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Using An Apn-Led Transitional Care Program To Reduce 30-Day Hospital Readmissions, Miaozhen Li

Walden Dissertations and Doctoral Studies

Heart failure (HF) is a serious public health problem associated with high mortality rates, hospital readmissions, and health care costs. Transitional care has emerged as a disease management model used to reduce readmissions for hospital-discharged patients with HF. However, the efficacy of an advanced practice nurse (APN)-led transitional care program (TCP) in readmission reduction is under debate. The practice question for this project examined the extent to which an APN-led TCP was effective in reducing 30-day all-cause readmissions for hospital-discharged HF patients. The logic model was the framework guiding this program evaluation. An analysis of quality improvement HF data from …

Assessing For Awareness And Knowledge Regarding Diabetes In Pre-Diabetes Obese Patients, Remona Lysa Brown

Walden Dissertations and Doctoral Studies

Over the past few decades, there has been an increase in prevalence of diabetes in the United States. Prevention of diabetes and improving patients' knowledge and awareness of diabetes are crucial for healthcare providers. Using the Health Belief Model (HBM) as a theoretical foundation, the student used the National Diabetes Prevention Program (NDPP) from the Centers for Disease Control and Prevention (CDC), to improve awareness and knowledge of diabetes among obese individuals with prediabetes. The key research question of this project was to determine whether the patients' diabetes knowledge and awareness improved after the NDPP program. A convenience sample of …

Culturally Competent Nutrition Counseling And Health Outcomes Of Patients On Emergency Dialysis, Edlyn Geraldine Bustamante

Walden Dissertations and Doctoral Studies

Undocumented end stage renal disease (ESRD) patients in the United States only have access to emergency dialysis. To compensate for the lack of regular dialysis these patients must follow strict renal dietary restrictions. However, nutrition counseling by a dietitian is not part of the renal management of patients on emergency dialysis. The purpose of this quantitative quasi-experimental treatment-control study was to assess how the application of nutritional counseling that is both culturally and linguistically competent affects dialysis frequency and biochemical lab values such as serum potassium, phosphorus, and vitamin D of patients in emergency dialysis. The study was grounded on …

Knowledge Of Malaria Infection And Treatment-Seeking Behavior Among Tanzanian Pregnant Women, Emebet T. Derjew

Walden Dissertations and Doctoral Studies

Despite the availability of effective drugs to prevent malaria during pregnancy using intermittent preventive treatment with Sulfadoxine-Pyrimethamine or Fansidar and insecticide bed net, use of these methods are still little used in Sub-Saharan Africa, including Tanzania. As a result, many pregnant women are at risk of malaria consequences such as maternal anemia and low birth weight babies, which increase the rate of infant mortality. Data from the Demographic Health Survey for Tanzania HIV/AIDs and the Malaria Indicator Survey 2011-2012 were used in a cross-sectional design guided by the health belief model. Logistic regression examined the association between (a) preventive treatment-seeking …

Consequences Of Community Water Fluoridation Cessation For Medicaid Eligible Children And Adolescents, Jennifer Meyer

Walden Dissertations and Doctoral Studies

Oral health impacts general health and well-being throughout the lifespan. Recent trends in the United States towards cessation of community water fluoridation (CWF) may increase disparities in oral health. The purpose of this quantitative retrospective cohort study was to analyze Medicaid dental claims records for caries related procedures among 0 to18-year-old patients during an optimal CWF year 2003 (n = 854) and compare them to claims records from 2012 (n = 1,053), 5 years after CWF was ceased. The theoretical framework of this study was the diffusion of innovations theory. Statistically significant results included higher mean number of caries related …

The Experiences Of African American Women Participating In Church-Based Weight Loss Programs, Mangle L. Shanks

Walden Dissertations and Doctoral Studies

While obesity is a nationwide phenomenon, African Americans - especially women - continue to be more severely affected than any other ethnic group. According to the Centers for Disease Control and Prevention, over 20% of African American women are obese compared to 15.6% of Caucasian women. The church is an important community center for many African Americans, and is often a site for health promotion programs, though little is known of the effectiveness of these programs. The purpose of this qualitative study was to study the experiences and attitudes of African American women who have gone through a church-based weight-loss …

Diabetes Self-Management Problems Of Older, Low-Income African American Women, Pearlean Day Day

Walden Dissertations and Doctoral Studies

Type 2 diabetes disproportionately affects low-income African American women, age 50 years and older: 30% to 40% of this population has this chronic disease. Two significant factors affecting poor diabetes practice adherence are food insecurity and depression; another is obesity. The purpose of this quantitative correlational study was to determine if either food insecurity or depression significantly affect Type 2 diabetes self-management practices; and/or if food insecurity significantly influences practice adherence indirectly, through the mediator of depression, while controlling for obesity. The research questions were aligned with the theoretical pathways posited in Matthews's reserve capacity model (RCM) and used the …

Breaking The Silence: Postpartum Depression Among Reproductive-Aged Women In Akwa Ibom State, Nigeria, Atim Henshaw

Walden Dissertations and Doctoral Studies

Postpartum depression (PPD) is internationally recognized as one of the most prevalent and severe but neglected maternal mental health complications of childbirth. Previous studies have indicated that there is a high burden of disease associated with PPD in both developed and developing countries. However, there remain gaps in the current literature regarding the recognition and management of PPD in remote parts of the developing world. Therefore, the purpose of this study was to understand the perceptions, attitudes, and beliefs of health professionals towards PPD and examine the factors that either facilitated or hindered its recognition and management in a remote …

Barriers To Preventive Healthcare For Immigrants In Michigan, Sondos Ghazi Al-Hachim

Walden Dissertations and Doctoral Studies

The Affordable Care Act expanded insurance coverage to the general population; however, expanding insurance coverage to immigrants might not be sufficient to improve utilization of annual physical preventive exams. This study evaluated adult Michigan immigrants' individual demographics, perceptions, and behaviors, as well as the collective cultural and system characteristics that might act as barriers to the utilization of annual physical preventive exams. Ken Wilber's integral operating system model for medicine conceptual framework was used to create a comprehensive map of factors and bring more clarity and understanding to the barriers to annual physical preventive exam. The quantitative survey was the …

Hassles Of African Americans With Type 2 Diabetes, Sharon H. Murff

Walden Dissertations and Doctoral Studies

There has been a steady increase in the incidence of diabetes in the United States. The purpose of this study was to determine whether there was a difference in the daily hassles of African American adults with a self-reported diagnosis of type 2 diabetes compared to those of African American adults without a self-reported diagnosis of type 2 diabetes. The theoretical underpinning for this quantitative, descriptive study was the cognitive appraisal theory (CAT), but the concept of stress and the effects stress has on the body was the broad framework that connected all the variables. The CAT was used to …

Using Multi-Theory Model To Predict Low Salt Intake - Nigerian Adults With Hypertension, Christine Adekemi Dokun-Mowete

Walden Dissertations and Doctoral Studies

Hypertension is a chronic non-communicable disease and a major risk factor for cardiovascular diseases, renal malfunction, disability, and premature death. One of the public health recommendations for the management of hypertension is the reduction of sodium/salt intake. There is need to develop and implement new evidence-based theoretical interventions to initiate and sustain behavior change in health education and promotion. Therefore, the quantitative cross-sectional method and design was used to investigate the adequacy of multi-theory model (MTM) constructs for the initiation and the sustenance of low sodium/salt intake behavior in hypertensive Nigerian adults. In addition, the impact of the MTM (initiation) …

The Effect Of Referral Source On Patient Participation In Diabetes Education Programs, Karyn Marie Gallivan

Walden Dissertations and Doctoral Studies

The goal of diabetes education programs (DEPs) is to improve patients' pattern-management habits for those with type 2 diabetes (T2D), though participation in DEPs is lower than expected due to low physician referral rates. This retrospective study examined secondary data of 162 T2D patients who had been referred to a DEP in a community center in RI to determine whether the source of referral affected patient attendance, participation persistence, and outcomes. Self-referred (n = 62) and physician-referred (n = 100) groups were analyzed for possible associations among the aforementioned variables. Chi-square (p = .04) and logistic regression (p = .04) …

The Association Between Dietary Flavonoid Intake And Chronic Obstructive Pulmonary Disease, Systemic Inflammation, And Comorbidity Burden, Tennador Sanderson

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality in the United States. Dietary habits may have an impact on COPD through anti-inflammatory mechanisms. For this cross-sectional secondary data analysis study, the advanced model of the epidemiology triangle was used as a guide to assess the association between total daily flavonoid intake and COPD diagnosis, COPD severity, systemic inflammation, and comorbidity burden. Data from over 5,100 male and female participants aged 30 and older were obtained from the 2007-2010 National Health and Nutrition Examination Survey. The prevalence of COPD was 5.2% according to spirometry data. Multiple …

Type 2 Diabetes Mellitus And Colorectal Cancer Risk And Survival In Oman, Rose Ngozi Mafiana

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus (T2DM) and colorectal cancer (CRC) are 2 chronic diseases with common risk factors related to physical inactivity, obesity, and diet. Literature on T2DM as a risk factor for CRC development and survival in Oman is scarce. Using de-identified archival data provided by Sultan Qaboos University Hospital (SQUH) Oman, a retrospective, case-control, and time-to-event study designs were used to compare odds of developing CRC, and survival rates among adults with and without T2DM. The ecosocial theory provided the theoretical base for this research. Logistic regression was used to examine the odds of developing CRC among 114 cases …

Prevalence Of Epilepsy In China Between 1990 And 2015: A Systematic Review And Meta-Analysis, Peige Song, Yezhou Liu, Xinwei Yu, Jingjing Wu, Adrienne N. Poon, Alessandro R. Demaio, Wei Wang, Igor D. Rudan, Kityee Chan

Research outputs 2014 to 2021

Background: Epilepsy is a major neurological disorder that affects approximately 65 million people worldwide. Globally, the burden of epilepsy is not evenly distributed, with more than 80% of sufferers residing in low- and middle-income countries. This study estimates the burden of epilepsy in mainland China from 1990 to 2015 and explores the variations of burden by age and gender.

Methods: We conducted a systematic review of the peer-reviewed literature from 1990 to 2015 using Chinese and English academic databases (CNKI, WanFang, VIP and PubMed) to identify population- based prospective studies on the prevalence of epilepsy in mainland Chinese. Multilevel mixed-effects …

Over-Provision Of Discretionary Foods At Childcare Dilutes The Nutritional Quality Of Diets For Children, Ruth M. Wallace, Leesa N. Costello, Amanda Devine

Research outputs 2014 to 2021

The childcare setting can significantly influence the lifelong eating habits and health outcomes of children.It is ideal for health-promoting interventions that optimise the provision of nutritious food and nutrition education. Unfortunately, these interventions are neither offered nor promoted in many childcare settings. Recent studies have indicated an increased risk of overweight/obesity with childcare attendance, which if present in early life is associated with increased risk of chronic disease and reduced psychological wellbeing.

Reducing Acute Cardiovascular Hospitalizations With A Weight Management Program (Reach), Laura A. Graham

All ETDs from UAB

Reducing cardiovascular (CVD) risk factors such as obesity through lifestyle and behavioral interventions like weight management programs should result in better cardiovascular health. However, there is conflicting evidence on the effectiveness of these interventions in reducing long-term CVD outcomes such as acute myocardial infarction or stroke. This reflects an important gap in our understanding about factors affecting recruitment and engagement in these programs and how these factors relate to improvement in long-term cardiovascular health. To address this gap, we will use a retrospective study with up to 11 years of follow up data from the nation’s largest health care system-associated …

Alternative Methodological Approaches For Quantifying Dental Caries And Non-Water Beverage Consumptions For The Improvement Of Caries Risk Analyses In Children, Kelsey Harris Jordan

All ETDs from UAB

Researchers assume caries progress constantly, all crowned/extracted tooth surfaces are carious, and non-water beverage consumption (NWBC) habits are similar by relying on increments, dmfs scoring, and consumption frequencies, respectively. These assumptions are likely inaccurate. The purpose of this research was to evaluate and modify the use of 1) longitudinal caries disease assessment, 2) the dmfs score and 3) NWBC variables to more accurately estimate disease and identify risk factors. To investigate, young (8-18 months at baseline), healthy, poor, rural, African American, Alabamian children were observed annually for five years. Three calibrated dentists performed oral examinations (without radiographs), calculating the number …

Effective Recruiting For Subgroups In The Systolic Blood Pressure Intervention Trial (Sprint), Thomas Marshall Ramsey

All ETDs from UAB

EFFECTIVE RECRUITING FOR SUBGROUPS IN THE SYSTOLIC BLOOD PRESSURE INTERVENTION TRIAL (SPRINT) THOMAS MARSHALL RAMSEY HEALTH EDUCATION / HEALTH PROMOTION ABSTRACT Background: The Systolic Blood Pressure Intervention Trial (SPRINT) recruitment focused on participants > 50 years old with systolic blood pressure of > 140 mm Hg (hypertension) with no evidence of diabetes or previous stroke. Priority participants were targeted in non-clinical subgroups (women and minorities) as well as three clinical subgroups (pre-existing cardiovascular disease, pre-existing chronic kidney disease, > 75 years old). Objective: The objective of this secondary analysis is to determine which of the five recruiting strategies was most effective? Which recruitment …

Racial Disparities In The Maintenance Of Healthy Lifestyles And Their Effect On Cumulative Blood Pressure Burden And Left Ventricular Mass In African Americans And Whites: Data From The Coronary Artery Risk Development In Young Adults (Cardia) Study, John N. Booth

All ETDs from UAB

The prevalence of healthy behaviors associated with optimal blood pressure (BP) levels and reduced risk for target-organ damage and cardiovascular disease (CVD) is lower in blacks compared with whites. Randomized controlled trials provide evidence that if healthy behaviors are maintained over the lifespan, including normal body weight, moderate physical activity, limited alcohol intake, limited sodium intake, adequate potassium intake and a rich diet of fruits and vegetables and low in high-fat dairy and saturated and total fat, then high BP may be preventable. The goal of this dissertation was to assess racial differences in the maintenance of healthy behaviors and …

The Benefits Of A Vegetable Gardening Intervention For Cancer Survivors, Mallory Gamel Cases

All ETDs from UAB

Due to improvements in screening and treatment, the number of cancer survivors continues to increase. Cancer survivors are at increased risk for second malignancies, comorbidities, and functional decline. All three papers draw data from Harvest for Health, a 12-month home-based vegetable gardening intervention for cancer survivors. This dissertation aimed to (1) explore changes in physical functioning and physical health-related quality of life in 44 cancer survivors aged >65 years old pooled from two iterations of Harvest for Health; (2) examine predictors of continued gardening and garden expansion 12-months post-intervention; and (3) assess the capacity of sustainability of Harvest for Health …

Associations Of Food Environment, Mediterranean Diet And Obesity In United States: A Geographic Information System (Gis) Analysis, Meifang Chen

All ETDs from UAB

Given the growing obesity epidemic in the U.S., modifying current obesogenic food environment, and identifying and promoting an obesity-modifying dietary approach that fits in the food environment context are urgent. Emerging evidence indicates that Mediterranean diet (MD) could be a beneficial dietary pattern to protect against overweight/obesity. However, as a relatively new dietary pattern in the U.S., how the unique food environment influences MD adherence, and whether consuming a MD can mediate the relationship between food environment and obesity among the population remain unknown. This dissertation, applying Geographic Information System (GIS) and path analytical methods using data from the REasons …

Effect Of Antihypertensive Drugs On Left Ventricular Traits In Africam American, Anh N. Do

All ETDs from UAB

The purpose of this dissertation is to evaluate the association of antihypertensive treatment as well genomic variants with left ventricular (LV) hypertrophy (LVH) -related traits among African Americans (AAs) in five cross-sectional epidemiology cohorts from the United States. AAs especially those with hypertension, are overburdened by left ventricular (LV) hypertrophy (LVH) compared to other ethnic groups. LVH is associated with increased risk for cardiovascular morbidity and mortality. Antihypertensive treatments have been found to improve LVH and related echocardiographic measures (i.e. LV traits) among hypertensive patients. However, the effect of antihypertensive treatments on LVH and related traits in AAs has not …

Phenotypic Characteristics And Dietary Treatment Of Pediatric Non-Alcoholic Fatty Liver Disease, Shima Dowla

All ETDs from UAB

Background: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disorder among children in the developed world and can progress to cirrhosis, hepatocellular carcinoma, and liver failure. Objectives: The primary objectives of this dissertation were to (1) review advances in the field of pediatric NAFLD, (2) describe the demographic, anthropometric and metabolic characteristics of children with NAFLD and evaluate whether differences existed based on ethnicity and diagnostic method, and (3) compare the effect of a carbohydrate restricted diet vs fat reduced diet on improvement in hepatic steatosis over an 8-week period among overweight and obese children diagnosed with NAFLD. …

Controlling Brochothrix Thermosphacta As A Spoilage Risk Using In Package Atmospheric Cold Plasma, Apurva Patange, Daniela Boehm, Carmen Bueno-Ferrer, Patrick J. Cullen, Paula Bourke

Articles

Brochothrix thermosphacta is a predominant spoilage microorganism in meat and its control in processing environments is important to maintain meat product quality. Atmospheric cold plasma is of interest for control of pathogenic and spoilage microorganisms in foods. This study ascertained the potential of dielectric barrier discharge atmospheric cold plasma (DBD-ACP) for control of B. thermosphacta in response to key parameters such as treatment time, voltage level, interactions with media composition and post treatment storage conditions. Challenge populations were evaluated as suspensions in PBS, as biofilms in meat model medium and surface attached on raw lamb chops under MAP.

ACP treatment …

Influence Of Maternal Breast Milk Ingestion On Acquisition Of The Intestinal Microbiome In Preterm Infants, Katherine E Gregory, Buck S Samuel, Pearl Houghteling, Guru Shan, Frederick M Ausubel, Ruslan I Sadreyev, W Allan Walker

Faculty, Staff and Students Publications

BACKGROUND: The initial acquisition and early development of the intestinal microbiome during infancy are important to human health across the lifespan. Mode of birth, antibiotic administration, environment of care, and nutrition have all been shown to play a role in the assembly of the intestinal microbiome during early life. For preterm infants, who are disproportionately at risk of inflammatory intestinal disease (i.e., necrotizing enterocolitis), a unique set of clinical factors influence the establishment of the microbiome. The purpose of this study was to establish the influence of nutritional exposures on the intestinal microbiome in a cohort of preterm infants early …

Connecting Culturally And Spiritually To Healthy Eating: A Community Assessment With Native Hawaiians, Mary Frances Oneha, Joan Dodgson, Mabel Ho`Oipo Decambra, Carol Titcomb, Rachelle Enos, Sandie Morimoto-Ching

Asian/Pacific Island Nursing Journal

Many of the chronic illnesses disproportionately experienced by Native Hawaiians are directly related to poor diets and long-standing obesity beginning in childhood. We report on the findings of in-depth key informant interviews (N = 14) that took place in two Native Hawaiian communities as part of a larger, community-based participatory research study that included a community assessment through individual interviews and focused group discussions, and a pilot intervention targeting pregnant women, their infants, and families. Four categories emerged from the qualitative analysis of interview transcripts that described an understanding of “healthy eating”: family roles and responsibilities, aspects of community …

Characteristics Of Medication Advertisements Found In Us Women’S Fashion Magazines, Jennifer Mongiovi, Grace Clarke Hillyer, Corey H. Basch, Danna Ethan, Rodney Hammond

Publications and Research

Background: Although prescriptions are dispensed at discretion of medical professionals, many pharmaceutical companies use direct-to-consumer (DTC) advertising to increase sales. Over-the- counter (OTC) medications are similarly marketed.

Methods: We examined the content of advertisements in 38 issues of 9 popular US women’s fashion magazines. We evaluated target audience, health condition, product availability, message appeal, target to females, and mention of potential side effects and benefits.

Results: Sixty total medication advertisements were identified, 58.3% (95% CI: 45.8, 70.8) for prescription products. In magazines targeted to non-Hispanic Whites, >65% of advertisements were for OTC medications whereas 80% (95% CI: 66.7, 94.5) of …

Tobacco Use, Cessation, And Locus Of Control Among College Students, Bernard Ambe

Electronic Theses and Dissertations

ABSTRACT

The purpose of this study was to (a) determine the locus of control among American college students (b) determine if tobacco use or cessation correlate with any demographic variables to better understand the efficacy of tobacco interventions and help design an intervention most effective in the prominent LOC of college students.

The Global Adult Tobacco Survey (GATS) was modified for the purposes of this study and used to determine demographic factors and tobacco usage status. The modified GATS survey also included the LOC questionnaire which yielded the data. Seventy-four responses were recorded. The mean locus of control scores were …

Burden Of Disease Associated With Lower Levels Of Income Among Us Adults Aged 65 And Older, Erica I. Lubetkin, Haomia Jia

Publications and Research

Background: Persons aged 65 years and older represent a heterogeneous group whose prevalence in the USA is expected to markedly increase. Few investigations have examined the total burden of disease attributable to lower levels of income in a single number that accounts for morbidity and mortality.

Methods: We ascertained respondents’ health-related quality of life (HRQOL) scores and mortality status from the 2003 to 2004, 2005 to 2006, 2007 to 2008 and 2009 to 2010 cohorts of the National Health and Nutrition Examination Survey (NHANES) with mortality follow-up through 31 December 2011. A mapping algorithm based on respondents’ age and answers …