represent the population with the lowest risk for CRC. However, in Africa as well as the United States, Black people participate the least in CRC screening. Little is known about the perceptions of CRC and CRC screening in the Black, male, African immigrants residing in Baltimore, Maryland. The low participation in CRC screening in this population was the problem addressed by this dissertation. The purpose of this qualitative study was to explore and describe Black, male, African immigrants’ experience with …

Family Predictive Factors Of Rural Malaria Prevalence In Nsukka, Eastern Nigeria, Gabriel Ugwuja Ugwu

Walden Dissertations and Doctoral Studies

Children in early childhood are still suffering from burdens of malaria-related morbidity and mortality. There have been insufficient studies on how family-level factors may predict the prevalence of malaria (PoM), and negatively impact the control of malaria in rural areas, especially among children. In this study, potential family factors were explored to address the challenges associated with the increase in PoM among the children in rural areas of Nsukka. Socioecological framework guided this study at the interpersonal level. The quantitative cross-sectional study used secondary data from Demographic and Health Surveys (DHS) of 2015 in Nsukka rural communities. Data were analyzed …

Oromo Ethiopians Perceptions Of The Prevalence, Causes, Treatment And Prevention Of Trachoma, Linda L. Gross

Walden Dissertations and Doctoral Studies

In Ethiopia, one of the primary contributors to blindness is trachoma, which is an infectious ocular disease. There is no record of any prevention programs in rural Ethiopian villages of Oromia, where the prevalence of trachoma is high. The original purpose of this phenomenological study was to explore the perceptions of rural Oromo villagers in Ethiopia on the causes, treatment, and prevention of trachoma, using the health belief model and the social-ecological model as a theoretical framework. Due to a security situation in Ethiopia, final interviews were conducted with immigrant Ethiopians in the US, all of them from the trachoma-endemic …

Trends In Prevalence And Predictors Of Undernutrition Among Children In South Central, Monica Kabahimba Zikusooka

Walden Dissertations and Doctoral Studies

Undernutrition is a global public health challenge. In Somalia, undernutrition is chronic with the situation often graded for emergency response. The purpose of this study was to provide contextual evidence regarding trends of prevalence and predictors of undernutrition in South Central Somalia. Following the UNICEF conceptual framework of determinants of undernutrition, the study examined which individual, household, and society factors were associated with undernutrition. Using secondary data from cross-sectional nutritional surveys implemented by the Somalia Food Security and Nutrition Analysis Unit from 2007 to 2012, a sample of 75,756 and 60,856 children aged 6-59 months was used in analyzing trends …

Role Of Primary Care Providers And Integrated Disease Surveillance In Chad, Dhoud Stave Gischel Samba

Walden Dissertations and Doctoral Studies

In the Republic of Chad, primary care physicians play a central role in the detection and control of outbreaks and are critical actors in the integrated disease surveillance system through mandatory reporting. Feedback on such surveillance must reveal the needs and perceptions of these physicians. These needs and perceptions were examined using a questionnaire survey distributed to a sampling of 20 physicians in Chad. The purpose of this qualitative study was to investigate the role of primary care providers in the integrated disease surveillance to identify factors that impact complete, quality, and timely reporting. The theory of planned behavior was …

Optimizing A Disease Severity Scale For Evaluating Travelers' Diarrhea In Adults, Nicole Maier

Walden Dissertations and Doctoral Studies

Primary efficacy endpoints for interventional products targeting travelers’ diarrhea (TD) prevention have been predominately based on stool frequency. However, reliance on stool-based endpoints alone may obscure potentially meaningful differences in illness profiles. A single, standardized scoring system optimized for use in adult travelers is needed to accurately measure TD severity and enable more robust estimates of treatment or intervention effectiveness. The purpose of this quantitative secondary data analysis was to describe the variability in TD signs and symptoms across traditional severity metrics such as stool output, identify which symptoms were significantly associated with a negative impact on activity, and determine …

Effect Of Access To Health Services On Neonatal Mortality In Uganda, Imelda Atai Madgalene Musana

Walden Dissertations and Doctoral Studies

Since 2006, Uganda has experienced a nonchanging neonatal mortality rate of 27 out of 1,000 live births, which is higher than the global average of 19 deaths for every 1,000 live births. The purpose of this retrospective cross-sectional study was to determine factors affecting access to health services and their impact on newborn deaths in Uganda. Mosley and Chen's model for child survival in developing nations provided the framework for the study. Secondary data from the 2016 demographic and health survey (UDHS) collected by the Uganda Bureau of Statistics (UBOs) was used. A total of 7,538 cases were used and …

Examining Relationships Between Sexual Education And Behaviors Among Virginia College Students, Dyani Meggett-Sowell

Walden Dissertations and Doctoral Studies

The college student population has a high prevalence of sexually transmitted infections (STI)s due to their participation in higher risk sexual behaviors such as serial relationships, drug and alcohol use and abuse, and inconsistent use of condoms. The purpose of this study was to examine the relationship between student exposure of sexual education and their sexual behaviors among college going students in Virginia. Guided by the health belief model, this quantitative cross-sectional study involved a random selection process to recruit college students to test the hypothesis. The research questions were designed to examine participants' exposure to sexual education, sexual behaviors, …

Public Health And Personal Choice: The Ethics Of Vaccine Mandates And Parental Refusal In The United States, Rebecca Horan

Undergraduate Honors Theses

No abstract provided.

Connecticut Primary Care Physicians And Chronic Lyme Disease, Yvette P. Ghannam

Walden Dissertations and Doctoral Studies

The prevalence of chronic Lyme disease (CLD) remains relatively unknown in Connecticut because there is not an agreement on what CLD is and how it should be diagnosed in addition to which pathological agent causes CLD. The aim of this quantitative study was to assess whether there were significant differences between two groups of primary care physicians (PCP) working in Connecticut from two different points in time regarding their knowledge in the diagnosis, treatment, and management of CLD. A knowledge, attitude, and practice model was used as the underlying theoretical framework for this study. A random cross-sectional survey was mailed …

Diagnosis Of Schistosoma Mansoni Infections: What Are The Choices In Brazilian Low-Endemic Areas?, Vanessa Silva-Moraes, Lisa M. Shollenberger, Liliane Maria Vidal Siqueira, William Castro-Borges, Donald A. Harn, Rafaella Fortini Queiroz E. Grenfell, Ana Lucia Teles Rabello, Paulo Marcos Zech Coelho

Biological Sciences Faculty Publications

The population of Brazil is currently characterised by many individuals harbouring low-intensity Schistosoma mansoni infections. The Kato-Katz technique is the diagnostic method recommended by the World Health Organization (WHO) to assess these infections, but this method is not sensitive enough in the context of low egg excretion. In this regard, potential alternatives are being employed to overcome the limits of the Kato-Katz technique. In the present review, we evaluated the performance of parasitological and immunological approaches adopted in Brazilian areas. Currently, the diagnostic choices involve a combination of strategies, including the utilisation of antibody methods to screen individuals and then …

Health For All: Using Utilitarianism To Require Childhood Vaccinations, Hannah Vercellotti

Augustana Center for the Study of Ethics Essay Contest

In the last few decades, many parents have chosen not to vaccinate their children against serious infectious diseases. In seeking exemptions, they often cite conflicting religious beliefs and fear of risks. Using the principle of utilitarianism, this paper argues that despite parents' cited religious beliefs and concerns about risks, state laws should require all children to get vaccinated unless doing so would cause direct harm to the child’s health. Adopting this mandate would ensure that the maximum number of people would benefit from immunity to serious and deadly diseases.

Training As An Intervention To Decrease Medical Record Abstraction Errors Multicenter Studies., Meredith Nahm Zozus, Leslie W. Young, Alan E. Simon, Maryam Garza, Lora Lawrence, Songthip T. Ounpraseuth, Megan Bledsoe, Sarah Newman-Norlund, J Dean Jarvis, Mary Mcnally, Kimberly R. Harris, Russell Mcculloh, Rachel Aikman, Sara Cox, Lacy Malloch, Anita Walden, Jessica Snowden, Irene Mangan Chedjieu, Chester A. Wicker, Lauren Atkins, Lori A. Devlin

Manuscripts, Articles, Book Chapters and Other Papers

Studies often rely on medical record abstraction as a major source of data. However, data quality from medical record abstraction has long been questioned. Electronic Health Records (EHRs) potentially add variability to the abstraction process due to the complexity of navigating and locating study data within these systems. We report training for and initial quality assessment of medical record abstraction for a clinical study conducted by the IDeA States Pediatric Clinical Trials Network (ISPCTN) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network (NRN) using medical record abstraction as the primary data …

Association Between Sanitary Toilet Coverage Rate And Intestinal Infectious Disease In Jiangsu Province, China, Tingting Chen

Chulalongkorn University Theses and Dissertations (Chula ETD)

Intestinal infectious diseases are one of the most common disease group prevalent worldwide. It is also the commonly report acute infectious diseases in Jiangsu Province, China. This problem may result from the use of unhygienic toilet. Chinese government had announced the China's toilet improvement campaign for more than decades. The purpose of this ongoing campaign is to improve the hygiene and promote health. However, there is limited study evaluating the effect of toilet improvement and the incidence of intestinal infectious diseases. This study aims to determine the association of the increasing of sanitary toilets and intestinal infectious diseases in Jiangsu …

Examining The Effects Of Indiana’S Syringe Exchange Program On New Hepatitis C And Hiv Diagnoses From 2015-2017, Katherine Youngen

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

In 2015, a rural Indiana county experienced an outbreak of HIV related to intravenous drug use. 181 people were diagnosed with HIV between Oct. 1, 2014 and Nov. 1, 2015. This outbreak prompted the state legislature to implement a policy that legalized syringe exchange programs for the first time ever in Indiana. This capstone attempts to summarize the situation that led to the creation of this policy and the effects of this policy, Indiana Senate Enrolled Act 461 (IN SEA 461). Finally, this capstone makes recommendations for modifying the existing policy or implementing a similar policy in an area experiencing …

Assessing The Tuberculosis (Tb) Screening Compliance Rates And Treatment Completion Among International Students At The University Of Kentucky, Bongiwe P. Malinga

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: Tuberculosis early screening and diagnosis are cost-effective strategies for infection control. Tuberculosis elimination which is aimed for 2030 requires that both latent tuberculosis and active disease be fully treated. This study measures the tuberculosis screening rates and treatment completion rates among the international students at the University of Kentucky between 2016 and 2018.

Methods: This retrospective cohort study included all J1 and F1 student visa holders enrolling from 2016 fall to 2017 fall. To accommodate the nine months treatment completion, the cohort period overlapped to 2018. Data were provided by the University Health Services and the sample size …

Evaluating The Effects Of Safe Injection Facility Legalization On Fatal And Non-Fatal Overdose And Infectious Disease, Olivia M. Ramirez

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

In 2017, 70,000 lives were lost to fatal drug overdoses with approximately 46,000 of those involving the use of prescription and illicit opioids (CDC, 2018b). Unaddressed, the opioid epidemic is costing large amounts of money, lost productivity and valuable lives.

Injection drug use has also become increasingly common in the United States, as it is an efficient means of consuming opioids. Unfortunately, injecting drugs is also an efficient method of transmitting bloodborne diseases. Estimates show that in the United States, 8% of all new HIV infections in 2010 and 22% of all adults and adolescents with HIV resulted from injection …