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Embracing Ujima: A Grounded Theory Of African Americans Choosing The Counseling Profession, Rashida Karriem Fisher

Walden Dissertations and Doctoral Studies

Racial and ethnic diverse populations experience discrimination in educational and career attainment and remain underrepresented in the counseling profession. The current literature provides limited guidance for the counseling profession and academic institutions for successfully recruiting racial and ethnic minority students in a master's level counselor training program. Social Constructivist theory and Adlerian/ Individual Psychology are the theoretical foundations of the study. This constructivist grounded theory study sought to understand the career decision-making process of African Americans choosing to enter in the counseling profession and the influence of racial and ethnic identity on this decision-making process. Utilizing semistructured interviews via video-conferencing; …

Factors That Influence The Prevalence Of Type 2 Diabetes Among Aboriginals In Canada, Olayinka Awoyemi

Walden Dissertations and Doctoral Studies

The focus of this study was on potential social determinants of health factors that influence the prevalence of type 2 diabetes in the general population of Canada, with emphasis on the disproportion in rates of the disease between Aboriginal and non-Aboriginal populations of Canada. This study also examined the risk factors that are peculiar to the general, Aboriginal, and non-Aboriginal population of Canada. A total number of 101,080 individuals who were 18 years and above provided data for this study. The data and information obtained from these participants were used to answer the major research questions regarding if there was …

Analysis Of Control Measures Used During Cholera Outbreaks Among Internally Displaced Persons, Nicole Devine Carneal-Frazer

Walden Dissertations and Doctoral Studies

Cholera remains a major public health problem affecting high-risk populations such as camps of internally displaced persons. During a cholera outbreak, it is essential to reduce transmission and minimize new infections. The Miasma theory, host-agent-environment model and Ecosocial theory were utilized for this study. This study was a retrospective comparison to determine whether historical cholera control measures are effective during current cholera outbreaks within camps of internally displaced persons. A quantitative approach ascertained changes in incidence and mortality rates following implementation of primary and/or secondary control measures. Cholera outbreaks were identified from the World Health Organization's (WHO) Disease Outbreak News …

A Comparison Of The Safety And Efficacy Of Three Medical Abortion Protocols, Dhammika Perera

Walden Dissertations and Doctoral Studies

Unsafe abortions pose serious threats to women's health. Medical abortion provides safer abortion access to many. The lengthy interval between misoprostol and mifepristone creates multiple barriers for women and providers.

A paucity of research exists about medical abortion protocols that allow single day procedures. The efficacy and the safety of 3 medical abortion protocols of varying lengths were explored in this study.

A secondary data set of over 55,000 patients from the United Kingdom was retrospectively analyzed using binomial logistic regression. Efficacy results showed no significant difference between the conventional and the simultaneous protocols; when compared to those, the 6- …

Living Arrangements, Referral Source And Young Adult Admissions To Drug Treatment, Daniel Samaila

Walden Dissertations and Doctoral Studies

Abuse of painkiller drugs and non-medical use of drugs among young adults continues to be a public health crisis in the United States. Living arrangements and source of treatment referral were considered as the social context that could contribute to increased admissions to treatment for drug abuse. The purpose of this study was to examine the relationship between, independent living arrangement, the principal source of referral, and abuse of opioid, heroin, and cocaine. Steered by the conceptual framework of the biopsychosocial model, this study used the data from the 2015 Treatment Episode Data Set: Admissions managed by the Substance Abuse …

Examining Congestive Heart Failure Hospital Readmissions From Skilled Nursing Facilities, Katherine Mary Day

Walden Dissertations and Doctoral Studies

In the United States, congestive heart failure (CHF) is a cardiac condition with increasing hospitalization and rehospitalization burden to patients, families, and the healthcare system. This chronic condition is expected to affect more than 8 million people by 2030; however, not much is known about the relationship between risk factors and hospital readmissions once CHF patients are discharged to a skilled nursing facility (SNF). Applying a systems theory unbounded systems thinking, coupled with a systems-thinking approach the purpose of this quantitative, retrospective cohort study was to examine CHF hospital readmissions from SNFs within a 90-day period using a secondary data …

Social-Ecological Predictors Of Contraceptive Use In Ethiopia, Mekonen Fisseha Gebrekidan

Walden Dissertations and Doctoral Studies

Unintended pregnancy is a global public health threat that affects the lives of women, families, communities, and society. In 2008, the rate of unintended pregnancy in Ethiopia was 101 per 1,000 women aged 14 to 44 years. Although Ethiopia has experienced a steady increase in modern contraceptive use since 2004, this increase did not result in a proportional decline in unintended pregnancy, total fertility rates, or rapid population growth. In this cross-sectional study, associations between individual, interpersonal, community, and societal factors and contraceptive uptake were tested using a sample of 3,863 women aged 15 to 49 years who participated in …

The Influence Of Food Choices, Eating Habits, And Body Image Of African American Mothers On Childhood Obesity, Debrua Perniece Coleman

Walden Dissertations and Doctoral Studies

The food decisions, dietary patterns, physical activity, and weight-related convictions of African American mothers are affected by their self-perceptions and views of body weight. The gap in the literature regarding the impact of these perceptions on children's food choices, eating habits, and body image is significant. Using the health belief model as the theoretical foundation and a cross-sectional survey as the research design, this study assessed the potential relationship between mothers' and children's eating habits and whether mothers' perceptions of their children's body image were reliable indicators of childhood obesity. Eighty-six mothers provided demographic information and completed the Child Feeding …

The Impact Of Congressional Attention And Policy Mood On Public Health Funding, Evelyn Denise Dunn

Walden Dissertations and Doctoral Studies

Congressional appropriations for federal public health agencies are subjected to external factors throughout the congressional appropriations process, resulting in fluctuations in funding. Recent literature has focused on externals factors, such as political attention and public attitudes, that could influence government funding levels; however, the impact of these factors on federal public health funding was not addressed. The purpose of this study was to determine whether a relationship exists between these external factors and federal public health appropriations. A quantitative study was used to examine congressional attention, policy mood, and the influence on the change in the level of federal public …

Adult Clients' Experience Of Walk-And-Talk Therapy, Denice Crowe Clark

Walden Dissertations and Doctoral Studies

Standards of healthcare exist to promote beneficent treatment; however, treatment approaches are sometimes not supported by research, creating potential ethical issues for clinicians expected to use evidence-based practices. For example, walk-and-talk therapy, where therapy sessions incorporate physical activity in an outdoor setting, is being offered at increasing rates, but research regarding the practice is sparse and primarily reflects the therapists' experiences. Thus, the purpose of this interpretative phenomenological analytic study was to explore the clients' experience of the altered frame of walk-and-talk therapy through the conceptual lenses of therapeutic frame and the biopsychosocial model of well-being. Data were collected through …

Hiv Prevalence And Donor Funding In Ethiopia, Walelign Meheretu Kassahun

Walden Dissertations and Doctoral Studies

Many researchers have documented the trend of decreasing financial support from donors for human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) responses in Ethiopia. Less information is available regarding the correlation between trends of HIV prevalence and external funding and ways to address the impact that funding scarcity could cause. The purpose of this study was to examine the trend of HIV prevalence and donor funding levels, analyzing how the 2 are correlated, and opportunities to improve responses. Using the proximate determinant framework, the research questions examined the changes in HIV prevalence in Ethiopia during the past 10 years; the association …

Coping Methods Of Caregivers Dealing With Patients Suffering From Geriatric Dementia, Blessing Baridakara Deemua

Walden Dissertations and Doctoral Studies

Dementia is a neurological disorder primarily diagnosed in the geriatric population. A problem for paid caregivers of patients diagnosed with stage-4 dementia is that they may experience caregiving stress while rendering care. However, there was no research that described the lived experiences of paid caregivers. Caregiving stress can be accompanied by behaviors or comorbid conditions and specific symptoms of stress can have a differential wellness impact. This phenomenological study explored the lived experiences of paid caregivers of patients with dementia through Vroom's expectancy theory. Data were gathered through interpretative interviews from a sample of 10 to 15 purposefully selected nursing …

Effect Of Health Information On Food Addiction Among Obese And Overweight Women, Kirsten Elyse Grant

Walden Dissertations and Doctoral Studies

Research on obesity, weight loss, and food addiction (FA) suggested a strong relationship between use of food additives and the brain's addictive response to food. Previous researchers have examined (FA) and have identified certain food additives such as monosodium glutamate (MSG) and high fructose corn syrup (HFCS) as contributors to food addiction and overeating. Social cognitive theory (SCT) has also been effective in addressing addictive behaviors such as drug addiction, alcohol addiction, and smoking cessation (Bricker et al., 2010). However, researchers had not examined food addiction, social cognitive theory, and obesity in the same study. The purpose of this quantitative, …

Cancer Treatment Decision Making In Aging Minorities, Patrice Kemp

Walden Dissertations and Doctoral Studies

Cancer incidence is high for aging minority and underserved populations, yet research is limited about patient-provider communications with aging racial and ethnic minority populations. Achieving high-quality cancer care is crucial to reducing health disparities for this population. However, potential shortages in professional health personnel, the cost to treat cancer, a strained health care system, and large aging populations contribute to the problem. The purpose of this qualitative study was to understand the personal experiences of aging minorities during cancer treatment decision making when communicating with their cancer care providers. Purposive sampling methods were used to recruit 10 minority women and …

Smoking And Surgical Site Infection In Orthopedic Patients' Lower Extremity Arthroplasty, Alicia Y. Mingo

Walden Dissertations and Doctoral Studies

Cigarette smoking has been a public health concern for many years, and the possible impact of smoking on surgical site infection (SSI) has been studied broadly. However, a gap in understanding has persisted concerning whether there is an association between smoking tobacco and the development of SSI among patients who undergo lower extremity surgery, specifically total knee arthroplasty (TKA). The purpose of this study was to examine the association between smoking and lower extremity SSI. Andersen's behavioral model (BM) was used to understand the risk factors relevant to the interaction between smoking and SSI. Application of the BM categories of …

Unmet Support Needs Of Informal Caregivers Of Older Adults, Julie Ann Smith Hinders

Walden Dissertations and Doctoral Studies

Due to projected growth of the 65-and-older population and concerns of an impending care gap, reliance on informal caregivers is expected to increase. Improving support for informal caregivers is viewed as a national priority, yet research related to the unmet support needs of informal caregivers is limited. The purpose of this cross-sectional correlational study was to examine predictive relationships between contextual factors (caregiving relationship and type of illness) and environmental factors (rurality) and the unmet support needs (classes, service access, support groups, counseling, and respite) of informal caregivers of older adults. The theoretical framework was Bronfenbrenner's ecological systems theory. Archival …

Interprofessional Intentional Empathy Centered Care (Ip-Iecc) In Healthcare Practice, Deepy Sur

Walden Dissertations and Doctoral Studies

Training interprofessional healthcare teams continues to advance practice for patient-centered care. Empathy research is also advancing and has been explored in social work, psychology, and other healthcare areas. In the absence of understanding empathy in an interprofessional setting, educators are limited in preparing teams to develop empathy as part of core competencies This grounded theory study explored for a theory of how interprofessional healthcare teams conceptualize and operationalize empathy in their practice. Azjen's theory of planned behavior and Barrett-Lennard's cyclical model of empathy framed the study. Data were collected using 6 focus groups and 24 semistructured interviews of varied healthcare …

Public Health Implications Of Retailer Resale Of Returned Textile Clothing Merchandise, Antonette M. A. Francis-Shearer

Walden Dissertations and Doctoral Studies

Historically, 18th century anecdotal accounts of the decimation of several tribes of U.S. of the Native American population by trading of infected textile blankets alludes to the role of retail in the transmission of infectious disease. This study explores implications of the modern day retail organization practice of reselling returned clothing textiles from a public health infectious disease perspective. A qualitative multi-case study, utilized responses from 20 open-ended, unstructured interviews of retail employees assigned to the returns process. Additionally, several informal observations of select U.S.based, top-ranked clothing retail organizations, identified by the National Retail Federation were completed. Select federal, state, …

Hiv Testing And Black Men Who Have Sex With Men, Stephaun Elite Wallace

Walden Dissertations and Doctoral Studies

HIV incidence among Black men who have sex with men (BMSM) is extremely high in contrast to their estimated population size and compared to other racial groups. Researchers have established that a significant proportion of these new cases annually originate from HIV transmission by BMSM who are unaware of their HIV status. The purpose of the study was to assess the relationship between age, sexual behavior, social support, substance use, internalized homophobia, depression, and HIV test history in BMSM. Guided by the social ecological model (SEM) as the conceptual framework, a quantitative cross-sectional study was designed to analyze secondary data …

Obesity Epidemic In The Military: Implications For Veterans, Tracy Lewis

Walden Dissertations and Doctoral Studies

The purpose of this study was to examine the impact of overweight and obesity on veterans' careers. Obesity, once thought unproblematic for the military, is being recognized as a health concern that has expansive implications for the health and readiness of service men and women, as well as for veterans. There is an abundance of information on obesity within the general population, but research on the impact of obesity on military careers is limited. This quantitative, cross-sectional research study investigated how obesity is a challenge throughout a veteran's career, from enlistment to retirement, using an online survey to gather data …

Thyroid Function Screening & Dysfunction In Patients With Heart Failure: An Examination Of Practice At The University Of Kentucky Albert B. Chandler Hospital From 2007-2017, Alexandra Paige Hall

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

Introduction: Heart failure constitutes a global pandemic affecting at least 26 million globally (an estimated 5.7 million of which are Americans), and its burden on our healthcare system is projected to increase.[1] As a result, it is imperative that diagnostics and treatment among that population be evidence based in order to contain costs and optimize patient outcomes. Over the last 20 years, thyroid function screening has been recommended for patients upon initial diagnosis of heart failure by the American College of Cardiology and other professional organizations. However, it remains unclear whether this recommendation is followed by practitioners and how much …

A Comparison Of Pediatric Prevention Policies To Pediatric Health Supervision Codes, Rania Burke

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

The number of policy statements from the AAP presents pediatricians with an increasing amount of advice related to prevention, yet the definition of prevention and well-child visits has not changed for outpatient office visits. Outpatient office visits are the primary means by which preventive care is administered. The objective of this study is to quantify and characterize the prevention policy recommendations that pediatricians are expected to provide patients/guardians beyond the well-child visit. Secondarily, an analysis was completed to demonstrate which prevention policies make recommendations that can be coded for reimbursement as part of a well-child prevention visit.

METHODS The author …

Socioeconomic Determinants Of Physical Activity Among Adult Arab Immigrants In Edmonton, Alberta, Samer Kobrosly

Walden Dissertations and Doctoral Studies

Little is known about leisure-time physical activity (LTPA) habits of Arab immigrants in Canada. Leisure-time physical activity has been linked to decreased risks for cancer, cardiovascular disease, and all causes mortality and increased life expectancy. Socioeconomic status has been recognized as a significant factor affecting health and wellbeing due to its impact on individuals’ attitudes, experiences, and exposure to several risk factors. The purpose of this cross-sectional descriptive study was to explore the levels of participation in LTPA among adult Arab immigrants in central Alberta, Canada, to examine the socioeconomic determinants of LTPA, and to investigate which individual, social, and …

Fruit And Vegetable Consumption, Physical Activity, And Colorectal Cancer Among African Americans, Stella Francoise Nanga Ndzana

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is a deadly and costly cancer, especially among African Americans. The purpose of this quantitative, retrospective, cross-sectional study was to examine African Americans' health behaviors that may have an association with CRC. The Health Belief Model was used to guide this study. The study addressed whether there is a statistical association between fruit intake, vegetable intake, and physical activity, and the occurrence of CRC while controlling for confounders, such as body mass index, smoking status, and income level. After conducting an overall analysis, the final research question examined if the association varied by race. In this study, …

Multilayered Stigma And Vulnerabilities For Hiv Infection And Transmission: A Qualitative Study On Male Sex Workers In Zimbabwe, Elleen Yuk-Ha Tsang, Shan Qiao Ph.D., Jeffrey S. Wilkinson, Annis Lai-Chu Fung, Freddy Lipeleke, Xiaoming Li Ph.D.

Faculty Publications

Male sex workers are marginalized in most societies due to intersectional stigma between prostitution and homosexuality. In Zimbabwe, a proliferation of male sex workers in major cities such as Harare and Bulawayo has been reported. However, there is a shortage of studies that explore their lives. The current qualitative study aims to describe the practices of sex work, life contexts, and HIV risks and vulnerabilities based on in-depth interviews among 15 male sex workers in Bulawayo. Our studies suggest that the stigma against male sex workers comes from diverse sectors including culture (“homosexuality is un-African, introduced by the Whites”), religion …

The Impact Of Shift Work On Health And Wellbeing, Stephanie M. Gagelin

Physician Assistant Scholarly Project Posters

• Many of today’s industries require workers to perform shift work (typically during 1600-0700). If workers are awake during this time period, circadian misalignment occurs. This scholarly project uses research studies and meta- analyses to provide information about increased health risks associated with circadian misalignment, focusing on the categories of glucose metabolism, cardiovascular system, carcinogenesis, and mental health and acuity.

• Shift work has been found to increase BMI and waist circumference of employees, as well as increase blood glucose levels to “prediabetic” levels in previously euglycemic individuals.

• Shift work has been proven to increase high-sensitivity C-reactive protein (hs-CRP), …

Accessibility Of Innovative Services In Radiation Oncology, Patricia Sansourekidou

Walden Dissertations and Doctoral Studies

The field of radiation oncology (RO) involves the use of highly advanced techniques to treat cancer and safely spare healthy organs. The discipline has experienced rapid growth in the past 25 years, with technological advancement as the driving force. Available data and an instrument to effectively measure the accessibility of innovation in the field were lacking. The purpose of this study was to investigate the accessibility of innovative services in RO in the United States and assess possible diffusion patterns. Two hundred and forty medical physicists practicing in RO in the United States completed a custom Internet-based survey. The diffusion …

Parental Perception Of Physician Cultural Sensitivity And Adherence To Asthma Treatment, Narue Jaynelle Wright-Jegede

Walden Dissertations and Doctoral Studies

In the United States, asthma remains a major cause of frequent urgent care visits, hospitalizations, and preventable deaths among children. Nationwide, the chronic disease continues to fall disproportionately on minorities, mostly residing in urban localities. When a child is diagnosed with asthma, the parents are typically tasked with managing the child's condition. Establishing a collaborative partnership between parents and their child's primary physician is significant for improving asthma self-management among youth. Using the theory of reasoned action as a theoretical framework, this mixed-methods study examined whether a relationship exists between parental perceptions of physician cultural sensitivity and parental care in …

Evaluating Fda Generic Approval After 2017 Agency Initiatives, Kuo Jiao

Public Health Theses

Importance: Generic drugs play an essential role in the US healthcare system, providing less costly alternatives to branded drugs that are equally effective and safe. The US Food and Drug Administration (FDA) regulatory policies influence the standards for generic drug approval. In 2017, the FDA instituted several initiatives to promote generic drug approval, particularly focused on those with limited competition.

Objective: To determine whether the initiatives begun by FDA in 2017 were associated with greater numbers of approvals of generic drugs with limited generic competition and histories of drug shortage.

Study Sample and Design: We conducted a cross-sectional study of …

A Qualitative Research Synthesis Of Contextual Factors Contributing To Female Overweight And Obesity Over The Life Course In Sub-Saharan Africa, Ifeoma Ozodiegwu, Mary Ann Littleton, Christian Nwabueze, Oluwaseun Famojuro, Megan Quinn, Rick L. Wallace, Hadii M. Mamudu

ETSU Faculty Works

Objective: Adult women are disproportionately affected by overweight and obesity in Sub-Saharan African (SSA) countries. Existing evidence on the sociocultural context remains unconsolidated. In this qualitative research synthesis, we aggregate research literature on contextual factors that potentially predispose adult women and adolescent girls to overweight and obesity to inform research, policies and programs over the life course.

Methods: PubMed, CINAHL, PsychInfo, ProQuest Central, EMBASE, and Web of Science were searched to locate qualitative research articles conducted in SSA countries beginning in the year 2000. After assessment for eligibility and critical appraisal, 17 studies were included in the synthesis. Textual data …