Digital Commons Network^™

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 …

African American Eighth Grade Students' Attitudes Toward Hiv/Aids In The District Of Columbia, Enock Kolawole Adewuyi

Walden Dissertations and Doctoral Studies

The group most affected by HIV/AIDS, according to the Centers for Disease Control and Prevention (CDC), is African Americans. The purpose of this study was to explore the knowledge of HIV/AIDS held by African American children as a first step towards developing prevention strategies for these youths. In order to bridge the knowledge-behavior gap, this study sought to investigate the attitude towards HIV/AIDS of African American 8th grade students. The study involved secondary data from the 2012 District of Columbia (DC) Middle School Youth Risk Behavior Survey, obtained from the District of Columbia Office of Superintendent of Education (OSSE). Guided …

Knowledge Of Overdiagnosis And The Decision To Participate In Breast Cancer Screening, Kimberly T. Nembhard

Walden Dissertations and Doctoral Studies

In 2014, breast cancer was the second leading cause of death among Canadian women, with women over age 50 years making up 82% of the identified cases. To address this issue, the Ontario Breast Screening Program developed a media campaign that promoted the benefits of mammogram screening, but not the associated risks (i.e., false-positive, false-negative, radiation exposure, and overdiagnosis). This study was designed to determine whether there was a statistically significant relationship between knowledge of overdiagnosis and participation in mammogram screening. This cross-sectional, correlational study used schema theory supported by the effective health communication model. Forty-one women were invited to …

Racial Differences In The Impact Of A Worksite Wellness Program On Cardiovascular Biomarkers, Ceabert Joseph Griffith

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) is responsible for approximately 600,000 deaths in the United States each year, with African Americans (AAs) disproportionately affected. Individual-level approaches to reducing CVD remain ineffective, mobilizing a movement that advocates for population-based solutions. Workplace wellness programs (WWPs) have gained considerable traction as a viable strategy for ameliorating CVD burden among workers in general. However, no studies have looked at the efficacy of WWPs in ameliorating CVD specifically among AA employees--a knowledge gap that this investigation aimed to close. Based on the health belief model and the social cognitive theory, this retrospective cohort study used de-identified secondary data …

Attitudes And Behaviors Of South African Women And Psychosocial Determinants Of Gonorrhea, Takiyah White Ndwanya

Walden Dissertations and Doctoral Studies

The incidence of gonorrhea had declined since the HIV epidemic in the late 1980s, but is now increasing globally due to the emergence of antibiotic-resistant forms of this disease. In South Africa, the incidence of gonorrhea is highest among Black women due to their high co-infection rates with HIV and other sexually transmitted infections (STIs). This study examined the psychosocial determinants of gonorrhea among Black women aged 18 - 35 in the Langa township in Cape Town, South Africa. All participants had reported at least one sexual experience and at least one positive test for gonorrhea in the past two …

Support Of Maternity Care Practices To Increase Breastfeeding Among First-Time Mothers, Jessica Strauch

Walden Dissertations and Doctoral Studies

Breastfeeding offers numerous health benefits to both the mother and infant, yet it is not routinely practiced due to a number of internal and external factors that influence the mother's decision. Guided by the social ecological model, the purpose of this study was to examine the effect of required reporting to The Joint Commission on perinatal measures, a proxy measure for maternity care practices, and those professional effects on breastfeeding initiation and exclusivity for first-time mothers. The hypotheses were that the mandatory reporting, and thus an increase in maternity care practices, would increase the initiation of breastfeeding and exclusive breastfeeding …

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 …

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 …

Facilitating Weight Tolerance Among Health And Fitness Majors Toward Obese Persons, Stephanie Boss

Walden Dissertations and Doctoral Studies

Weight bias exists in some health-related degree programs. Overweight and obese persons who experience weight bias in health-related services often delay or avoid medical attention altogether. Guided by the attribution theory, the purpose of this sequential explanatory study was to examine weight bias among health majors at a southwest regional university to illuminate how attitudes can affect the level of care provided to overweight persons. The Attitudes toward Obese Persons (ATOP) scores from a convenience sample of 184 health majors revealed that participants' scores were found to be significantly lower than the midpoint (60) of the ATOP scale, M = …

Uric Acid Level Is Associated With Postprandial Lipemic Response To A High Saturated Fat Meal, Roy Gail Cutler

Walden Dissertations and Doctoral Studies

Hyperlipidemia caused by a diet high in saturated fat can lead to visceral fat weight gain, obesity, and metabolic syndrome. Being over-weight from visceral fat has been linked to increased risk of developing most age-related diseases and disability, along with a lower income potential and quality of life. However, researchers are just beginning to understand the biological mechanisms that regulate the conversion of excess calories into visceral fat storage rather than glycogen or muscle. Epidemiological studies have repeatedly shown a comorbid association between age-related diseases involving hyperlipemia and circulating levels of uric acid, but not a direct association. This study …

Correlations Between Childhood Obesity And Obesogenic Environmental Variables Within Durham County, North Carolina, Eureka Capri Daye

Walden Dissertations and Doctoral Studies

The application of geographic information systems was used to map obesogenic conditions by zip code tabulation areas in Durham County, North Carolina and evaluated associations between those conditions and the understudied area of early childhood obesity. Of the thirty one percent of the children in Durham County, North Carolina who were considered obese in 2010, four hundred and thirty three (1:5) 2 - 4 year old children who received supplemental nutrition services for women, infants and children were obese with BMI levels greater or equal to the 95th percentile and were used as the criterion variable in the study (N=433). …

The Predictors Of Physician-Patient Discussions Of Sexual Health With Older Adults, Dana Marie Werner

Walden Dissertations and Doctoral Studies

The number of adults aged 65 years and over has been rising quickly, as has the rate of new onset sexually transmitted diseases within this population. Discussions of sexual health between physicians and older adults are currently lacking in frequency and effectiveness. Using the foundation of stereotype embodiment theory, the purpose of this study was to identify the factors that predict frequency of discussing sexual health with older adult patients. A comparative sample of geriatric physicians and family practitioners completed 2 researcher-developed questions and the Sexual Health Care Scale-Attitude tool that assessed their stereotype beliefs toward discussing sexual health with …

Stories Of Challenge And Resilience: The Impact Of Ecological Factors On The Lived Experiences Of Low Income, Urban Young Adults Living With Hiv/Aids, Kathleen Anne Thoma

UNF Graduate Theses and Dissertations

Transitioning to adulthood is a challenging experience for all young adults, but especially for those who are living with HIV/AIDS and residing in low income, urban areas. Young adults, particularly those who live in low income, urban areas, have the highest rate of new HIV cases among all age groups in the United States. The purpose of this study was to examine the lived experiences of a purposive sample of young adults living with HIV/AIDS who resided in a selected low income, urban area in order to better understand how ecological and health factors presented opportunities and challenges for resilience …

Breast-Feeding And Postpartum Maternal Weight Trajectories, Laura Mullaney, Amy O'Higgins, Shona Cawley, Rachel Kennedy, Daniel Mccartney, Michael J. Turner

Articles

We examined whether breast-feeding, and in particular exclusive breast-feeding, was associated with maternal weight and body composition changes at 4 months postpartum independently of other maternal variables.

Perspectives On Hiv/Aids: American-Based Nigerian Women Who Experienced Polygamy In Rural Nigeria, Christianah Oluseyi Olorunfemi

Walden Dissertations and Doctoral Studies

Traditionally, in Nigeria women play a subservient role in relation to men. While a man can practice polygamy by marrying many wives, women cannot marry more than one husband at a time. Although researchers have documented the effects of polygamy on the spread of HIV/AIDS, little is known about the experiences of polygamy by Nigerian women who stopped practicing polygamy by immigrating to the United States without their husbands. It is important to know the experiences of these women as they pertain specifically to the spread of HIV/AIDS so as to develop a preventive intervention for HIV/AIDS among Nigerian women …

The Association Between Online Risk Behaviors And Real Life Sexual Behaviors Among African American Female Adolescents, Nicole Rankine

Walden Dissertations and Doctoral Studies

An increased exposure to the sexual content of traditional mass media (i.e., television, magazines, movies, music) affects real life sexual behaviors among adolescents. Engaging in online risk behaviors such as sharing/posting sexual content using social networking sites, cellphones, smartphones, IPads, or other new media devices has become common among adolescents. The purpose of this quantitative, correlation study, based upon the theory of reasoned action and three pre-existing national surveys, was to determine whether significant associations exist between attitudes, intentions, and behaviors related to online risk behaviors and real life sexual behaviors among African American female adolescents in Metro Atlanta. Data …

Impact Of Environmental And Individual Risk Factors On Pregnant And Parenting Teenagers, Lakeasha Thrasher

Walden Dissertations and Doctoral Studies

Teenage pregnancy is both a social and a public health problem in the United States, with approximately 750,000 young women between the ages of 15 and 19 becoming pregnant each year. In addition, teen pregnancy is more prevalent in the African American (15%) and Hispanic (14%) communities than it is in White communities (5%). The purpose of this study was to identify risk factors contributing to teen pregnancy among racially diverse teenagers 15 to 19 years of age living in the rural south. This study, guided by social cognitive theory, used a quantitative, cross-sectional research design to determine whether living …

Race/Ethnicity, Diet, And Physical Activity Behavior Among College Students, Ronda Herbert

Walden Dissertations and Doctoral Studies

Scarce knowledge exists about the lifestyle of college students from heterogeneous racial/ethnic backgrounds and how race/ethnicity may influence their diet and physical activity behaviors. College students, especially those who are members of minority groups, are at risk for unhealthy lifestyles resulting in negative health outcomes. The purpose of this quantitative study was to examine the role of racial diversity on dietary and physical activity habits. The study was guided by social cognitive theory, and the research questions examined the relationship between race/ethnicity on diet and physical activity in a multiracial ethnic population. The study research design was a quantitative cross-sectional …

Chlamydia Trachomatis And Neisseria Gonorrhoeae: Impact Of Health Literacy On Prevalence, Patricia Alice Abshier

Walden Dissertations and Doctoral Studies

Millions of dollars are spent each year on preventing sexually transmitted diseases (STDs), yet the rates of chlamydia trachomatis (chlamydia) and neisseria gonorrhoeae (gonorrhea) infection continue to be high. Health literacy and its impact have been recognized in diabetes maintenance, control of hypertension, medical adherence, and reproductive health outcomes, yet no research has been conducted regarding the relationship between health literacy and chlamydia and gonorrhea prevalence. This study examined the relationship between health literacy scores and chlamydia and gonorrhea prevalence health literacy scores and reproductive health/STD knowledge, and reproductive health/STD knowledge and chlamydia and gonorrhea prevalence. Participants included 114 women …

Health Information Exchanges And Patient Portals In Behavioral Health, Christine Peterson

Applied Research Projects

We live in an electronic world. Technology is everywhere, including in our healthcare system. With the advent on the electronic health record and the push to meet Meaningful Use, many healthcare organizations have already started using patient portals and sharing information among providers via health information exchanges. There have been roadblocks to successful implantation of patient portals and health information exchanges, one of which is how to handle behavioral health information and would these new technologies be accepted by patients with mental health diagnoses

The Challenges Of Establishing Partners In Health Information Exchange (Hie), Torian Tate

Applied Research Projects

Health information exchange (HIE) has become a focus of the health care industry. The ability to share information electronically between multiple health care providers is thought to be a key ingredient in the creation of a more efficient global health care system. VA Hospital Memphis has significant challenges in regard to HIE. The Virtual Lifetime Electronic Record (VLER) coordinator at the facility has been charged with establishing an HIE system. This requires the coordinator to identify partners to share health information with electronically, obtain buy-in from patients and providers through education, and to promote/market the VLER program facility-wide. The VA …

Peer Support Education For Uncontrolled Hypertension Among African Americans Adults, Melvina Juliana Semper

Walden Dissertations and Doctoral Studies

Hypertension is a major chronic health problem that can lead to heart attack, stroke, and kidney failure. African Americans disproportionately suffer from the morbidity and mortality of hypertension-related illnesses. The purpose of this comparative project was to determine the impact of peer support educational workshops as an avenue for lifestyle modification, using changes in blood pressure (BP) before and after participation. The target population consisted of 64 African Americans with hypertension in Brooklyn NY, aged 20 to 65 years old. BP measurements were taken within 1 month before and after participating in a weekly peer support educational workshop facilitated by …

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 …

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 …

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 …

Needs Assessment For A Nurse Practitioner-Led Transitional Care Program, Maria Victoria Trinidad Salcedo

Walden Dissertations and Doctoral Studies

The rising cost of health care and changes in healthcare delivery have prompted a need to improve continuity from the hospital to home. This scholarly project was initiated to assess the impact on patient outcomes related to initiation of a nurse practitioner-led transitional care program (TCP). Using the Diffusion of Innovations and Health Belief Models, the purpose of this study was to identify the impact of a TCP on improving the health of patients with congestive heart failure (CHF), diabetes mellitus Type II (DM II), and chronic obstructive pulmonary disorder (COPD). The impact of the TCP was evaluated by a …

Underserved Patients' Perspectives On How The Ehr Impacts Their Health, Marie Mirna Lexima

Walden Dissertations and Doctoral Studies

Our modern health care system requires technology that can deal with multidisciplinary and complex processes, operations, and situations. The EHR, by far, is one of the greatest health information technology innovations that satisfy these requirements because of its efficiency and the effectiveness of its features. This study sought to develop an in-depth understanding of how underserved patients' perspectives about their health and illness, can contribute to greater use of the EHR. It also sought to improve their health outcomes and maintain sustainable change in the lives of the underserved. A quantitative non-experimental design study was conducted over a 6-week period …

Predictors Of Condom Use Among Middle-Income, African American Women, Yvonne Maire Reed

Walden Dissertations and Doctoral Studies

Abstract

The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome

(AIDS) continue to be a major public health threat, not only within the United States but

also on a global scale. Within the U.S. heterosexual population, African Americans

(AAs) continue to bear the greatest burden of new HIV infections. Additionally,

HIV/AIDS interventions have focused on low-income AA women, virtually ignoring

their middle-class counterparts who may be subject to the same sexual risks. The purpose of this quantitative, cross-sectional study was to determine whether if there was an association between the 5 constructs of the Health Belief Model (HBM) and …

Spheres Of Influence: Understanding African American Males' Perceptions And Attitudes Toward Infant Feeding Practices, Makeva M. Rhoden

Walden Dissertations and Doctoral Studies

Although U.S. breastfeeding rates have steadily increased since 2000, there continues to be a disparity in breastfeeding rates for African American (AA) women compared to their non-Hispanic White counterparts. A male partner's perception, specifically his positive attitude toward breastfeeding, may influence breastfeeding initiation and duration rates. This study was an exploration of AA male perceptions and attitudes toward breastfeeding and what effect masculinity ideology (gender norms) has on such attitudes. The socio-ecological model (SEM) was used as the theoretical framework to examine the various environmental levels that intersect with one another to influence these attitudes. A mixed methods study design, …

Interpersonal Safety Of Active Duty Women In The Deployed Environment Of Bagram Afghanistan, Cynthia Tara Ferguson

Walden Dissertations and Doctoral Studies

In the United States Armed Forces, 30% of women in the military suffer physical assault each year; in 2009, there were 22 reported cases of sexual assault in the U.S. Central Command. Aggravated assault, gang violence, sexual assault, homicide, and suicide can damage the morale of military personnel at a deployed site and collectively cost millions of dollars over time. Interpersonal violence in the United States military is destructive to the military system and directly diminishes mission readiness. This study was designed to illuminate the environmental, cultural, and political influences that affect interpersonal safety among military women in the deployed …