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The Impact Of A Parent-Only Pediatric Obesity Intervention Program On Quality Of Life In Racially Diverse Children, Taylor Vashro

Theses and Dissertations

Pediatric obesity has been associated with significant decrements in pediatric quality of life (QOL) comparable with severe pediatric diseases such as cancer. Parenting interventions have yielded health benefits for children with obesity; however, few studies have investigated the impact of parent-focused interventions on QOL in children with overweight and obesity. This study investigated the impact of a 6-week intensive parenting intervention program on the QOL of 5-12 year old, predominantly Black children with overweight and obesity. Parents were randomized into either the parenting intervention (NOURISH+) or a control group, and QOL, as well as variables related to child and parenting …

Qvoices: Queer Voices In Oncology Igniting Change Through Empowered Stories Of Survivorship, Viktor Clark

Theses and Dissertations

Background: Each year in the United States there are roughly 2 million new cancer diagnoses, with over 600,000 deaths due to cancer. The National Cancer Institute developed a six-stage cancer control continuum framework ranging from etiology to survivorship to organize the cancer experience. Sexual and gender minorities (SGM) are comprised of multiple communities representing ~23.6 million adults in the US, SGM face disparities at each stage of the cancer control continuum. This study emphasizes three stages, prevention, detection, and treatment. Engagement in prevention can prevent or prolong cancer, early detection through engagement in cancer screening improves cancer trajectories and compliance …

Social Determinant Of Health Impact On Diabetes Device Use And Clinical Outcomes In Youth With Type 1 Diabetes, Emily R Crain, Ryan Ramphul, Ashley M Butler, Xiaofan Huang, Charles G Minard, Maria J Redondo, Daniel J Desalvo

Faculty, Staff and Student Publications

Background: Youth with Type 1 diabetes (T1D) who are Black, Hispanic, or lower socioeconomic status (SES) have lower rates of diabetes device use, higher hemoglobin A1c (HbA1c), and higher rates of diabetic ketoacidosis (DKA). However, the associations of individual-level social determinants of health (SDoH) and neighborhood-level factors with device use and clinical outcomes are unknown. Area deprivation index (ADI) is a neighborhood level measure of SES reported in deciles (range 1-10 with 10 representing most deprived neighborhood).

Methods: We evaluated the association of ADI and other SDoH factors with pump/continuous glucose monitor (CGM) use, HbA1c, and DKA in 1,461 youth …

Risk Factors Associated With The Development Of Type Ii Diabetes-Related Complications, Jessica Danielle Lucas Williams

Walden Dissertations and Doctoral Studies

By 2040, it is estimated that 642 million people ages 20 to 79 will have Type II diabetes, thereby making it a heavily studied topic among scholars. As more people are diagnosed with Type II diabetes each year, the literature is slowly shifting to long-term complications. However, the many risk and protective factors that exist have created gaps in the literature. The purpose of this study was to determine the relationship between participation in diabetes self-management classes, mental health, physical health, BMI, smoking status, exercise, and possible diabetes complications (diabetes-related retinopathy and diabetes-related kidney disease). The gap in the literature …

Moderators Of Peripheral Neuropathy On Overall And Cardiovascular Mortality In People Without Diabetes, Adeoye Muideen Adenekan

Walden Dissertations and Doctoral Studies

Peripheral neuropathy (PN), a group of common heterogeneous disorders with varied etiologies, is associated with substantial morbidity and mortality. PN presents both as a diagnostic and therapeutic challenge to physicians and other healthcare providers. Socioeconomic moderators of PN in adults without diabetes in the United States have not been well studied. The consequences of PN can be devastating and include foot ulcers, amputations, a general decline in the quality of life, and death. The overall prevalence of PN in the United States is 13.5% in adults with diabetes and 11.6% in adults without diabetes. Clearly, these statistics indicate a public …

Sexual Violence And University Campus Response To Sexual Violence, Jennifer Bivins

Walden Dissertations and Doctoral Studies

While anyone can be a victim of sexual violence, college-aged females between the ages of 18 and 21 are more likely to be victimized than any other group. Sexual violence continues to be a barrier to education, and colleges/universities make it challenging for students to report on campus. The purpose of this study is to explore the factors, intervention/prevention strategies, and policies/procedures used to address sexual violence on a university campus. The framework used was the ecological model, which focuses on factors and influences within the environment that affected individual behavior. The research questions focused on participants describing their experiences …

Association Between Childhood Obesity And Cerebral Palsy, Down Syndrome And Epilepsy Or Seizure Disorder, Stephanie Swanson

Walden Dissertations and Doctoral Studies

The purpose of this quantitative correlation study was to examine the association between childhood obesity (dependent variable) and cerebral palsy, Down Syndrome, and epilepsy and seizure disorders (independent variables), while controlling for the child’s age, race, and sex among United States children ages 0-17, as well as the guardian’s education and income levels. There are many studies related to childhood obesity; however, few focus on the independent variables in the current study in relation to overweight children. The Social Cognitive Theory (SCT) was used to understand and interpret the research findings. Secondary analysis of data was conducted using the National …

Assessment Of Factors That Affect Men’S Access And Utilization Of Tuberculosis Services In Zululand District In South Africa, Maureen Fatsani Tshabalala

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) remains the leading cause of death in South Africa, with higher mortality rates among men compared to women, despite the availability of free TB services and a reduction in TB death rates. However, research on the factors influencing men's access to and utilization of TB services is limited. The purpose of this study was to assess the factors affecting men's geographical access and quality utilization of TB services in the Zululand district of KwaZulu Natal province, South Africa. A survey questionnaire was used to collect data from 200 men recruited from selected primary health care facilities. Andersen's model …

Association Between Psychosocial, Obstetric, And Lifestyle Factors And Antenatal Depression, Tomnema Xiong

Walden Dissertations and Doctoral Studies

Antenatal depression, or depression during pregnancy, is a mental health concern in the United States that impacts mothers and their infants. This study examined the associations between psychosocial, obstetric, lifestyle factors, and antenatal depression. This study was guided by social cognitive theory, specifically the reciprocal determinism construct. Secondary data from the 2007–2018 National Health and Nutritional Examination Survey (NHANES) were used in this quantitative cross-sectional study. Every participant of the NHANES completed the Patient Health Questionnaire-9 depression screening form. The study sample consisted of 274 women who were pregnant at the time of participating in the NHANES, approximately 28.8% of …

Examination Of The Association Between Poverty, Income, And Education Levels On Tuberculosis Prevalence In Nigeria: Rural Niger Delta Case Study, Nwinmene George Zarakpege

Walden Dissertations and Doctoral Studies

Despite the global decline in tuberculosis (TB) cases, the prevalence of TB in rural populations in Nigeria is rising. To date, poverty and low educational levels continue to affect treatment and other prevention strategies to eradicate the disease. The purpose of this cross-sectional study was to assess the association between poverty, educational levels, household structure and vaccination status on TB prevalence in rural Niger Delta, Nigeria. The theoretical framework for this study was the socio-ecological model. Data were obtained from residents of rural Niger Delta in Nigeria attending a teaching hospital in southern Nigeria. The relationship between the stated demographic …

Food And Income Insecurity And Academic Progress Among African American College Students During The Covid-19 Pandemic, Gloria Brown Moore

Walden Dissertations and Doctoral Studies

The impact of food insecurity on minority college students is an ongoing concern that reached new importance during the COVID-19 pandemic. Although researchers have examined food insecurity among college students during COVID-19, they had not explored the role of coping responses among African American college students during the onset of the pandemic. The purpose of this study was to investigate coping responses as mediators between situational stressors (students’ experiences of food insecurity, residential changes, and changes in employment) and academic progress among African American college students during COVID-19. The instruments used for this study were the Brief COPE Inventory, Global …

Issues Encountered By Parents In Continuing School-Based Obesity Prevention Programs At Home, Prenu Skaria

Walden Dissertations and Doctoral Studies

Childhood obesity is a public health problem that can lead to various chronic health diseases such as cardiovascular disease and diabetes later in life. School-based obesity prevention programs are a public health recommendation to reduce and prevent obesity in schools through increased physical activity and better nutritional habits. This qualitative research involved exploring the reason for the discontinuation of school-based interventions at home using multi-theory model (MTM) constructs for health behavior change. A convenience sample of three focus groups of consenting parents whose children participated in the Wolf Pack Coaches Challenge (WPCC), a school-based obesity prevention program in Nevada, was …

Self-Care And Psychosocial Factors That Predict Sickle Cell Disease-Related Outcomes Among African Americans In The Usa, Datonye Agina-Obu

Walden Dissertations and Doctoral Studies

Existing beliefs and conceptions regarding sickle cell disease (SCD) have had a significant impact on the appropriate management of the condition, including self-care and psychosocial factors, particularly among African Americans. The aim of this study was to examine the influence of self-care and psychosocial factors on SCD-related outcomes among African Americans in the United States. The study was grounded in the self-care management theory and employed a cross-sectional, quantitative design. Regression analyses were conducted to explore the associations between self-care and psychosocial factors and SCD-related outcomes sample of 180 individuals. The results indicated three factors showed significant relationships for sickle …

Promoting Healthier Treatment Outcomes In Obese Cancer Patients Taking High Dose Methotrexate, Carly Dell'ova

Walden Dissertations and Doctoral Studies

Cancer and obesity rates continue to rise, creating enormous public heath burdens to the individual and at the national and global levels, reducing quality of life, and increasing spending. Moreover, the relationships between cancer and obesity are not well understood. A commonly used chemotherapy for several types of cancer is high dose methotrexate (HDMTX). Along with chemotherapy, especially at high doses, comes toxicity to specific organs and the entire body. However, limited research has been conducted on obese cancer patients as they are often excluded from clinical studies. Practitioners need to better understand how to dose these patients to provide …

Diabetes Self-Management Education, Jean David Thomas

Walden Dissertations and Doctoral Studies

AbstractAccording to the World Health Organization, Type 2 diabetes mellitus (T2DM) is a chronic, metabolic disease that can lead to damage throughout the body and development complications if self-care management is not implemented. Studies have demonstrated a lack of preparedness of nursing staff on T2DM self-care. At the federally qualified health clinic where this Doctor of Nursing Practice project occurred, a gap in practice existed related to the use of outdated American Diabetes Association (ADA) guidelines and lack of patient education documentation on self-care management of T2DM. The purpose of this staff education project was to plan, implement, and evaluate …

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 …

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 …

Association Between Psychosocial, Obstetric, And Lifestyle Factors And Antenatal Depression, Tomnema Xiong

Walden Dissertations and Doctoral Studies

Antenatal depression, or depression during pregnancy, is a mental health concern in the United States that impacts mothers and their infants. This study examined the associations between psychosocial, obstetric, lifestyle factors, and antenatal depression. This study was guided by social cognitive theory, specifically the reciprocal determinism construct. Secondary data from the 2007–2018 National Health and Nutritional Examination Survey (NHANES) were used in this quantitative cross-sectional study. Every participant of the NHANES completed the Patient Health Questionnaire-9 depression screening form. The study sample consisted of 274 women who were pregnant at the time of participating in the NHANES, approximately 28.8% of …

Risk Factors Influencing Poliomyelitis Seroprevalence In Polio High Risk Areas Of Afghanistan, Wasan Abdulaziz Al-Tamimi

Walden Dissertations and Doctoral Studies

Afghanistan is one of the remaining polio endemic countries in the world. Nearly one million children under 5 years of age have missed polio vaccination in Afghanistan from May 2018 until January 2021. This quantitative study used the socioecological model as the theoretical framework and secondary data analysis of the 2020 polio serosurvey (N = 1384) to investigate various risk factors such as gender, parental education, family origin (language/location), wealth, distance to nearest health facility, and number of polio vaccine doses on the level of antibodies (i.e., seroprevalence) against all three types of polioviruses in children of two age groups, …

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 …

Walking The Talk: A Qualitative Exploration Of Gatekeeping Staff Perceptions Surrounding Implementation Of Nutrition Policy In Florida Food Banks, Rachel Lynn Mccandless

UNF Graduate Theses and Dissertations

Food insecurity is an independent risk factor for adverse health outcomes; providing nutrient-dense food through the emergency food system to individuals who regularly seek assistance can impact population-level health disparities. This research explored the extrinsic and intrinsic barriers and facilitators surrounding formal nutrition policy implementation as seen by the logistical gatekeepers in a sample of Feeding Florida food banks. A secondary aim of this research was to explore the change readiness of these same logistical decision-makers in nutrition policy implementation. Research Questions included the following: What are the critical gatekeeping staff perceptions of the barriers and facilitators to implementing formal …

Country Readiness And Prerequisites For Successful Design And Transition To Implementation Of Essential Packages Of Health Services: Experience From Six Countries, Ala Alwan, Reza Majdzadeh, Gavin Yamey, Karl Blanchet, Alemayehu Hailu, Mohamed Jama, Kjell Arne Johansson, Mohammed Yusuf Ahmed Musa, Omar Mwalim, Sameen Siddiqi

Community Health Sciences

This paper reviews the experience of six low-income and lower middle-income countries in setting their own essential packages of health services (EPHS), with the purpose of identifying the key requirements for the successful design and transition to implementation of the packages in the context of accelerating progress towards universal health coverage (UHC). The analysis is based on input from three meetings of a knowledge network established by the Disease Control Priorities 3 Country Translation Project and working groups, supplemented by a survey of participating countries. All countries endorsed the Sustainable Development Goals target 3.8 on UHC for achievement by 2030. …

Acute Placental Inflammation And Growth Outcomes In Preterm Infants, Emily Gunawan

All ETDs from UAB

Background. Acute placental inflammation (API) has been associated with various adverse outcomes in preterm infants. However, little is known about how API affects their body composition and growth outcomes. This study aims to examine the association between API and growth outcomes in preterm infants. Methods. We conducted a retrospective cohort study of mother-infant dyads born < 326/7 weeks of gestation with fat mass (FM) accretion measured using air displacement plethysmography at term-equivalent age. API severity including maternal inflammatory response (MIR) and fetal inflammatory response (FIR) was staged according to criteria by Society for Pediatric Pathology based on placental pathology reports. We examined the differences in characteristics of mother-infant dyads by API severity using ANOVA or the Kruskall-Wallis test. The association between API severity and growth outcomes was analyzed using linear regression models and adjusted for statistically significant confounders. Mediation analyses were used to study the direct and indirect association of API and growth outcomes via gestational age. Results. Among 375 mother-infant dyads analyzed, 104 (28%) dyads had MIR. FIR was found in 82% of dyads with MIR. Adjusted models indicated that API severity progression was positively associated with FM accretion. Gestational age partially (49%) iv mediated the association between API severity and FM z score (indirect effect: b=0.12, 95% CI: 0.05-0.19; direct effect: b=0.12, 95% CI: 0.01-0.25). Conclusions. API severity is associated with growth outcomes and helps to accurately predict body composition in preterm infants.

Neighborhood Disadvantage, Sleep Quality, And Shift Work: The Reasons For Geographic And Racial Differences In Stroke (Regards) Study, Rebecca Williams

All ETDs from UAB

The first study used data (n=14,609) from the REasons for Geographic and Racial Differences in Stroke (REGARDS) to test the associations among Area Deprivation Index (ADI) and self-reported total sleep time (TST), sleep efficiency (SE), and number of restless nights within the last week. The second study (n=12,496) tested the associations among ADI, shift work status, and restlessness.Regression models were fit to examine associations between ADI and SE or TST or restlessness, as well as assess the relation between ADI and SE in clinically meaningful categories. Moderation analyses indicated whether sex or race impact the association between ADI and sleep. …

Examining The U.S. Disaster Management Program: A Case Study Of The U.S. Virgin Islands Hurricanes Irma And Maria Evacuation, Victoria F. Vachon

Walden Dissertations and Doctoral Studies

AbstractWhether from natural or human causes, every global community is at risk for overwhelming, destabilizing incidents. Hurricanes Irma and Maria devastated the U.S. Virgin Islands in late August and early September 2017, necessitating the urgent evacuation of hemodialysis patients over 1000 miles to the U.S. mainland. Because the damage and response to the U.S. territory were unprecedented, the public health implications of the government’s strategies on the evacuated population subset were unexplored. However, available information suggested that some evacuees sustained avoidable harm while in the protracted care and custody of the government. This qualitative case study, conceptually framed by Bronfenbrenner’s …

An Association Of The Transgenerational Implications Of Redlining And Obesity On Pediatric Type Ii Diabetes, Carlin Dexter Nelson

Walden Dissertations and Doctoral Studies

s the prevalence and incidence of childhood obesity has increased, so has the number of cases of pediatric Type 2 diabetes mellitus (T2DM). Although made unconstitutional in 1968, the transgenerational implications of redlining can be observed in disinvestments resulting in neighborhood detraction. Utilizing the 2019–2020 National Children’s Health Survey, the purpose of the study was to evaluate the relationship between obesity, T2DM, and neighborhood detraction elements as well as assessed indicators of T2DM in non-institutionalized children 6 through17 years of age (N = 34,725). The social determinants of health perspective served as the conceptual framework for the study. Results indicated …

Non-Alcoholic Fatty Liver Disease And Metabolic Syndrome: The Role Of Gender Differences And Menopausal Status Of Women, Kimberly Kushner

Walden Dissertations and Doctoral Studies

There are few studies that investigate the association between non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) predominantly in menopausal women. This quantitative study investigated the association between MetS and NAFLD while controlling for age, gender, ethnicity, and menopausal status of women. The theoretical framework that helps establish and guide the research was the diffusion of innovation (DOI). A multivariable logistic regression was conducted using secondary data from the National Health and Nutrition Examination Survey. There is a statistically significant association between MetS, and NAFLD after controlling for age (OR = 2.96, 95% CI = 2.319–3.778, p < 0.001). However, ethnicity was not statistically significant. After further controlling for gender, the relationship remained statistically significant and exhibited a decrease in risk for females compared to males (OR = -.734, 95%CI = .387–.596, p < 0.001). Lastly, focusing on women only, and further controlling for menopausal status, the association between MetS and NAFLD was still statistically significant (OR = 2.227, p < 0.001). Mexican Americans, other Hispanics, and Non-Hispanic Black women were at higher risk (95% CI 1.102–7.039, 1.321–5.351, and 1.255–3.013, respectively). Implications for positive social change include adopting proactive and preventative strategies that can improve the quality of life for vulnerable patients and reduce morbidity and mortality associated with MetS and NAFLD.

Age, Race/Hispanic Origin, And Covid-19 Mortality Among Sickle Cell Disease Patients In The United States, Joe Lamont Ndula

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic remains a global health challenge, with 6.7 million deaths worldwide as of January 2023. It has illuminated the health iniquities in underserved communities and populations like those with sickle cell disease (SCD). Researchers have associated the COVID-19 outcome among SCD patients in other regions of the globe. The purpose of this retrospective cross-sectional observational study was to investigate the relationship between age, race/Hispanic origin, and COVID-19 mortality among persons with SCD in the United States from January 2020 to March 2021. The Krieger ecosocial theory of disease distribution framed the study. Data were drawn from an existing …

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 …

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 …