Digital Commons Network^™

Social Cognitive Theory Constructs That Predict Betel Nut Chewing Among Secondary Students, Lepani Waqatakirewa

Walden Dissertations and Doctoral Studies

After alcohol, tobacco, and caffeine, areca or betel nut is the 4th most common substance of abuse in the world, and its prevalence of use in the Solomon Islands is estimated at 68% in young people. Long-term use of betel nut can result in detrimental health outcomes such as oral cancers and metabolic syndrome. Guided by the social cognitive theory (SCT), the purpose of this quantitative cross-sectional study was to determine whether the constructs of SCT predict betel nut use in Year 12 secondary students in the Solomon Islands. Five SCT constructs of expectations (outcome expectations and outcome expectancies), self-efficacy, …

Area-Level Factors Linked To Obesity In African American And Caucasian Women In Michigan, Marjorie Arrey

Walden Dissertations and Doctoral Studies

Obesity is a major public health crisis, affecting every segment of the U.S. population. African American women have higher prevalence of obesity than all other subpopulations and are disproportionately burdened by the disease and its comorbidities. Despite this disparity, African American women are often underrepresented in obesity research. This research examined obesity-related risk factors specific to African American women compared to those for Caucasian women. The design was based on the socioecological model and social cognitive theory, both emphasizing the impact of social factors on health outcomes. The data set included only adult Michigan women from the NHANES study. Multiple …

Quality Of Life, Physical Activity, And Weight Status For A Sample Of Online Students, Walaa Awad

Walden Dissertations and Doctoral Studies

Obesity has been identified as a global health problem and a risk factor for many chronic diseases. While previous studies discussed the weight status and factors associated with overweight and obesity among adults enrolled in traditional universities, few studies have yet estimated the obesity rate among adults who choose online education. Guided by the social cognitive theory, this descriptive exploratory quantitative study used a survey to collect primary data from adult online students of three higher educational institutions. The survey examined the effect of quality of life and physical activity level on the weight status of the participants; taking into …

Racial Disparities In Periconceptual Folic Acid Levels, Kelvin Gibson

Walden Dissertations and Doctoral Studies

Periconceptional folate level deficiencies are associated with birth defects of the brain and spinal cord, posing a significant public health problem. In 2009, Black and Hispanic women exhibited lower periconceptual folate levels and higher rates of folate-related birth defects compared with non-Hispanic White women, prior to enactment of the Affordable Care Act (ACA) of 2010. It is not known if improved access to prenatal care under the ACA narrowed the gap in mean periconceptual folate levels between non-Hispanic White, Black, and Hispanic women between 2009 and 2017. The purpose of this causal-comparative cross-sectional quantitative study was to determine whether there …

Understanding Characteristics Of Chronic Obstructive Pulmonary Disease Readmissions In An Acute Care Hospital, Jordan Danyale Brautigam

Walden Dissertations and Doctoral Studies

Patients suffering from chronic obstructive pulmonary disease (COPD) not only face difficulties managing their disease but are also faced with a higher risk of being readmitted to a hospital after an initial visit for acute exacerbation of their condition. Despite hospitals’ many attempts to offset this burden, readmission reduction programs are not effective. The purpose of this quantitative study was to further research an organization’s specific population surrounding patient comorbidities, reasons for readmissions, and demographic characteristics that may lend insight into reasons for readmissions. The research design was a retrospective analysis of a health system’s electronic medical record with a …

Assessing School-Based Telehealth Utilization In Medically Underserved Communities, Danielle Wesley

Walden Dissertations and Doctoral Studies

Medically underserved communities face challenges accessing health care services, and millions of Americans have no access to primary care. In many areas of the United States, the supply of primary care providers cannot keep up with the demand for health services. Newer healthcare delivery models are needed to address the issue. Using telehealth can augment the physician workforce shortages. The purpose of this quantitative dissertation is to examine the associations of telehealth utilization using a pediatric school-based telehealth model in Health Professional Shortage Areas (HPSAs) in North Texas. Texas has many counties without a primary care provider, making them medically …

Lifestyle Factors And Social Determinants As Predictors Of Weight/Body Mass Index, Uthman Alhaji Baba

Walden Dissertations and Doctoral Studies

Obesity is a major public health concern that includes the risk of developing cardiovascular disease and premature death in adults. Previous studies have established the relationship between gender, educational level, household income and respondents’ weight but additional research is needed to factor the nature of education in relation to gender differences, diet, and other important behavioral mediators such as social determinants. The purpose of this quantitative cross-sectional study is to determine the extent to which frequency of physical activity, household income, social determinants of health (money for balanced meals, finances at the end of month, and poor mental health), respondent …

Mandibular Attachment Device Effects On African American Veterans With Heart Failure, Tracey T. F. Carter

Walden Dissertations and Doctoral Studies

Heart failure is a growing epidemic that affects people nationwide and is disproportionate to African Americans. The purpose of this quantitative repeated measures study was to determine whether mandibular attachment device (MAD) therapy impacts symptoms of heart failure in African American male veterans diagnosed with obstructive sleep apnea (OSA). The oxidative stress theory was applied in this study to assess whether MAD therapy received from Veterans Affairs (VA) dental clinics impacted heart failure symptoms, after controlling for patient body mass index (BMI) levels and smoking status. Research questions examined whether MAD had a significant effect on symptoms of heart failure …

Behavioral, Demographic, And Clinical Determinants Of Hiv Serostatus In Zambian Women, Debebe Masresha Gebreyohannes

Walden Dissertations and Doctoral Studies

The rate of human immunodeficiency virus (HIV) infection shows a diminishing trend at the global level while it shows increasing in intensity of mortality, morbidity, and burden in Sub-Saharan Africa. The intertwined behavioral, demographic, and clinical determinants fueled the incidence of infections in Zambian women. The purpose of this study was to determine the association between demographic, behavioral, and clinical determinants with HIV serostatus in Zambian women. With the conceptual framework of the World Health Organization’s Commission for Social Determinants of Health (CSDH) and quantitative method of MANOVA, this study examined Zambian Demographic Health Survey data for Zambian women of …

The Association Between Provider Cultural Competence And Type 2 Diabetes Health Behaviors, Bernadette Joyce Mejia-Tran

Walden Dissertations and Doctoral Studies

Provider cultural competence is poorly understood in relation to the outcome of Type 2 diabetes patient health behaviors. The purpose of this study was to examine the association between provider cultural competence and diabetes patient health behaviors. The chronic care model provided the conceptual framework for this study. The research questions were designed to determine whether 5 measures of provider cultural competence play a role in diabetes patient health behavior change. The research design of the study was a quantitative cross-sectional survey using the 2017 National Health Interview Survey. The 2,342 participants included in the study represent a national sample …

Planned Behavior And Congolese Physicians’ Practice: Predicting Advanced Preventive Health Services Provision, Jean-Clément Milabu Mumbusi

Walden Dissertations and Doctoral Studies

The provision of preventive services, health promotion, and health maintenance has become the cornerstone of primary care practice in the United States and other Western countries to prevent morbidity and premature mortality and to increase the quality and years of a healthy life. Unfortunately, the delivery of these advanced preventive health services (APHS) has been sporadic in the Democratic Republic of Congo, a country with poor health indicators. The purpose of this cross-sectional mixed-method study was to apply Ajzen’s theory of planned behavior (TPB) to predict the intention of Congolese primary care physicians (PCPs) in the provision of APHS. Using …

An Assessment Of Knowledge, Behavior, And Consumption Patterns Surrounding Sugar- Sweetened Beverages Among Young Adults, Anne Harguth

All Graduate Theses, Dissertations, and Other Capstone Projects

Background The obesity epidemic is a growing problem in this country. Many studies have been conducted in effort to unravel and derail the rise in obesity and overweight status among Americans. Strong evidence supports the notion that excessive sugar consumption is largely contributing to an increase in obesity and risk for many chronic diseases and conditions.

Objective This study assessed sugar-sweetened beverage consumption, knowledge of sugar-sweetened beverages, disease risk associated with consumption, and correlation between the knowledge and consumption among a sample of students at a large midwestern university. A cross-sectional, retrospective design with random sampling was utilized for this …

Video Games, Screen Time, And The Impact On Body Mass Index And The Cardiovascular Fitness Of Adolescence, Joshua Sylvan

Scholarship in Medicine - All Papers

Objective: To determine the effect of screen time/video gameplay has on the BMI and cardiovascular fitness of adolescence between the ages of 12 and 15 years old.

Methods: All data were collected and analyzed based on the CDC’s NHANES National Youth Fitness Survey (NNYFS).

Results: Analysis showed that there was no significant difference between body mass index and time spent using a computer as well as no significant difference between estimate maximal O2 uptake (primary endpoint for cardiovascular fitness) and time spent using a computer.

Insufficient Sleep In 2020: Where Does Ohio Stand?, Daniel Masters

Scholarship in Medicine - All Papers

Objective: To determine the impact of insufficient sleep on premature death and mental health as well as see how the levels of insufficient sleep in Ohio compare to previous years and to other states in the US. Methods: Data on insufficient sleep, premature death, smoking, food environment index, physical inactivity, and poor mental health days was all collected from County Health Rankings and then analyzed. Results: Insufficient sleep was found to be moderately correlated to years of potential life lost in a positive manner in Ohio in 2020. Insufficient sleep has risen in Ohio from 2016 (35.76%) to 2020 (37.04%). …

Territorial Inequality In Health Service Delivery: Lessons From Latin America’S Federations, Agustina Giraudy, Jennifer Pribble

Political Science Faculty Publications

Access to quality healthcare varies across the national territory inside Latin American countries, with some subnational units enjoying higher-quality care than others. Such territorial inequality is consequential, as residents of particular regions face shorter life spans and an increased risk of preventable disease. This article analyzes trajectories of territorial healthcare inequality across time in Argentina, Brazil, and Mexico. The data reveal a large decline in Brazil, a moderate decline in Mexico, and low levels of change followed by a moderate decline in Argentina. The article argues that two factors account for these distinct trajectories: the nature of the coalition that …

The Impact Of Income On Nutrition: A Case Study Of Northern Mozambique, Hunter Swanigan, Lawton Lanier Nalley

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

In 2017, Mozambique ranked as one of the least developed countries in the world by measures of health, education, and income. With a minimal annual income, purchasing adequate food to meet recommended levels of nutrients for a healthy diet is difficult, leaving 40% of the country undernourished. This study analyzed what foods are available during the dry months (hungry season) of May through October in the Nampula province of Mozambique to determine if it is possible to meet recommended levels of nutrients from purchasing and growing food. Three different levels of income were used to determine what percentage of the …

Differences Between Older And Younger Adults With Diagnosed Cardiovascular Disease: An Analysis Of Fels Study Data, Jacqueline Jacobs

Master of Public Health Program Student Publications

Most deaths in the United States (U.S.) result from complications of chronic diseases and at the heart of the matter is America’s number one killer: cardiovascular disease (CVD). CVD is culpable for 33% of U.S. deaths, killing more people than all cancers and chronic lower respiratory diseases combined.

Traffic And Our Health, Atteh Akoto

Scholarship in Medicine - All Papers

Objective: The intent of this study is to find a correlation between long commute times, physical health, and mental health. Methods: Data was collected from a publicly available dataset on countyhealthrecords.org. Results: Increased percentage of lone drivers with long commutes and obese adults, positive correlation between long commuters and access to exercise opportunities, and negative correlation between long commuters and poor mental health days.

Cardiovascular Fitness And Muscle Strength In Asthmatic Children, Kaitlynne Pak

Scholarship in Medicine - All Papers

Objective: The aim of this retrospective study is to evaluate the cardiovascular fitness and muscle strength performance of children with asthma versus without.

Methods: Participants include patients who were involved in the 2012 NHANES National Youth Fitness Survey (NNYFS) as published by the Centers for Disease Control and Prevention. The average cardiovascular fitness and muscle strength scores will be appreciated by analyzing the averages of time spent on treadmill, maximal heart rate, heart rate at end of exam, recovery time, maximal endurance time, cardiovascular fitness report, upper body strength and lower body strength using two-tailed T-tests between patients with asthma …

The Impact Of Food Insecurity On Diabetes Prevalence In The Us: A Look At The Northeast And The Midwest, Richard Mensah

Scholarship in Medicine - All Papers

Diabetes is one of the most common chronic conditions globally. Various risk factors have been found to be associated with the incidence of diabetes. These include genetic predispositions, physical activity and diet. However, less attention has been given to the potential risk of food insecurity to diabetes prevalence. Therefore, the goal of this study was to look at the prevalence of food insecurity and diabetes in New York and Ohio, and try to see if a correlation exists between food insecurity and diabetes prevalence in these states.

In our methods, we used the 2019 data from County Health Rankings (CHR) …

Growing Green Minds: Implementation Of A School Garden & Nutrition Program For The Freedom Area School District In Rural Wisconsin, Marissa Schuh

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

Most children in the U.S. consume too few fruits and vegetables which is putting them at risk to develop obesity and other lifestyle diseases. The 2015-2020 Dietary Guidelines for Americans recommends that individuals should increase the amount and variety of fruits and vegetables consumed in order to prevent weight gain and other chronic diseases. Research shows that garden-based educational programs can increase children’s fruit and vegetable intake as well as change their preferences and attitudes towards eating and trying new fruits and vegetables. Incorporating a garden and nutrition curriculum into a school setting is an ideal opportunity to improve children’s …

Against The "Safety Net", Matthew B. Lawrence

Faculty Articles

Then-Representative Jack Kemp and President Ronald Reagan originated the “safety net” conception of U.S. health and welfare laws in the late 1970s and early 1980s, defending proposed cuts to New Deal and Great Society programs by asserting that such cuts would not take away the “social safety net of programs” for those with “true need.” Legal scholars have adopted their metaphor widely and uncritically. This Article deconstructs the safety net metaphor and counsels against its use in understanding health and welfare laws. The metaphor is descriptively confusing because it means different things to different audiences. Some understand the safety net …

The Perception, Usage, And Knowledge Of Moringa Oleifera In Mare-Brignol, Haiti After Increased Education And Access, Preethashree Anbukkarasu, Phillip Saad, Nichika R. Holdrum, Chinelo Germain, Leticia Ebihara, Archi Patel

Digital Repository: Showcase of Undergraduate Research Excellence

No abstract provided.

#Science: The Potential And The Challenges Of Utilizing Social Media And Other Electronic Communication Platforms In Health Care., Violette Gijsen, Michele H. Maddux, Adam Lavertu, Graciela Gonzalez-Hernandez, Nilam Ram, Byron Reeves, Thomas Robinson, Victoria Ziesenitz, Valentina Shakhnovich, Russ Altman

Manuscripts, Articles, Book Chapters and Other Papers

Electronic communication is becoming increasingly popular worldwide, as evidenced by its widespread and rapidly growing use. In medicine, however, it remains a novel approach to reach out to patients. Yet, they have the potential for further improving current health care. Electronic platforms could support therapy adherence and communication between physicians and patients. The power of social media as well as other electronic devices can improve adherence as evidenced by the development of the app bant. Additionally, systemic analysis of social media content by Screenome can identify health events not always captured by regular health care. By better identifying these healthcare …

State Park Selection As Determined By User Health, Connor Phelan

Master's Theses or Doctor of Nursing Practice

The purpose of this study was to determine whether state park difficulty affected location of travel. This study was conducted at three state park locations within the United States. Surveys and on-site examinations were made at the following locations; Wilson State Park, Kansas, Petit Jean State Park, Arkansas, and Kiholo State Park, Hawaii. Park locations were chosen by varying levels of terrain difficulty, as well as a rating from the Recreation Opportunity Spectrum. Participants were asked to report data via iPads on exercise habits, mobility limiting impairments, and frequency of exercise so a ranking of the healthiest participants could be …

The Association Between The Medicare Bundled Payments Initiative And Cardiac Rehabilitation Enrollment, Jing Li

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

Cardiac rehabilitation (CR) represents a proven-effective intervention in secondary prevention that can stabilize, slow or reverse cardiovascular disease (CVD) progression, facilitate the ability of the patient to preserve or resume an active and functional contribution to the community, and reduce the risk of future cardiovascular events. Despite multiple guideline recommendations for CR and coverage by Medicare and most health plans, participation in CR remains low. Bundled payments are one of the suggested reforms designed to move health care providers toward to value-based care and is very applicable to the CR utilization in patients diagnosed with acute myocardial infarction (AMI) or …

Prevalence Of Restricted Spirometry Within Two Eastern Kentucky Counties A Cross Sectional Study, Quincy Bascombe

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

Objective: This study examines the prevalence of restrictive spirometry in Eastern Kentucky and its association among men and women with various demographic and exposure (occupational and environmental) factors.

Methods: A cross sectional, cluster sample (N = 685) of participants from Letcher and Harlan Counties, aged 21 and over, answered a questionnaire focused on risk factors for respiratory health outcomes including questions on demographic, health, occupational, and environmental exposures variables. Pulmonary function tests were administered to all participants with no significant cardiovascular or cerebrovascular events within the past 30 days. Log-binomial regression was used to calculate prevalence ratios (PRs) …

Policy Analysis Of California Senate Bill 1138: Mandating Plant-Based Meal Options In Hospitals And Prisons, David Morton

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

Obesity, chronic disease, and poor nutrition are prevalent in the United States while healthcare costs rise. Nutritional research advancements have suggested the healthfulness of plant-based diets. In 2018, the California state senate passed Senate Bill 1138, requiring plant-based meal options in hospitals and prisons. This paper sought to examine the context surrounding the bill, determine the appropriateness of the bill, and recommend next steps for nutritional policies in the United States. In a review of the literature, malnutrition in hospitals and prisons is highly prevalent, and state governments have already made efforts to improve their citizens’ nutrition. In this analysis, …

Implementing The Be Proud! Be Responsible! Program In Wolfe County Public Schools, Casey Gill

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

Kentucky’s teen pregnancy rate is higher than the national average, and Wolfe County has one of the highest rates of teen pregnancy in the state. Teen pregnancy causes adverse health effects for both mother and baby. Teen mothers have a higher likelihood of dropping out of high school, increased health problems related to pregnancy such as preterm labor and preeclampsia, increased risk of being a single parent, and lower income and SES status. The baby is also affected, with an increased risk of living in a single parent household, and living in poverty. The Kentucky River District Health Department plans …

An Analysis Of The Association Between Adverse Childhood Experiences And Food Insecurity Within The United States, Margaret Brooks

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

Adverse childhood experiences and food insecurity are significant public health issues within the United States. Previous studies have established the overall relationship between ACEs and food insecurity. This research investigates the statistical relationship between individual ACE indicators and food insecurity as well as the relationship between having two or more ACEs and food insecurity.