Digital Commons Network^™

Best Practices For Controlling Tuberculosis - Training In Correctional Facilities: A Mixed Methods Evaluation, Ellen Reynolds Murray

Walden Dissertations and Doctoral Studies

According to the literature, identifying and treating tuberculosis (TB) in correctional facilities have been problematic for the inmates and also for the communities into which inmates are released. The importance of training those who can identify this disease early into incarceration is vital to halt the transmission. Although some training has been done by public health authorities for corrections, there is little to no evaluation of such training. The aim of this mixed methods retrospective study was to evaluate the effectiveness of a training to control TB in correctional facilities. The Southeastern National Tuberculosis Center (SNTC) conducted 12 trainings between …

Perceptions Of Behavioral And Lifestyle Changes Among African American Women With Type 2 Diabetes, Myriam Almonor

Walden Dissertations and Doctoral Studies

The prevalence of type 2 diabetes (T2D) continues to rise and is predicted to increase to 30 million people by 2030 in the United Sates alone. African Americans (AA) have one of the highest prevalence rates of T2D among all ethnic groups. African American Women (AAW) are 100% more likely to develop T2D compared with their white counterparts. The aim of this study was to quantitatively investigate the relationship of the perceptions of AAW not previously identified that could lead to a reduction in risk of T2D among AAW. A cross-sectional study of 183 AAW 20 to 65 years old …

Perceptions Of Infertility Among Arab Women In The U.S, Zena Hamdan

Walden Dissertations and Doctoral Studies

Infertility is a serious public health issue. Infertile couples may perceive infertility differently based on their own cultural background. There is a paucity of literature about how infertility is perceived among Arab women living in the United States. The purpose of this study was to be able to understand how Arab women who live in Dearborn, Michigan feel about infertility and to understand their concerns and worries about their health status. The primary research questions asked Arab women how they perceive infertility and how infertility may impact their future. This qualitative case study was guided by the social support theory …

Association Between Biopsychosocial Factors And Physical Activity Among U.S. Stroke Survivors, Claire Johnson

Walden Dissertations and Doctoral Studies

Stroke causes substantial morbidity and mortality, and physical activity can reduce the risk of stroke occurrence. The purpose of this study was to test the association between biopsychosocial factors and levels of physical activity and to develop a model to predict inactivity for US stroke survivors. A quantitative, cross-sectional analysis was performed of the 2013 National Health Interview Survey (NHIS), which is a representative sample of US households. Association for 1,077 stroke survivors was tested with chi-square between physical activity and independent variables: biological factors (age, sex, race, body mass index, musculoskeletal conditions, and cardiovascular diseases), psychological factors (mental distress, …

Barriers To Breast Cancer Prevention And Screening Among African American Women, Abosede Francisca Obikunle

Walden Dissertations and Doctoral Studies

Breast cancer is a serious illness that often has fatal consequences. Adherence to the recommendations for breast cancer surveillance is poorly practiced among African American women. The purpose of this phenomenological study was to seek individual professed barriers to breast cancer screening among African American women to better understand why breast cancer continues to be one of the principal basis of mortality among African American women. The theoretical framework for this study was the behavioral model of health services use. Purposeful selection was used to invite 14 African American women to participate in the in-depth interview process. Interview data were …

An Ecological Approach To African American Adolescent Food Choices In Low Income Neighborhoods, Clarence E. Mcmillan

Walden Dissertations and Doctoral Studies

Childhood obesity remains prevalent among African American (AA) adolescents in low income neighborhoods with limited access to a variety of foods from stores. Guided by the ecological framework, the purpose of this study was to examine the impact of neighborhood stores on food choices, and physical activity among AA adolescents in a low income neighborhood. A quantitative research design with cross sectional primary and secondary surveys was used. Participants included 176 high school students and 42 store merchants. Data sources were the 2011 New Jersey Student Health Survey with core questions from the Youth Risk Behavior Survey and the Hmong …

Use Of Maternal Health Services And Pregnancy Outcomes In Nigeria, Abubakar Sadiq Umar

Walden Dissertations and Doctoral Studies

Maternal health services (MHS) provide primary, secondary, and tertiary levels of prevention to achieve better pregnancy outcomes. However, use of prenatal and natal services among Nigerian women has been ranked among the lowest in the world and, consequently, the country is among the 10 countries with the highest maternal mortality ratio. Moreover, nationwide community-based studies on the use of maternal health services in Nigeria are limited. To address this gap, this quantitative, cross-sectional study analyzed the 2008 Nigerian Demographic and Health Survey (NDHS) data to identify whether Nigerian women's biological, cultural, and socioeconomic characteristics are associated with their use of …

Risk Of Maternal Smoking On Breastfed Infants And The Development Of Otitis Media, Judith C. Ogbonna

Walden Dissertations and Doctoral Studies

Despite advances in health promotion through efforts to reduce tobacco smoking, tobacco-related health conditions have continued to be significant. Exposure to secondhand smoke has been identified as a health risk also in addition to infant health risks related to maternal smoking. In contrast, breastfeeding has been found to promote infant health and is strongly encouraged. Despite literature supporting both of these statements, the combined effects of both breastfeeding and maternal smoking on infant wellbeing have not been delineated. Otitis media represents a common health problem among infants and young children. Tobacco exposure has been shown to increase its incidence while …

Effects Of Social Support On Cardiac Recurrence Among African Americans, Yolanda Phillips

Walden Dissertations and Doctoral Studies

Heart disease is the leading cause of death among African Americans. Despite advances in treatment modalities, based on better understanding of the disease's pathology and access to health care, African Americans continue to die from heart disease at rates significantly higher than other races. The available literature on cardiovascular disease among African Americans does not adequately explore how social support affects heart health in this group. The purpose of this study was to examine the effects of social support on cardiac recurrence among African American adults. Cohen's ISEL support system variables: tangible, appraisal, belonging, and self-esteem; and five demographic variables: …

The Underuse Of Hospice Care In The African American Military Beneficiary Population, Wanda Castleberry Richards

Walden Dissertations and Doctoral Studies

Hospice services provide a holistic approach to end-of-life care to terminally ill patients though there is some evidence to suggest that African American military beneficiary populations may not access hospice care as often as expected. The purpose of this nonexperimental study was to evaluate reasons for the low use of hospice care among the terminally diagnosed members of this population, between the ages of 18 and 64. Kolcaba's comfort theory provided the theoretical framework for this study. The research explored whether a statistically significant difference exist among African Americans military beneficiaries population as compared to non-Hispanic Whites pertaining to their …

Wellness Intervention As A Quality Of Life Predictor In Mentally Ill Veterans, Tosha Lashon Ellis

Walden Dissertations and Doctoral Studies

Veterans with serious mental illness (SMI) are at high risk of developing conditions such as insulin resistance, obesity, and smoking, which may lead to chronic medical problems. As a result, the morbidity and mortality of people with SMI are high compared to the general population. It appears that integrated care improves the wellbeing of veterans; however, there is a gap in the literature on wellness-based interventions for veterans with SMI. The purpose of this cross-sectional study was to evaluate the association between a wellness intervention for veterans and their perceived quality of life (QOL). Social cognitive theory was the theoretical …

Heroes Or Victims: The Lived Experiences Of Women On Female Genital Mutilation/Cutting In Northwestern Nigeria, Sarah Kasham Philips

Walden Dissertations and Doctoral Studies

The custom of female genital mutilation/cutting (FGM/C) is a traditional practice inimical to women's health with profound implications. There is a gap in the literature on the lived experiences of women who have undergone FGM/C and their statuses within their communities. Guided by the social cognitive theory and the ecological model, this qualitative study aimed at explicating the attitudes and perceptions of women in the northwest region of Nigeria towards the practice of FGM/C, to illuminate how the women view themselves in their society and the inspiration for the continued practice of FGM/C. Interview and observation data were gathered from …

Environmental Factors Associated With Body Mass Index Among Long Haul Truck Drivers, Charlotte Hughes Huntley

Walden Dissertations and Doctoral Studies

In 2009–2010, the prevalence of obesity among U.S. adults was 40%, and the prevalence was 69% among long haul truck drivers. Researchers have not established a clear relationship between working environment and weight among truck drivers. This quantitative cross-sectional study, using an ecological framework, evaluated the relationship between the working environment (sleep performance, food choices, driving environment, and activity level) and weight severity (e.g., body mass index [BMI]) among long haul truck drivers. One hundred and twenty six adults (46 + 10, years of age), including both genders (male = 97 and females = 29) completed an online questionnaire evaluating …

Correlates Of Influenza Vaccination Uptake Among Older Adults, Cheryl Hilliman

Walden Dissertations and Doctoral Studies

Seasonal influenza is associated with signiï¬?cant morbidity and mortality among older adults, aged 65 and older. Since vaccination is the single most effective preventive measure against seasonal influenza, clinicians and senior citizen center administrators need a better understanding of the perceptions of older adults concerning the reason for poor influenza vaccine uptake. The purpose of this study was to identify perceived factors that may be associated with poor influenza vaccination uptake among older adults. The health belief model (HBM) guided the study. The research questions examined perceptions predicting the odds of influenza vaccination uptake among older adults. This quantitative cross-sectional …

Emergency Room Utilization Of Participants With Mental Health Conditions Enrolled In Health Home Services, Amanda Duff

Walden Dissertations and Doctoral Studies

Large numbers of individuals utilize the ER each year for mental health reasons. The health home agency in this study was designed under the Affordable Care Act with the intention of increasing patient self-management thus decreasing high-cost service utilization. The effectiveness of health homes in reducing mental health-related ER visits has remained unexplored. In this study, the relationship between participation in this program and ER utilization was examined, using the theoretical framework of the Health Belief Model. The sample of 128 health home participants with documented mental health conditions was selected using systematic random sampling. A one-way, repeated-measures t-test and …

Neoliberalism Redux: The Global Health Policy Agenda And The Politics Of Cooptation In Latin America And Beyond, Anne E Birn, Laura Nervi, Carlos Eduardo Siqueira

Gastón Institute Publications

This article explores the neoliberal cooptation of social justice-oriented global health policies over the last three decades, from primary health care and ‘health for all’ to various contemporary so-called ‘health equity’ initiatives, such as Universal Health Coverage and ‘health convergence’. The authors illustrate and contextualize the different periods and approaches with examples from a range of Latin American countries, drawing on diverse political experiences and social struggles in the health arena. The analysis concludes with reflections about the region’s experiences of resisting and challenging the neoliberal health agenda, in spite of domestic and global environments that have constrained these efforts, …

Motivating Parents Of Kids With Asthma To Quit Smoking: The Effect Of The Teachable Moment And Increasing Intervention Intensity Using A Longitudinal Randomized Trial Design, Belinda Borrelli, Erin M. Tooley

Arts & Sciences Faculty Publications

Aims—We tested two aims: 1) The Teachable Moment (TM): whether second hand smoke exposure (SHSe) feedback motivates cessation in parents of children with asthma vs. parents of healthy children (HC) and 2) whether greater intervention intensity (Enhanced-PAM) produces greater cessation than a previously tested intervention (Precaution Adoption Model; PAM).

Design and interventions—Aim 1: Two home visits (asthma education or child wellness), and cessation induction using Motivational Interviewing and SHSe feedback. Aim 2: Post home-visits, parents with asthmatic children were randomized to PAM (n=171; 6 asthma education calls) or Enhanced-PAM (n=170; 6 asthma education/smoking cessation calls + repeat SHSe …

Social Determinants Of Maternal And Child Undernutrition In Cambodia: A Systematic Review, Pheak Chhoun, Khuondyla Pal, Sreymom Oy, Candice Collins, Sovannary Tuot, Siyan Yi

Background: Maternal and child undernutrition is one of the major contributors to the increasing of overall disease burden and mortality in the globe and Cambodia. Therefore, a systematic literature review was conducted to identify social determinants of maternal and child undernutrition in Cambodia.

Methods: Systematic literature search was performed through journal databases including ProQuest Central, Scopus, PubMed, Medline (Ovid), Google scholar, and World Health Organization Statistical Information System (WHOSIS). Keywords were used to search for literature in English published from 2003 to 2015. Content analysis was conducted among final selected papers.

Results: In total, 25 articles met …

Hepatitis C Virus In Mexican Americans: A Population-Based Study Reveals Relatively High Prevalence And Negative Association With Diabetes, Gordon P. Watt, Kristina Vatcheva, Laura Beretta, Jen-Jung Pan, Michael Fallon, Joseph B. Mccormick, Susan P. Fisher-Hoch

School of Mathematical & Statistical Sciences Faculty Publications

This study aimed to estimate the prevalence and risk factors for hepatitis C virus (HCV) infection in Mexican Americans living in South Texas. We tested plasma for the presence of HCV antibody from the Cameron County Hispanic Cohort (CCHC), a randomized, population-based cohort in an economically disadvantaged Mexican American community on the United States/Mexico border with high rates of chronic disease. A weighted prevalence of HCV antibody of 2·3% [n = 1131, 95% confidence interval (CI) 1·2-3·4] was found. Participants with diabetes had low rates of HCV antibody (0·4%, 95% CI 0·0-0·9) and logistic regression revealed a statistically significant negative …

Resolving The Policy Paradox: The Case Of Biofuel Production In Ireland, Alan Gilmer, Mark J. Mcgarrity, Vivienne Byers

Articles

Purpose – The purpose of this paper is to determine the status of policy design and policy implementation in the biofuel sector in Ireland. The focus of the work addresses the overarching operational context of the biofuel sector in Ireland and the role of different actors in shaping and resolving inconsistencies in policy outlook and practice. Design/methodology/approach – This study used a qualitative research approach involving a series of semi-structured interviews with members of the relevant sub-groups concerned. This study sought to address two questions – whether current or proposed policy is likely to affect consumption of indigenous biofuel feedstocks …

The National Exercise Referral Framework, Catherine B. Woods, Noel Mccaffrey, Brona Furlong, Lorraine Fitzsimons D'Arcy, Maire Murphy, Michael Harrison, Liam Glynn, John O'Riordan, Biddy O'Neill, Sinead Jennings, Caroline Peppard

Reports

A 2013 Review of the HSE funded GP Exercise Referral Programme (GPERP) highlighted the need for a new National Exercise Referral Framework (NERF). The evidence suggests that exercise referral is an effective targeted health intervention for specific patients and with the increasing prevalence of chronic disease it is imperative that we examine, design and progress the implementation of scalable, sustainable evidence-based, interventions, integrated across the health system to improve the health and wellbeing of the population. The development of this proposed National Exercise Referral Framework, commissioned by Health Promotion and Improvement, was led by DCU involving a multi-disciplinary Working Group …

Supporting Nutrition For Australian Childcare (Snac): The Development, Implementation And Evaluation Of An Online Nutrition Education Intervention, Ruth Wallace

Theses: Doctorates and Masters

The provision of a nutritious diet in a child’s early years can have an immense effect on their future health and wellbeing. Due to the increasing number of children attending child care, this setting is strategically placed for teaching children important food literacy skills and establishing positive eating habits, which remain through to adulthood. However, food served in child care facilities is often not of the best nutritional quality (Zuercher, Grace, & Kranz, 2011) and there is lack of positive role modelling among staff. Both of these factors pose obstacles to a health-promoting environment for the children who attend.

The …

Physical Activity: Like Mother, Like Daughter?, Suzanne M. Keep

Michigan Journal of Public Health

Physical inactivity is a leading cause of death in the United States (U.S.), and is a public health priority. The majority of individuals do not engage in regular physical activity (PA). Hispanics have the highest inactivity rates (51.3%) in the U.S. (HealthyPeople.gov, 2012). This paper reports a gap in knowledge concerning factors that affect PA. Data was collected in Kent and Ottawa counties in Michigan, with Hispanic mothers (N=79) and their daughters (N=79). This study supports the relationship among societal norms, exercise self-efficacy and activity related affect, on commitment to a plan of PA. Theorized relationships appear to be more …

Health And Socio-Economic Impacts Of Livelihoods Programs Among People Living With Hiv In Cambodia: A Case-Control Study, Sovannary Tuot, Kouland Thin, Mayumi Shimizu, Samedy Suong, Samithrea Sron, Pheak Chhoun, Siyan Yi

Background: In Cambodia, the circumstances surrounding people living with HIV (PLHIV) remain serious conditions. To ameliorate these situations, KHANA has implemented livelihoods programs since 2010, including village saving and loans (VSL), skill trainings, and cash grants with on-going technical support. This study aims to evaluate the impacts of the programs in improving socio-economic conditions, health, and psychological well-being of PLHIV in Cambodia. Methods: In August 2014, a case-control study was conducted in six selected provinces. The cases were defined as PLHIV who lived in the selected operational districts where KHANA has implemented the livelihoods programs, and have participated in …

Social Return On Investment: A Cost-Benefit Analysis Of The Hiv Integrated Care And Prevention Programs In Cambodia, Sovannary Tuot, Liza Tong, Sopheab Heng, Minh-Anh Luong, Khuondyla Pal, Pheak Chhoun, Siyan Yi

Background: KHANA’s HIV Integrated Care and Prevention (ICP) project provided comprehensive care and support to HIV-affected communities through home and community-based care teams from 2007 to 2011. The aim of this study was to use Social Return on Investment (SROI) methodology to evaluate the social, health, and economic impacts of the ICP project, enabling the calculation of a ratio cost-to-benefit for the community in terms of HIV care, support, and treatment. Methods: The SROI methodology is a social cost-benefit analysis framework that measures and accounts for the values created by a program or series of initiatives. Values were mapped to …

How Feedback And Goal-Setting Impact Children's Recess Physical Activity, Ryann Koufoudakis, Heather Erwin, Aaron Beighle, Michelle L. Thornton

Kinesiology and Health Promotion Faculty Publications

In recent years, schools desire to promote physical activity (PA) for their students but are restricted due to resources being expended in other areas of their curriculum, including standardized testing preparation. Recess/lunch periods have potential to contribute important amounts of PA to youth’s overall levels. Interventions to maximize PA during recess are warranted. The purpose of this study was to demonstrate the impact of feedback and goal-setting on students’ PA during recess. A sample of 136 (67 females, 69 males) 4^th and 5^th grade students in the Southeast United States wore unsealed Walk4Life pedometers during recess for one …

The Role And Impact Of School Nurses And Intentions To Delegate Diabetes-Related Tasks Amidst Budget Cuts And Legislative Changes, Michelle J. Lineberry

Theses and Dissertations--Kinesiology and Health Promotion

As the percentage of school children with chronic conditions such as diabetes continues to rise, funding for school nurses to keep those students healthy and safe is decreasing. This dissertation includes three studies: (1) a systematic review of the literature on the role and impact of American elementary school nurses, (2) a focus group study that further examined the role of Kentucky school nurses and described their reaction to a new regulation that necessitates delegation of diabetes-related nursing tasks to unlicensed assistive personnel (UAP), and (3) a quantitative study that examined Kentucky school nurses’ past behaviors and future intentions regarding …

Lifestyle Contributors To Cardiovascular Disease Risk, Adam J. Berrones

Theses and Dissertations--Kinesiology and Health Promotion

Aortic stiffness is an independent risk factor that has prognostic value regarding future cardiovascular disease (CVD) events such as myocardial infarction, strokes, and heart failure. Although death rates due to coronary heart disease have declined in recent years, the leading global killer remains CVD and prevalence is still high. Understanding lifestyle contributors associated with aortic stiffness would provide the public with insight into targeting key health-related behaviors.

The purpose of this observational study was to examine the association of physical activity, physical function, and dietary quality as independent factors contributing to aortic stiffness in apparently healthy middle aged men. Fifty-two …

Reasons For Missing Antiretroviral Therapy: Results From A Multi-Country Study In Tanzania, Uganda, And Zambia, Olivier Koole, Julie A. Denison, Joris Menten, Sharon Tsui, Fred Wabwire-Mangen, Gideon Kwesigabo, Modest Mulenga, Andrew F. Auld, Simon G. Agolory, Ya Diul Mukadi, Eric Van Praag, Kwasi Torpey, Seymour Williams, Jonathan Kaplan, Aaron Zee, David Bangsberg, Robert Colebunders

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objectives To identify the reasons patients miss taking their antiretroviral therapy (ART) and the proportion who miss their ART because of symptoms; and to explore the association between symptoms and incomplete adherence.

Methods Secondary analysis of data collected during a cross-sectional study that examined ART adherence among adults from 18 purposefully selected sites in Tanzania, Uganda, and Zambia. We interviewed 250 systematically selected patients per facility (≥18 years) on reasons for missing ART and symptoms they had experienced (using the HIV Symptom Index). We abstracted clinical data from the patients’ medical, pharmacy, and laboratory records. Incomplete adherence was defined as …

An Analysis Of Folic Acid Supplementation In Women Presenting For Antenatal Care, Shona Cawley, Laura Mullaney, Aoife Mckeating, Maria Farren, Daniel Mccartney, Michael Turner

Articles

Background: Neural tube defects (NTDs) are major congenital malformations that are potentially preventable if the woman takes periconceptional folic acid (FA) supplements. A recent report found that NTD incidence had increased in Ireland. This study examined the usage of FA supplementation in women presenting for antenatal care in a maternity hospital.