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The Influence Of Cardiovascular Disease Risk Factors On Exercise Participation, Chadrick Cooper Jan 2017

The Influence Of Cardiovascular Disease Risk Factors On Exercise Participation, Chadrick Cooper

Walden Dissertations and Doctoral Studies

The study's purpose was to analyze whether the control (sustained healthy level) of independent cardiovascular disease risk factors could be used to significantly predict aerobic exercise status. The health belief and ecological model helped describe health awareness, autonomy, and ecological influences that could also influence the control of each risk factor. Multiple logistic regression analysis of behaviors and demographics was utilized to assess relationships of met aerobic recommendations to hypertension, diabetes, obesity, tobacco/alcohol use, diet, physical activity limitations, mood, and socio-economic status. The study consisted of 340 African American participants (37% male 63% female), between the ages of 30-64 who, …

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Barriers To Switching Patients To Second-Line Antiretroviral Treatment Among Clinicians In Tanzania, Peter Charles Mgosha Jan 2017

Barriers To Switching Patients To Second-Line Antiretroviral Treatment Among Clinicians In Tanzania, Peter Charles Mgosha

Walden Dissertations and Doctoral Studies

Poor decision making among clinicians to transferring human immune deficiency virus (HIV) patients into second-line antiretroviral therapy (ART) has led to an increase in morbidity and mortality to people living with HIV (PLHIV). No clear barriers are known for clinicians not switching their patients. This is a descriptive qualitative research aimed to discover obstacles that influence clinicians' decision making to transferring patients into second-line ART despite higher level resistance to first-line ART. The researcher applied a participatory action research framework to solve the identified barriers with clinicians. Using the research questions the researcher explored reasons, perceived barriers and enabling factors …

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Discovering Opportunities To Improve Profitability At A Federally Qualified Health Center, Robert Jackson Jackson Jan 2017

Discovering Opportunities To Improve Profitability At A Federally Qualified Health Center, Robert Jackson Jackson

Walden Dissertations and Doctoral Studies

Federally Qualified Health Center (FQHC) organizations, which provide health care services to low-income, underserved patients, are underfunded. From 2000 to 2007, the cost of treating an FQHC patient increased by $146, while federal compensation to FQHCs increased by only $44 per patient. One FQHC organization in rural Alabama experienced financial losses from the fiscal year 2011 through 2014, jeopardizing services to approximately 6,000 low-income patients. The purpose of this qualitative case study was to analyze the subject organization and discover opportunities to improve financial performance. The research question pertained to the opportunities for improving profitability at the subject organization. The …

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The Impact Of Maternity Healthcare Employees Professional Development On Pregnant Teen Health, Patricia.Kelley Kelley Jan 2017

The Impact Of Maternity Healthcare Employees Professional Development On Pregnant Teen Health, Patricia.Kelley Kelley

Walden Dissertations and Doctoral Studies

Knowledge gaps exist related to the care and education of pregnant teens. This project study addressed the problem of an inadequate amount of professional development (PD) and training for healthcare professionals (HCPs) caring for pregnant teens at a maternity clinic in the Southeastern United States. Unless HCPs are appropriately trained, the ability to meet the needs of pregnant teens is deficient and negative health outcomes for these patients are likely to be exacerbated. The humanistic learning theory was used in this phenomenological exploratory study to explore perception of 9 HCPs who had the responsibility for patient teaching, clinical care, and …

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Measuring Determinants Of Oral Health Behaviors In Parents Of Low-Income Preschool Children, Josefine Ortiz Wolfe Jan 2017

Measuring Determinants Of Oral Health Behaviors In Parents Of Low-Income Preschool Children, Josefine Ortiz Wolfe

Walden Dissertations and Doctoral Studies

Dental decay is a preventable disease, but it remains the most unmet healthcare need of American children. Untreated dental decay has adverse and long-lasting effects on a child's quality of life. Healthy oral habits among preschool children are essential for a healthy permanent dentition and are achieved primarily by 3 oral health related behaviors: proper dental hygiene, a healthy noncariogenic diet, and regular dental visits. This quantitative study, based on the theory of planned behavior, explored the relationship between these 3 oral health behaviors and 4 determinants: attitude, subjective norms, perceived behavioral control, and intention, using a 71-item questionnaire. The …

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Development And Validation Of An Adult Diet And Physical Activity Program In Primary Care Setting, Christiana Chinyere Keke-Ekekwe Jan 2017

Development And Validation Of An Adult Diet And Physical Activity Program In Primary Care Setting, Christiana Chinyere Keke-Ekekwe

Walden Dissertations and Doctoral Studies

Obesity is a national health problem with serious medical, psychological, and economic outcomes. Nurses and nurse practitioners (NPs) are frequently the first point of patient contact and play an essential role in the management of obesity. The current literature noted that practitioners working in primary care settings demonstrate inadequate knowledge related to evidence based practice (EBP) strategies to treat obesity, including diet modification and physical activity. The purpose of this DNP project was to develop and validate an EBP provider educational module related to diet modification and physical activity education for adult patients diagnosed with obesity in a primary care …

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Understanding The Importance Of Culturally Appropriate Patient-Provider Communication In Diabetes Self-Management, Anita Mwalui Jan 2017

Understanding The Importance Of Culturally Appropriate Patient-Provider Communication In Diabetes Self-Management, Anita Mwalui

Walden Dissertations and Doctoral Studies

According to the Centers for Disease Control and Prevention, 29.1 million people in the United States have diabetes. Among those 29.1 million people, 21 million have been diagnosed, but 8.1 million have not. Changing demographics in the United States and the prevalence of diabetes are projected to be burdens on the health care system through 2050. Guided by the social cognitive theory, the purpose of this qualitative case study was to understand the importance of culturally appropriate patient-provider communication to the self-management of Type 2 diabetes by patients who are African immigrants. Culturally based health care has unique challenges when …

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Cardiovascular Disease Risk Factor Assessment And Lifestyle Adjustments In African Americans, Biruk Nigatu Nigatu Jan 2017

Cardiovascular Disease Risk Factor Assessment And Lifestyle Adjustments In African Americans, Biruk Nigatu Nigatu

Walden Dissertations and Doctoral Studies

Multiple studies have indicated a higher burden of overweight/obesity and exposure to environmental toxins, such as alcohol and tobacco smoke, in association with higher prevalence of cardiovascular disease (CVD) in the African American population. Thus, the purpose of this research was to determine if there was a significant difference in the use of lifestyle adjustments such as moderating alcohol consumption, weight loss, and smoking cessation on the prevalence of CVD in the African American population. The theoretical foundation was social cognitive theory and the social ecological model that posits the interplay of individual, social, and environmental factors. This cross-sectional quantitative …

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Serum Iron Concentration And Prostate Cancer In The United States, Aleeshaia Danner Raymonvil Jan 2017

Serum Iron Concentration And Prostate Cancer In The United States, Aleeshaia Danner Raymonvil

Walden Dissertations and Doctoral Studies

Over 2 million adult men in the United States have been diagnosed with prostate cancer, with nearly 200,000 new diagnoses each year. This type of cancer is the leading cause of mortality in U.S. men. One possible risk factor for prostate cancer is a high level of iron in the body, but the association has yet to be confirmed. This study was an investigation of the relationship between serum iron concentration and prostate cancer using data obtained from the 2009-2012 National Health and Nutrition Examination Surveys. This quantitative study involved 1,850 men in the U.S. aged 51 to 70 years. …

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Using Administrative Healthcare Records To Identify Determinants Of Amputee Residuum Outcomes, Judith Gail Walden Jan 2017

Using Administrative Healthcare Records To Identify Determinants Of Amputee Residuum Outcomes, Judith Gail Walden

Walden Dissertations and Doctoral Studies

In the United States, the number of major limb amputees is predicted to exceed several million in the coming decades. For those amputees using a prosthesis, their quality of life (QoL) is often modulated by residuum limb problems resultant from its use. Multiple factors preclude quality evidence-based medicine (EBM) research in the field of prosthetics, leading to greater health risk from prosthetic prescription ambiguity. Positive social change is integral to good QoL; studies support administrative healthcare (AHc) as useful to support such, especially in the absence of EBM. This study utilized Veterans Healthcare Administration (VHA) AHc data to discriminate determinants …

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The Impact Of Palliative Care On Health Status In Hiv-Positive Children, Aabid Abdulmajid Ahmed Jan 2017

The Impact Of Palliative Care On Health Status In Hiv-Positive Children, Aabid Abdulmajid Ahmed

Walden Dissertations and Doctoral Studies

HIV-positive children in sub-Saharan Africa have numerous challenges to overcome. These challenges increase psychosocial stress as well as symptom burden including fatigue, weight loss, pain, and mental changes. The symptoms may persist even after initiation of antiretroviral therapy, so such children need additional care. Palliative care lays emphasis on holistic patient-centered care, including physical, psychological, social, and spiritual symptoms, alongside antiretroviral therapy. There is limited data on the impact of integrating palliative care with standard HIV care and treatment in children. The purpose of this study was to fill the gap in the literature by investigating the impact of palliative …

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The Effect Of Two Modes Of Aerobic Assessment On Fifth Grade Students' Self Efficacy, Debra Roth Jan 2017

The Effect Of Two Modes Of Aerobic Assessment On Fifth Grade Students' Self Efficacy, Debra Roth

Walden Dissertations and Doctoral Studies

Declining youth physical activity levels and lack of aerobic fitness have been well documented with a corresponding rise in obesity levels and health issues. Based on Bandura's social cognitive theory, healthy physical activity levels and aerobic fitness are strongly connected to positive physical activity self-efficacy beliefs. This study examined whether student physical activity self-efficacy, motivation, and effort were different for the FitnessGram-® (FG) 1-Mile Run when compared to the 15-minute Aerobic Assessment Based on Improvement (AABI). A concurrent mixed method quasi-experimental approach measured 5th grade students' physical activity self-efficacy beliefs through a pretest and posttest survey while aerobic assessment scores …

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Predicting Weight Management Advice Behavior Using Social Cognitive Theory Among Psychiatry Professionals, Chidi Chima Jan 2017

Predicting Weight Management Advice Behavior Using Social Cognitive Theory Among Psychiatry Professionals, Chidi Chima

Walden Dissertations and Doctoral Studies

Obesity remains a public health concern among persons with mental illness resulting from the interaction of a combination of factors such as genetic, medication, effects of their symptoms, social, and environmental factors. Obesity complications account for increased mortality and morbidity, reduced life expectancy, and quality of life in persons with mental illness. The management of obesity is challenging and predicting the ability of mental health professionals to advise patients on weight management behavior is important to improve patients' overall well-being. The social cognitive theory constructs knowledge, expectations, situational perception, self-efficacy, and goal setting were utilized in predicting Weight Management Advice …

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Nutrition Services, Viral Suppression, Cd4, And Retention In Ryan White Program Participants, Theresa Jumento Jan 2017

Nutrition Services, Viral Suppression, Cd4, And Retention In Ryan White Program Participants, Theresa Jumento

Walden Dissertations and Doctoral Studies

The Ryan White HIV/AIDS Program (RWHAP) provides HIV-related medical and support services for uninsured and underinsured people living with HIV (PLWH) in the United States. In addition to HIV-related medical care, the program provides medical nutrition therapy and food assistance. The role of nutrition in the health of PLWH is well-documented, especially in resource poor areas; however, the role of medical nutrition therapy and food assistance provided through the RWHAP in resource rich areas is not well documented. This study addressed the association between the nutrition services of food assistance and medical nutrition therapy and the HIV-related health outcomes of …

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Impacts Of Observing Live Open Heart Surgery On Young Adults' Health Behaviors, Muhammad Musa Qarizadah Jan 2017

Impacts Of Observing Live Open Heart Surgery On Young Adults' Health Behaviors, Muhammad Musa Qarizadah

Walden Dissertations and Doctoral Studies

Having a heart healthy lifestyle at a younger age is beneficial in reducing the risk of coronary heart disease (CHD) in adulthood and various health education programs for CHD prevention exist to persuade young adults to adopt a heart healthy lifestyle. Little is known, however, about the influence of watching live open heart surgery on young adults' adoption of a heart healthy lifestyle. To address that gap in knowledge, this study was conducted at a health facility in Virginia where students came to observe live open heart surgery. The purpose of the study was to understand whether watching live open …

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Perceptions Of Childhood Obesity Among African Americans In A Low-Income Community, Cotella Wilkes Wilkes Jan 2017

Perceptions Of Childhood Obesity Among African Americans In A Low-Income Community, Cotella Wilkes Wilkes

Walden Dissertations and Doctoral Studies

Childhood obesity is a prevalent chronic condition affecting millions of children and adolescents in the United States and is rising in record-breaking numbers among African Americans in low-income communities. Guided by the social cognitive theory, the purpose of this evidence-based project was to understand the impact of an educational intervention on parents' perceptions of childhood obesity risk factors, weight status, and prevention strategies in a rural South Carolina community. A convenience sample of parents who attended a church-based community health promotion service in a low-income area (n = 10), aged 28 to 54, completed The Childhood Obesity Perceptions survey before …

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Parental Self-Efficacy, Feeding Practices And Styles, And Obesity In Mexican American Children, Maria Carmen Goodwin Jan 2017

Parental Self-Efficacy, Feeding Practices And Styles, And Obesity In Mexican American Children, Maria Carmen Goodwin

Walden Dissertations and Doctoral Studies

Childhood obesity rates among Mexican Americans have risen along with the concerns of public health professionals. The purpose of this cross-sectional study, based on social cognitive theory, was to investigate the relationships among parental self-efficacy, parental feeding practices and styles, and childhood obesity, as measured by the parental perception of child weight, among Mexican Americans in Texas. Mothers and fathers (n=83; 33 males, 64 females), with at least 1 child between 8 and10 years, formed the sample. Relationships were assessed using the Tool to Measure Parenting Self-Efficacy questionnaire, the Parental Feeding Practices Questionnaire for Mexican American parents, the Parenting Dimensions …

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Nonresidential Fathers Parenting Their Children Residing In Shelters: A Phenomenological Study, Karen Denise Hudson Jan 2017

Nonresidential Fathers Parenting Their Children Residing In Shelters: A Phenomenological Study, Karen Denise Hudson

Walden Dissertations and Doctoral Studies

This phenomenological qualitative study explored the parenting role of nonresidential fathers of children living in shelters. Special attention was paid to the perceived contributions of these fathers to the overall health and general well-being of their children residing in shelters. Often separations of nonresidential fathers from their children in shelters decreased their contributions to their children's health and well-being. Increased knowledge of these parental roles and contributions can enhance programs and policies to support these fathers in improving the health and well-being of their children. In-depth semistructured interviews were conducted with 6 demographically diverse nonresidential fathers living in Philadelphia. The …

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Determinants Of Switching From Peritoneal To Hemodialysis In Preserving Residual Renal Function, Mohamed Katerji Jan 2017

Determinants Of Switching From Peritoneal To Hemodialysis In Preserving Residual Renal Function, Mohamed Katerji

Walden Dissertations and Doctoral Studies

There are more than 2 million end stage renal disease (ESRD) patients in the world. ESRD is becoming more manageable with the advent of competent therapies such as peritoneal dialysis (PD) and hemodialysis (HD). While recent evidence suggests that switching from PD to HD may preserve residual renal function longer than either PD or HD alone as an alternative approach, little is known about the optimal timing and the long-term efficacy of switching dialysis modes. The purpose of this quantitative retrospective study, based on the bio-psychosocial model, was to investigate the optimal timing and determinants of the effectiveness of switching …

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Impact Of Plans, Finance, And Zoning Policies On What Developers Choose To Build, Michele Ann Williams Jan 2017

Impact Of Plans, Finance, And Zoning Policies On What Developers Choose To Build, Michele Ann Williams

Walden Dissertations and Doctoral Studies

While there is considerable academic research on the intersection of comprehensive plans, finance policies, zoning policies and how these factors influence real estate developers' choice of what land to develop and what buildings to construct on that land, little is understood about whether these three variables promote or hinder real estate developers' choice of whether to build communities that promote healthy living. Using urban planning theory as the foundation, the purpose of this correlational study was to determine how real estate developers' decisions are made to support healthy New Urbanism development in the United States. Secondary data from the Urban …

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Impact Of Adverse Childhood Experiences On Maternal Health And Birth Weight In Appalachia, Kristen Baker Dickerson Jan 2017

Impact Of Adverse Childhood Experiences On Maternal Health And Birth Weight In Appalachia, Kristen Baker Dickerson

Walden Dissertations and Doctoral Studies

Adverse birth outcomes and adverse childhood experiences (ACE) are concerns in the United States, with potential to impact health indices now and in the future. The purpose of this study was to quantitatively examine the association between maternal exposure to ACE, low birth weight, and county of residence in the Appalachian population using the Life Course Approach as the theoretical framework. A cross-sectional study design and clustering strategy was used to randomly select potential respondents from a data set that was provided by Ohio Department of Health. Self-administered questionnaires were sent to potential respondents to collect information about ACE in …

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Night Shift Work And Weight Gain Among Female Filipino Nurses, Raymundo Mintac Apellido Jan 2017

Night Shift Work And Weight Gain Among Female Filipino Nurses, Raymundo Mintac Apellido

Walden Dissertations and Doctoral Studies

The research problem is the increasing numbers of overweight and obese nurses working the night shift. Study on overweight and obesity among female Filipino nurses has not been conducted. It was important to conduct a research study among female Filipino nurses to find out if there are statistically significant associations between night shift work and weight gain. The purpose of this correlational and cross-sectional study was to determine if there are statistically significant associations between insufficient sleep, abnormal eating patterns, working 12-hour shifts, years of working night shift, age, stress, marital status, nursing units, decreased physical activity, and level of …

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Health Portal Functionality And The Use Of Patient-Centered Technology, Anita Joyce Simmons Jan 2017

Health Portal Functionality And The Use Of Patient-Centered Technology, Anita Joyce Simmons

Walden Dissertations and Doctoral Studies

Health portals are dedicated web pages for medical practices to provide patients access to their electronic health records. The problem identified in this quality improvement project was that the health portal in the urgent care setting had not been available to staff nor patients. To provide leadership with information related to opening the portal, the first purpose of the project was to assess staff and patients' perceived use, ease of use, attitude toward using, and intention to use the portal. The second purpose was to evaluate the portal education materials for the top 5 urgent care diagnoses: diabetes, hypertension, asthma, …

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Hiv Testing Practices And Provider-Identified Barriers In The Acute Care Setting, Alex Ariri Jan 2017

Hiv Testing Practices And Provider-Identified Barriers In The Acute Care Setting, Alex Ariri

Walden Dissertations and Doctoral Studies

Despite the Centers for Disease Control and Prevention recommendations to test patients ages 13 to 64 years for HIV at health care settings, routine HIV testing is lacking. As a result, many people are unaware of their HIV seropositive status. The purpose of this quantitative cross-sectional study was to examine relationships between HIV testing and provider type, knowledge, attitudes, and behaviors regarding HIV testing in the acute care setting. The study was informed by social cognitive theory. Using a convenient sampling method, a questionnaire derived from previous surveys (Society of General Internal Medicine and University of Washington) was sent to …

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Influences Of Provider-Patient Communication On Health Literacy And Public Policy Relevant Outcomes, Rachel Carla Cartwright-Vanzant Jan 2017

Influences Of Provider-Patient Communication On Health Literacy And Public Policy Relevant Outcomes, Rachel Carla Cartwright-Vanzant

Walden Dissertations and Doctoral Studies

Several artifacts of federal policy address the connection between health literacy of patients and health outcomes. These laws include The Plain Writing Act, Health Information Technology for Economic and Clinical Health, and the Health Insurance Portability and Accountability Act. Even with this policy structure, little is known about how nurses' knowledge of health literacy may influence patient understanding of medical information and health outcomes. Using Knowles' principles of effective communication, the purpose of this mixed-methods study was to concurrently examine the relationship between nurse knowledge of health literacy and communication techniques used by nurses to identify any causal relationships in …

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Arizona's Mentally Ill And Their Use Of The Emergency Department, Charlalynn Harris Jan 2017

Arizona's Mentally Ill And Their Use Of The Emergency Department, Charlalynn Harris

Walden Dissertations and Doctoral Studies

Emergency departments (ED) are an integral component of the United States' health care system. The underlying factors related to ED use among Arizona's mentally ill are not fully understood and the patterns necessary to classify patients as frequent users have not been examined. The purpose of this study was to increase the understanding of frequent users and further examine the conditions by which they present to the ED. The theoretical foundation for this study was the fourth version of Andersen's behavioral model (1995) and this model's use to frame this study allowed for an objective analysis of ED use among …

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School Nurses' Role In The Management Of Children With Type 2 Diabetes, Rosaline Jane Martinez-Culpepper Jan 2017

School Nurses' Role In The Management Of Children With Type 2 Diabetes, Rosaline Jane Martinez-Culpepper

Walden Dissertations and Doctoral Studies

An estimated 215,000 children and adolescents younger than 20 years old were diagnosed with Type 1 or Type 2 diabetes in 2011. Management of children with Type 2 diabetes requires 24-hour care provided by health care providers, parents, and school nurses. Guided by the health belief model (HBM), the purpose of this qualitative case study was to explore and describe beliefs, attitudes, and practices of school nurses who manage children with Type 2 diabetes. A pilot study with 2 nurses was conducted to finalize interview guide. Volunteer school nurses were recruited through an e-mail announcement from their school district. Face-to-face, …

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Health Disparity In Preventive Care Among Nigerian Immigrants In The United States, Loveday E. Nwobilor Jan 2017

Health Disparity In Preventive Care Among Nigerian Immigrants In The United States, Loveday E. Nwobilor

Walden Dissertations and Doctoral Studies

The roles of immigration status in preventive health care services among Nigerian immigrants in the United States were investigated in this quantitative, cross-sectional survey study. About 260,724 Nigerian immigrants reside in the Unites States, but many do not complete lifesaving preventive health services such as immunization and screening, a major factor contributing to the rise in the cost of healthcare resultant from their use of emergency room services. This study investigated the extent to which immigration status independently explains the relationship between health disparities and risks in non-completion of preventive health care among Nigerian immigrants in the United States by …

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African American Pastors' Perspectives On Health Promotion Ministries, Brenda Ivy Watson Jan 2017

African American Pastors' Perspectives On Health Promotion Ministries, Brenda Ivy Watson

Walden Dissertations and Doctoral Studies

The centrality of the church in African American communities makes it a culturally compelling sponsor for health promotion activities targeting health disparities among the medically underserved. Pastoral support is critical in determining whether a church initiates or supports a health promotion agenda, but there is little understanding of the variables that influence this decision. The aim of the qualitative study was to investigate the perceptions of African American pastors regarding the decision to incorporate health promotion programs in their churches. This study was guided by the health belief model using a phenomenological approach. Data were collected using both semi-structured and …

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Assessment Of Postoperative And Postdischarge Wound Infection After Abdominal Hysterectomy, Jinni J. Amin Jan 2017

Assessment Of Postoperative And Postdischarge Wound Infection After Abdominal Hysterectomy, Jinni J. Amin

Walden Dissertations and Doctoral Studies

Surgical site infection (SSI) is the most common healthcare-associated infection. Approximately 2% to 14% of surgical patients are diagnosed with SSI, which may extend length of stay in the hospital or lead to readmission and may necessitate another surgical procedure. Patient readmission due to SSI costs health care industries about $3,000 to $29,000 per case and a total of $10 billion per year. The purpose of this quantitative cross-sectional retrospective study was to examine the association between SSI and teaching status, hospital ownership, and number of beds in the hospital. The epidemiological triad was used as a framework to describe …

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