Digital Commons Network^™

The Impact Of Universal Free Meals During Covid-19 On Family Life And Perspective Of School Meals In Central Washington State, Charlotte Green

All Master's Theses

This study explored the impact of the USDA COVID-19 Universal Free Meal (UFM) waivers on family life, school meal participation, and child eating habits from parents with children in Central Washington state (WA) schools. n = 119 parents/caregivers with students who were in K-12^th grade in Central WA from August 2019-February 2023 completed a 10 question electronic, and descriptive survey. The survey measured changes in participation in school lunch/breakfast pre to post COVID-19 waiver, which provided free meals for all children, and whether UFM were beneficial to families, impacted perception of school food, child’s sense of community at school …

Associations Of Stress, Health Behaviors, And Obesity Among African American Immigrants, Wole David Akinsola

Walden Dissertations and Doctoral Studies

AbstractObesity has been identified as a predisposing factor that poses a serious threat for the development of chronic diseases and contributes to health disparities affecting both minority and vulnerable populations. Though previous studies reported the association of stress with health status and behavior, there is little or no research on the heterogeneity of obesity predictors in specific minority populations in the United States. The purpose of this study was to examine the predictors of obesity among adult African American immigrant populations in the United States. Studying obesity in this population may help policymakers tailor interventions that could reduce obesity prevalence. …

Associations Between Socioecological Factors And Breastfeeding Duration Among Obese Mothers In Mississippi, Maria Mercedes Miranda Porter

Walden Dissertations and Doctoral Studies

There is a growing obesity pandemic in the United States. Low breastfeeding duration rates and socioecological factors lead to obesity in the most southern states. Overweight and obese breastfeeding mothers have not been primarily studied. There is mixed information regarding duration of breastfeeding, BMI, and heart health, as well as a lack of quantitative analyses involving reducing obesity rates in mother-child dyads. The purpose of this quantitative cross-sectional study was to investigate whether there were any associations between breastfeeding duration and BMI, heart health problems, breastfeeding support, and eating and exercise among Mississippi overweight and obese postpartum women based on …

A National Assessment Of Household, Community, And Environmental Situations On Breastfeeding Decisions, Marnita Siglar Thomas

Walden Dissertations and Doctoral Studies

Exclusively breastfeeding has been proven to be an effective preventive measure for childhood obesity; however, breastfeeding practices decline after 6 months. Secondary data from the 2018-2019 combined National Survey of Children's Health were used for this study to determine the household, community, and physical environment relationship between individuals' decisions to breastfeed and sustainment in the United States (N=16,750). Grounded by the theoretical framework of the socio-ecological model, the results suggested that household, community, and physical environments predict individuals' decisions to initiate breastfeeding and sustainment nationally (p < 0.001). Binary logistic regression, controlling for maternal age, indicated a statistical significance between breastfeeding initiation and income (p = 0.043, p = 0.041), family structure (p = 0.003, p < 0.001), education (p < 0.001, p < 0.001, p < 0.001), neighborhood support (p < 0.001), and neighborhood amenities (p = 0.039, p <0.001, p < 0.001). A statistical significance between breastfeeding duration and family structure (p = 0.061), education (p < 0.001, p < 0.001), maternal overall health (p <0.001), neighborhood support (p = 0.008), neighborhood safety (p = 0.006), and neighborhood amenities (p = 0.019) was found when controlling for maternal age. Implications for positive social change include providing health professionals with knowledge on breastfeeding decision making to encourage new recommendations and implement new practices and policies to promote breastfeeding and ultimately reduce the incidence of overweight and obesity in children nationwide.

Impact Of Race And Socioeconomic Factors On Infant Mortality Between Non-Hispanic Black And White Women, Chukuma Clifton Chijioke

Walden Dissertations and Doctoral Studies

Abstract This quantitative retrospective study with a correlational design examined the impact of race and socioeconomic factors on the high infant mortality (IM) among non-Hispanic Black women compared to non-Hispanic White women in one midwestern US state county. Though the IM in the U.S. has consistently decreased, a disparity exists between non-Hispanic Black and non-Hispanic White women. Non-Hispanic Black women are twice as likely to experience infant deaths as non-Hispanic White women. This study utilized secondary data derived from vital records maintained by the county public health department. The research was grounded in the ecological model. Logistic regression was used …

Risk Factors Of Human Papillomavirus Positive Oropharyngeal Cancer In Men, Kentress Davison

Walden Dissertations and Doctoral Studies

The human papillomavirus (HPV) is a leading domestic and global sexually transmitted disease. The purpose of this secondary quantitative, cross-sectional study is to investigate if there is an relationship between the rate of oral HPV-oropharyngeal squamous cell carcinoma (OPSCC) and race, exposure to smoking cigarettes (tobacco), risky sexual behavior, and participation in oral sex of male-to-male contact vs. male-to-female contact. The social cognitive theory grounded this study. The University of Alabama at Birmingham cancer database population supplied the study’s sample size of 337 males greater than 18 years of age with a diagnosis of OPSCC. I conducted descriptive analyses using …

Factors Associated With Human Papillomavirus (Hpv) Vaccine Uptake Among Female Adults In Mudan District, Heze, Shandong, China: A Cross-Sectional Study, Cong Liu

Chulalongkorn University Theses and Dissertations (Chula ETD)

Introduction: Cervical cancer ranks second globally in cancer-related deaths among women. There is evidence linking the incidence and risk of cervical cancer to the prevalence of human papillomavirus (HPV). HPV vaccination has the potential to prevent more than 90% of HPV-attributable cancers. However, the HPV vaccination rate in China is still low. Therefore, factors associated with HPV vaccination are required among those who never received the vaccine. Objective: China has implemented programs to promote HPV vaccination; however, the HPV infection rate is still very high in Shandong Province, especially Heze City, and there is no study on the vaccination factors …

Experiences With Access To Seeking And Maintaining Home Health Care Services In Low-Income Communities, Staci Yvette Kennedy

Walden Dissertations and Doctoral Studies

AbstractHome health care services (HHCS) are a cost-effective service option often underutilized by individuals living in low-income communities. For this population, barriers to care may result in higher health care costs and poor health outcomes. Gaps in literature indicated a need to explore experiences of accessing and maintaining home health care among individuals living in low-income communities. The purpose of this qualitative research study was to gain insight into how individuals living in low-income communities perceive their access to HHCS. The conceptual framework used for this phenomenological study was Penchansky and Thomas’s model of access, which addresses access from seven …

The Association Between Working Habits And Hypertension Among First Generation African Immigrants, Olalekan Kilo

Walden Dissertations and Doctoral Studies

Even though hypertension affects people of all races, it is more prevalent among African Americans. However, recent research has revealed that the prevalence of hypertension is progressively increasing across Africa. African immigrants in the United States are the least-studied immigrant group prone to health inequalities when compared to their African American counterparts. To help bridge this gap, a secondary data analysis of a cross-sectional study was conducted to investigate the association between working habits (hours worked, diet at work), length of stay in the United States, and hypertension rates for first-generation African immigrants residing in the United States. The study …

Experiences Of Older Adults With Hiv/Aids Enrolled In Case Management Programs In Northwest Indiana, Antoinette Cardenas

Walden Dissertations and Doctoral Studies

AbstractIn 2016, more than half of those infected with HIV/AIDS were age 50 years or older. Since the introduction of antiretroviral therapy, the survival rate of HIV patients has been on the rise with a predicted increase by 2030, but this has also contributed to early onset of comorbidities such as cardiovascular disease, osteoporosis, and kidney failure. The purpose of this generic qualitative study, driven by ecological systems theory, was to explore the experiences of older adults (age 50 and older) with HIV/AIDS who were enrolled in case management programs in Northwest Indiana. Data were collected from semi structured interviews …

A Biblioguidance Approach To Fostering Students’ Self-Efficacy To Advocate For Health, Jennifer R. Banas, Sara Gershon

Health Sciences and Physical Education Faculty Publications

Teaching the components of health advocacy is straightforward, but fostering young people’s self-efficacy to be health advocates for themselves, others, and their community is more complex. This complexity sometimes renders advocating for health, the basis of National Health Education Standard (NHES) #8, challenging to teach. We utilized a pedagogical approach called biblioguidance to teach this skill to 10th-grade students. The premise of biblioguidance, also called bibliotherapy, is that information, guidance, and even solace can be found through reading and vicariously living story events. To implement this approach, we consulted the literature and created a six-step framework to guide the design, …

School-Based Intervention Impacts Availability Of Vegetables And Beverages In Participants’ Homes, Erin A Hudson, Marissa Burgermaster, Sophia M Isis, Matthew R Jeans, Sarvenaz Vandyousefi, Matthew J Landry, Rebecca Seguin-Fowler, Joya Chandra, Jaimie Davis

Faculty, Staff and Student Publications

As rates of metabolic syndrome rise, children consume too few vegetables and too much added sugar. Because children tend to eat what is available at home, the home environment plays a key role in shaping dietary habits. This secondary analysis evaluated the effects of a school-based gardening, cooking, and nutrition education intervention (TX Sprouts) compared to control on the availability of vegetables, fruit juice, and sugar-sweetened beverages (SSBs) at home. In the TX Sprouts cluster-randomized trial, 16 schools were randomized to TX Sprouts (

Selinexor In Combination With Weekly Paclitaxel In Patients With Metastatic Solid Tumors: Results Of An Open Label, Single-Center, Multi-Arm Phase 1b Study With Expansion Phase In Ovarian Cancer, Shannon N Westin, Siqing Fu, Apostolia Tsimberidou, Sarina Piha-Paul, Fechukwu Akhmedzhanov, Bulent Yilmaz, Lacey Mcquinn, Amanda L Brink, Jing Gong, Cheuk Hong Leung, Heather Lin, David S Hong, Shubham Pant, Brett Carter, Amir Jazaeri, David Gershenson, Anil K Sood, Robert L Coleman, Jatin Shah, Funda Meric-Bernstam, Aung Naing

Faculty, Staff and Student Publications

OBJECTIVE: Selinexor is a first-in-class, oral selective inhibitor of nuclear export (SINE) compound which blocks Exportin-1 (XPO1). Our objective was to determine maximum tolerated dose (MTD) and recommended phase II dose (RP2D) of selinexor and weekly paclitaxel.

METHODS: This was an open label, single-center, multi-arm phase 1b study utilizing a "3 + 3" design and a "basket-type" expansion in recurrent solid tumors. Selinexor (60 mg or 80 mg twice weekly orally) and weekly paclitaxel (80 mg IV 2 week on, 1 week off) were one of 13 parallel arms. Efficacy was evaluated using RECIST version 1.1.

RESULTS: All 35 patients …

Trends And Correlates Of Low Hiv Knowledge Among Ever-Married Women Of Reproductive Age: Evidence From Cross-Sectional Bangladesh Demographic And Health Survey 1996–2014, Md Tariqujjaman, Md Mehedi Hasan, Mohammad Abdullah Heel Kafi, Md Alamgir Hossain, Saad A Khan, Nadia Sultana, Rashidul Azad, Md Arif Hossain, Mahfuzur Rahman, Mohammad Bellal Hossain

Faculty, Staff and Student Publications

BACKGROUND: The human immunodeficiency virus (HIV) burden has frequently been changing over time due to epidemiological and demographic transitions. To safeguard people, particularly women of reproductive age, who can be exposed to transmitting this burden to the next generation, knowledge regarding this life-threatening virus needs to be increased. This research intends to identify the trends and associated correlates of "low" HIV knowledge among ever-married women of reproductive age in Bangladesh from 1996 to 2014.

METHODS: We analyzed data derived from six surveys of Bangladesh Demographic and Health Surveys conducted in 1996, 1999, 2004, 2007, 2011, and 2014. Analyses were primarily …

Black Midwives For Black Mothers: Ameliorating Racial Disparities In The Quality Of Maternal Healthcare, Kimberly Navarro

Theses and Dissertations

In the United States, maternal mortality represents a dire health crisis with a stark racial imbalance. Black women are two and a half to three times more likely to die from pregnancy and birth-related complications than their White counterparts. Racial disparities in maternal health can be explained by variations in the quality of maternal healthcare services that women tend to receive. Racial and ethnic minority women are more likely to receive inferior quality prenatal care (PNC), which brings to question the care model of traditional PNC and its adequacy in serving the healthcare needs of Black women. Since Black women …

An Evaluation Of A Health, Wellbeing And Lifestyle Promotion Intervention Among A Cohort Of Year 1 Male Gaelic Games Student Athletes In An Irish University Setting, Anthony Casey

Theses

Background: The current research investigated the health, wellbeing and lifestyle behaviours of a cohort of 1st year male Gaelic Games student athletes (Study 1), and subsequently evaluated the impact of a bespoke intervention on these health, wellbeing and lifestyle behaviours in the same cohort (Study 2).

Methods: Participants were 1st year male Gaelic Games student athletes (mean age 18.6 ± 0.6 years, n=166) in a university in southern Ireland. Data were collected using a mixed-methods approach during the 2018/19 and the 2019/20 academic years. Data collection consisted of an online questionnaire (Bickerdike et al., 2018), which assessed health, wellbeing …

‘A Healthy Mtu’ A Mixed Methods Baseline Programme Of Research To Empirically Inform A Campus Health Promotion Initiative Within An Irish Higher Education Setting, Andrea Bickerdike

Theses

Higher Education Institutions (HEIs) have been called to lead global health promotion actions, yet there remains a dearth of empirically informed ‘Healthy University’ (HU) initiatives. This thesis constituted a baseline mixed methods needs assessment to inform a settings-based health promotion (HP) initiative (‘A Healthy MTU’) within a multi-campus ‘case’ HEI in Ireland (Cork campuses of MTU, formerly CIT). Specific aims were to (i) investigate student and staff health metrics, and (ii) identify the cultural and environmental determinants of health and wellbeing within the case HEI setting. Using a phased, mixed methodology (QUAN-QUAL), five sequential empirical studies were undertaken. Quantitative data …

Vitamin D Supplementation And Exercise For Improving Physical Function, Body Composition And Metabolic Health In Overweight Or Obese Older Adults With Vitamin D Deficiency: A Pilot Randomized, Double-Blind, Placebo-Controlled Trial, Jakub Mesinovic, Alexander J. Rodriguez, Mavil May Cervo, Anoohya Gandham, Cecilia L. H. Xu, Costas Glavas, Barbora De Courten, Ayse Zengin, Peter R. Ebeling, David Scott

Research outputs 2022 to 2026

Purpose:

Vitamin D supplementation may have non-skeletal health benefits and enhance exercise responsiveness, particularly in those with low vitamin D levels. We determined whether, compared with placebo, vitamin D supplementation taken prior to and during a 12-week exercise program improves physical function, body composition or metabolic health, in overweight and obese older adults with vitamin D deficiency.

Methods:

Fifty overweight or obese older adults (mean ± SD age: 60 ± 6 years; BMI 30.6 ± 5.7 kg/m2) with vitamin D deficiency (25-hydroxyvitamin D [25(OH)D] < 50 nmol/L) were recruited. Participants were randomly allocated to receive either vitamin D3 (4000 IU/day) or matching placebo for 24 weeks. Between weeks 12 and 24, all participants completed multi-modal exercise three days per week while continuing with vitamin D/placebo. Mean changes in physical function (primary outcome: gait speed), body composition and biochemical parameters at weeks 12 and 24 were compared between groups.

Results:

Vitamin D supplementation, with or without exercise, had no effect on gait speed. From baseline …

Issue Of Data Imbalance On Low Birthweight Baby Outcomes Prediction And Associated Risk Factors Identification: Establishment Of Benchmarking Key Machine Learning Models With Data Rebalancing Strategies, Yang Ren, Dezhi Wu, Yan Tong, Ana Lopez-De Fede

Publications

Background: Low birthweight (LBW) is a leading cause of neonatal mortality in the United States and a major causative factor of adverse health effects in newborns. Identifying high-risk patients early in prenatal care is crucial to preventing adverse outcomes. Previous studies have proposed various machine learning (ML) models for LBW prediction task, but they were limited by small and imbalanced data sets. Some authors attempted to address this through different data rebalancing methods. However, most of their reported performances did not reflect the models’ actual performance in real-life scenarios. To date, few studies have successfully benchmarked the performance of ML …

Effectiveness Of The Catch (Coordinated Approach To Child’S Health) Rainbow Program In Elementary Schools For Change In Fruit And Vegetable Intake, Ashley M. Valinskas

Graduate Research Theses & Dissertations

Background: There is currently a lack of nutrition education programs that effectively increase fruit and vegetable (FV) intake among children. Not meeting the recommendations for fruits and vegetables increases the risk for poor academic achievement, obesity, and chronic diseases such as cardiovascular disease, type II diabetes, asthma, and more. Nutrition, cooking, and gardening lessons individually and together have shown to increase fruit and vegetable (FV) consumption in school-aged children.Methods: Two-Hundred Twenty-five 4th and 5th graders participated in six cooking and six gardening lessons between September 2021 and May 2022 at Genoa Elementary school. Each nutrition education session was 25-minutes long, …

National Emissaries For Preventive Healthcare. Visiting Nurses In Interwar Bulgaria And Yugoslavia, Evguenia Davidova

History Faculty Publications and Presentations

In the interwar period, as part of a wholesale reorganization of public healthcare, Bulgaria and Yugoslavia saw the emergence of a new healthcare protagonist: the visiting nurse. Grounded in archival materials, by means of an analysis that intertwines gender and class, this article argues that the visiting nurse became a crucial (and cheaper) link between the hospital and the home in the fight against social diseases and reducing child mortality. These social interactions were often mediated by international humanitarian organizations. In this context, the visiting nurse serves as another bridge—this time between national and international public health policies. Visiting nurses …

Relationship Between Food Insecurity, Depression, And Race/Ethnicity Among U.S. Adults Aged 60–69 Years, Patrick E. Crandon

Walden Dissertations and Doctoral Studies

Abstract Food insecurity (FI) and depression among older populations in the United States are public health concerns. Although FI has declined in the United States, it is a psychosocial stressor prevalent among the growing population of adults over 60. It is unknown to what extent FI contributes to depression among racial/ethnic minorities in this population. The purpose of this quantitative cross-sectional study was to examine the relationships between FI and race and depression among U.S. adults aged 60–69 years when adjusting for other variables. The social-ecological model was used to understand the interplay between individual and environmental factors that may …

Health Education Practices For Middle Eastern Women With Polycystic Ovary Syndrome, Walaa Daffaalla

Walden Dissertations and Doctoral Studies

Polycystic ovarian syndrome (PCOS) is a complex women’s health condition that reduces women’s quality of life, leading to health complications, such as menstruation issues, infertility, insulin resistance, risk of type 2 diabetes, depression, anxiety, emotional stress, being overweight or obese, and more. Research on PCOS has focused on the etiology and complications in women from different ethnicities. But limited research has explored the experiences and perspectives of Middle Eastern (ME) women in the United States with PCOS related to PCOS health education. The purpose of this qualitative study was to explore the perspectives and experiences of ME women of reproductive …

Relationship Of Acetaminophen And Alcohol To Incipient Renal Insufficiency: The Role Of Race In Estimating Glomerular Filtration Rate, Preston Eledu

Walden Dissertations and Doctoral Studies

There are increasing concerns about the incorporation of race in the estimated glomerular filtration rate (eGFR) prediction equation. which has been used to measure renal function in studies that have shown a relationship between therapeutic dose of acetaminophen and light-moderate alcohol use to incipient renal insufficiency. The purpose of this study was to assess the same relationship, using a redefinition of renal insufficiency based on the chronic kidney disease–epidemiology collaboration creatinine-based eGFR, with and without race, and exploring the potential impact of race in the hypothesized relationship. Data from the 2003-2004 National Health and Nutrition Examination Survey were analyzed using …

Tuberculosis-Associated Knowledge, Stigma, And Health Seeking Behavior Among Traders In Onitsha Main Market, Anambra State, Nigeria, Benedeth N. Ezeosim

Walden Dissertations and Doctoral Studies

The utilization of tuberculosis (TB) health care services in a Nigerian state has not been optimal. Many residents do not utilize available health care resources when they experience symptoms of TB. Although much is known about the determinants of health seeking behavior (HSB), there is a gap on how TB knowledge and TB related stigma among traders in one main market contribute to HSB. This study examined the effect of TB knowledge and TB related stigma on HSB among traders. The health stigma and discrimination and health belif models served as the theoretical foundation. A quantitative cross-sectional analytical survey design …

The Relationship Between Preterm Birth Rates, Sociodemographic Factors, And Prenatal Care, Natasha Grant

Walden Dissertations and Doctoral Studies

Reducing preterm births is a local, national, and global public health priority. Preterm birth rates continue to rise with evident racial and ethnic differences. The purpose of the quantitative study was to analyze the Mississippi Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 8 data to investigate the association between preterm births, timing of prenatal care, insurance types, and marital status among 5,666 women who gave birth in Mississippi between 2016 - 2020 using logistic regression. The social-ecological model was used to explain the impact of preterm births at the individual, interpersonal, and policy levels. Marital status was shown to be …

Experiences Of Women Faculty Using Meditative Practices Through Workplace Health Promotion In Ontario, Kelly Lynn Henley

Walden Dissertations and Doctoral Studies

Workplace stress is pervasive and changes to the postsecondary teaching and learning environment have contributed to stress among women faculty and adversely impacted their personal well-being. The purpose of this qualitative study was to understand how the constructs in the health belief model (HBM) play a role in the use of worksite wellness initiatives to manage stress and promote wellness among women postsecondary faculty in Ontario. The research questions were designed based on the HBM to examine the participants’ perceptions of severity and susceptibility to workplace stress, perceived benefits and barriers to participation, motivation to participate, and self-efficacy. Women faculty …

Associations Between Substance Use And Obesity Among Native American Adolescents, Joseph Jude Janosky

Walden Dissertations and Doctoral Studies

Obesity and substance use are two significant public health issues among Native American adolescents. Despite much evidence linking obesity and substance use during adolescence to several long-term health conditions and increased morbidity and mortality, evidence describing the relationship between current substance use and obesity among Native American adolescents is lacking. The purpose of this quantitative study was to investigate associations between current substance use – specifically alcohol, marijuana, and tobacco products – and obesity among Native American high school students, when adjusted for sex, soda consumption, and physical activity. Rosenstock’s health belief model served as the theoretical foundation for this …

Experiences With Access To Seeking And Maintaining Home Health Care Services In Low-Income Communities, Staci Yvette Kennedy

Walden Dissertations and Doctoral Studies

AbstractHome health care services (HHCS) are a cost-effective service option often underutilized by individuals living in low-income communities. For this population, barriers to care may result in higher health care costs and poor health outcomes. Gaps in literature indicated a need to explore experiences of accessing and maintaining home health care among individuals living in low-income communities. The purpose of this qualitative research study was to gain insight into how individuals living in low-income communities perceive their access to HHCS. The conceptual framework used for this phenomenological study was Penchansky and Thomas’s model of access, which addresses access from seven …

Awareness Of The Role Of Nutrition In Cancer Causation And Prevention Among Rural Adult Population: A Cross-Sectional Study, Sayana Basheer, Kavya G. Upadhya, Sana Khader M

Digital Journal of Clinical Medicine

Background

In recent years, nutrition has received an increasingly important role in the aetiology of cancer. Thus, public education about dietary factors associated with cancer risk or prevention could be an important intervention for cancer prevention, particularly in low- and middle-income countries where the burden of cancer is increasing rapidly and access to care is limited. This study aimed to assess the awareness among rural adults about the role of nutrition in cancer development and its prevention.

Methods

A cross-sectional study was conducted among 300 individuals in the adult population (> 18 years) in rural field practice area of a …