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Challenges To Successful Health Care Transition Among Hiv Positive Youth With Perinatal Acquisition, Tyler Andrew Termeer

Walden Dissertations and Doctoral Studies

To ensure stability in the continuum of health care for HIV-positive youth with perinatal acquisition, there is a need for a successful transition from pediatric to adult primary care. However, there are a growing number of perinatally infected HIV-positive young persons remaining in pediatric care beyond the age of 21. Using Mohr’s program theory and a phenomenological approach, the lived experiences of Ohio HIV clinicians were examined to determine why many perinatally infected HIV-positive youths are remaining in pediatric care beyond the age of 21. Audio recorded video interviews via SKYPE were conducted with 12 participants, transcribed, underwent thematic analysis, …

Human Immunodeficiency Virus And Homelessness Among U.S.-Born And Foreign-Born Tuberculosis Cases In Georgia, Semra Ramosevac

Walden Dissertations and Doctoral Studies

According to the Centers for Disease Control and Prevention, tuberculosis (TB) is an infectious disease caused by bacteria and can easily spread in the U.S. and worldwide. TB infections in the U.S. have been much lower compared to other countries around the world in the last 40 years, but with the recent increase in an immigrant foreign-born population, there is a serious risk of the spread of TB. The goal of the study was to look into U.S.-born vs. foreign-born populations among TB/HIV/homeless cases in the state of GA from 2014 to 2018. The quantitative study was performed using secondary …

Educating Clinicians In A Nursing Facility To Proactively Manage Urinary Tract Infections, Setha Joseph

Walden Dissertations and Doctoral Studies

AbstractUrinary tract infections (UTIs) have been identified as the most common reason for hospital visits among adults. The Centers for Disease Control and Prevention indicates that the prevalence of UTIs in long-term care facilities ranges from 20%-50%. The purpose of this staff education project was to implement an educational program to increase staff knowledge of proactive management of urinary tract health with the ultimate goal of reducing acute illnesses at the skilled nursing facility (SNF). Knowles theory of adult learning informed curriculum development and Kirkpatrick's levels of training evaluation guided program evaluation. The project team planned, developed, implemented, and evaluated …

Service Members’ Perspectives On Veteran Homelessness In Maryland And Virginia, Olasunkanmi G. Amosu

Walden Dissertations and Doctoral Studies

Homelessness among military veterans (HAMV) is a protracted problem. In November 2009, the U.S. Department of Veterans Affairs pledged to end the issue, but almost 12 years later, HAMV persists despite various solutions proposed. In January 2020, 37,252 veterans were reported as experiencing homelessness in the United States. The creation of previous solutions did not include the perspectives of service members. The purpose of this study was to bridge this gap in knowledge by discovering the views of service members on why veteran colleagues experience homelessness. The theoretical framework for this study was Allport’s trait theory. A qualitative case study …

The Power Of Exogenous Variables In Predicting West Nile Virus In South Carolina, Christopher Lee Glaze

Walden Dissertations and Doctoral Studies

Despite the availability of medical data, environmental surveillance tools, and heightened public awareness, West Nile Virus (WNv) remains a global health hazard. Reliable methods for predicting WNv outbreaks remain elusive, and environmental health managers must take preventive actions without the benefit of simple predictive tools. The purpose of this ex post facto research was to examine the accuracy and timeliness of exogenous data in predicting outbreaks of WNv in South Carolina. Decision theory, the CYNEFIN construct, and systems theory provided the theoretical framework for this study, allowing the researcher to broaden traditional decision theory concepts with powerful system-level precepts. Using …

Comparison Of The Therapeutic Efficacy Of Rheumatoid Arthritis Treatments, Kacy Smith Davis

Walden Dissertations and Doctoral Studies

Rheumatoid arthritis (RA) is an autoimmune condition that causes chronic joint pain and destruction. The current standard regimen of monotherapy disease modifying anti-rheumatic drug (DMARD) treatments may not be as effective as that of combination therapy of a DMARD and a biologic agent in treating RA. The purpose of this study was to answer the question, is there a difference in the therapeutic efficacy of combination DMARD treatments with a biologic, compared to monotherapy DMARDs without a biologic, in U.S. Caucasian women between the ages of 30 and 60 that have been diagnosed with RA? Guided by the theoretical framework …

Barriers To Effective Personal Protective Equipment Use In Public Health Workers, Sheila Storr-Mathis

Walden Dissertations and Doctoral Studies

Exposure to infections continues to be a significant concern for nursing practice and for other health care professionals. Personal protective equipment (PPE) minimizes occupational exposure; however, their use is subject to variability. This quality improvement project addressed the impact of an educational intervention on attitudes and barriers to proper use of PPE for public health workers at the study site. The health belief model and the literature review provided theoretical support for the project and evidence of current trends in PPE use. There were 44 employees who completed the preintervention survey and 22 who completed the postintervention survey to gauge …

Sociodemographic And Psychosocial Factors And Wellbeing Among Adults 65 And Older In England, Dainelle Clark

Walden Dissertations and Doctoral Studies

The increased number of older adults living longer parallels with the growth of public health concerns regarding the impact of sociodemographic and psychosocial factors (e.g., loneliness and social isolation) on older adults' wellbeing. The purpose of this quantitative study was to examine the association between loneliness, social isolation, the combined model of loneliness, and social isolation on wellbeing among older adults when accounting for age, gender, ethnicity, and social support. The socioecological model (SEM) was used to evaluate the multiple levels of environmental determinants for loneliness, social isolation, and wellbeing. The target population included older adults 65 years and older …

Race, Class, And Socioeconomic And Sentencing Laws In Opioid Cases, Phaedra Denise Jackson

Walden Dissertations and Doctoral Studies

AbstractThe purpose of the study was to explore social constructs and bureaucratic decisions to assess their effects on sentencing laws based on race, class, and socioeconomic status (SES). The research question guiding the study whether there was a relationship between race, class, SES, and arrests among opioid users. A cross-sectional correlational design using secondary data from Substance Abuse and Mental Health Services Administration 2010-2018 surveys of 265,442 participants and FBI Uniform Crime Reports were assessed to understand the bureaucracy of the opioid epidemic. Lipsky’s street-level bureaucracy theory was used to examine the historical, political, and racial structures within the judicial …

Knowledge And Perceptions Of Antibiotic Resistance Stewardship Among Prehealth And Agriculture Students, Claudia Maria Da Silva Carvalho

Walden Dissertations and Doctoral Studies

The global threat of antibiotic resistant infection has resulted in health organizations to compile an antibiotic stewardship program, in which the education of current/future medical prescribers and farmers is central for the preservation of current and future antimicrobial treatments. The purpose of this study was to assess and compare the knowledge and perceived threat of antibiotic and antibiotic resistance, as well as the perceived benefit of antibiotic stewardship, among undergraduate students in biology and agriculture at a state university in Kansas. Framed by the health belief model, a cross-sectional study was conducted using a structured online survey of 136 undergraduate …

Drug-Resistant Neisseria Gonorrhoeae; Identification Of At-Risk Groups In Florida By Regional Variation, Scott August Herber

Walden Dissertations and Doctoral Studies

Neisseria gonorrhoeae has been on the rise in the State of Florida since 2013. Florida currently follows the Centers for Disease Control and Prevention guidelines for identifying those at-risk for gonorrhea and drug resistant gonorrhea infections. These groups are narrowly defined and do not consider the different population dynamics throughout the State. This study examined the question of who is at-risk for contracting drug resistant strains of gonorrhea in the eight different regions of Florida based on the prescribed use of last-line-of-antibiotic-defense. Florida’s Surveillance Tools and Reporting System provided 12 years of secondary data from 2007 to 2018. The data …

Effects Of Hepatitis On Human Immunodeficiency Virus Viral Suppression, Andrenita Checoby West

Walden Dissertations and Doctoral Studies

Coinfection with human immunodeficiency virus (HIV) and viral hepatitis leads to unfavorable health outcomes, making treatment of HIV difficult and increasing the odds of HIV transmission. The purpose of this study is to assess whether viral hepatitis (B and C) hinders HIV viral suppression and impacts the white blood cell count (CD4) when a person is concurrently infected with both viruses. The syndemics theory guided this study. Two research questions tested whether there was an association between coinfection with viral hepatitis and HIV viral load suppression. The research design was quantitative case-control with secondary data from 65,626 reports of HIV, …

Association Between Learning Methods And Analgesic Opioid Abuse, Nicole Marie Blanchard

Walden Dissertations and Doctoral Studies

Opioids are an extremely addictive class of medication used to treat pain; overprescribing practices and chronic misuse has led to an epidemic that continues to grow. The opioid epidemic not only has the potential to cause injury or even death but also has a large impact on the U.S. economy. Research regarding determinants of abuse are needed to improve safeguards for opioid abuse prevention. The purpose of this quantitative study was to determine if learning capabilities and/or learning medium preference are correlated with analgesic opioid abuse. The social-ecological model was used to evaluate the social levels of influence for abuse …

New Graduate Nurses’ Transfusion Training Views: Reflection On Experiences With Adverse Reactions, Hind Jaber-Daou

Walden Dissertations and Doctoral Studies

Abstract:New graduate nursing students transitioning to becoming professionals undergo education and training to gain knowledge and competence about transfusions. Nonetheless, new graduate nurses experience stress during a blood transfusion adverse reaction, which can be associated with lack of knowledge and inadequate training. The purpose of this qualitative study was to gather data from new graduate nurses who described their lived experiences with patients exhibiting symptoms of adverse reactions, how they reflected on their emotional effects, and the influences of the training on their knowledge and confidence. The research was grounded in social cognitive theory that centers on the concept of …

Workplace Experiences Of Migrant Workers In Colorado, Lynann Holly Butler

Walden Dissertations and Doctoral Studies

AbstractMigrant workers often endure a variety of abuses in the workplace, including financial exploitation, exposure to toxins, isolation, and lack of access to health care. Although researchers have demonstrated that these circumstances exist for migrant workers in other parts of the world, there was a dearth of research on the lived experiences of migrant workers in Colorado. The purpose of this hermeneutic phenomenological study was to better understand the lived experiences of migrant workers in Colorado, who are a growing and impactful population in Colorado. The theoretical framework was Rawl’s social justice theory, which purports that no one group of …

The Impact Of Community Churches And Barbershops On Preventive Care Utilization Among African American Men, Quiante Chappell Hager

Walden Dissertations and Doctoral Studies

Preventive health care screening plays an essential role in reducing chronic diseases and mortality rates; yet, even as health care access has increased, African American men’s utilization of preventive screenings remains low in rural areas. The purpose of this qualitative case study was to investigate why African American men are not utilizing preventive care services and ascertaining the impact that social determinants may have on their utilization of these services. The theoretical framework of this research study comprised the social-ecological modal and health belief model to investigate the barriers to preventive care utilization in the African American community. Twelve African …

Association Between Food Insecurity And Influenza Outcome In The United States., Sabrina Fiona Pink

Walden Dissertations and Doctoral Studies

AbstractThe influenza virus is one of the most commonly occurring respiratory viral infections in the world. The outer capsule of the virus contains 18H proteins and 11N proteins, which allows the virus to reform in over 100 different strands and outperform the vaccine. Despite efforts to improve access to care and reduce vaccine inequities; the Center for Disease Control and Prevention estimates 9-45 million documented influenza-related illnesses, 140,000 to 810,000 hospitalization, and 64,000 deaths yearly. The purpose of this study is to investigate whether food insecurity, access to care and other social determinants of health such as age, race, and …

A Systematic Review Of Tobacco Cessation Strategies Tailored For Military Personnel, Ni Ketut Supiyati

Walden Dissertations and Doctoral Studies

AbstractA Systematic Review of Tobacco Cessation Strategies Tailored for Military Personnel by Ni Ketut Supiyati

MS, Walden University, 2000

Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice

Walden University August 2021

Perceptions Of Correctional Practitioners On Contraband Prevention In Maryland Adult State Prisons, Patrick Orock Agbortarh

Walden Dissertations and Doctoral Studies

AbstractAlthough contraband trafficking has been a focus of scholars since 2013, researchers have yet been able to establish a more reliable contraband control strategy. The present study was based on the perceptions of correctional practitioners of Maryland State Department of Public Safety and Correctional Services (DPSCS). These perceptions were necessary in devising a strategy to prevent the flow of contraband items into Maryland’s adult state prisons. The purpose of this study was to explore the experiences of 10 correctional practitioners from Maryland correctional facilities, with the goal of providing insight into which efforts are most effective in preventing contraband from …

Relationship Between Media Coverage And Child Measles Vaccination Uptake, Tanika Ward

Walden Dissertations and Doctoral Studies

Childhood vaccines have been a source of heated debates between both opponents and proponents of vaccination. Childhood immunizations have proven to be effective and save lives, but antivaccine movements continue. The purpose of this retrospective cross-sectional quantitative study was to determine if there was a significant difference in child measles vaccine uptake based on provider facility type and census region, after adjusting for age and education of mother, for the years 2003–2012, pre-and-post 2007 media coverage deeming vaccines unsafe, and for the years 2013–2017, pre-and-post exposure to measles at Disneyland in 2014–2015 for children aged 19–35 months. The social ecological …

Educating Nurse Practitioners To Avoid Urine Cultures To Prevent Overuse Of Antibiotics, Diane Evelen Deangelo

Walden Dissertations and Doctoral Studies

Unnecessary antibiotics are often ordered for positive urine cultures in long-term care (LTC) residents despite a lack of symptoms, indicating asymptomatic bacteriuria (ASB). Treating ASB with antibiotics can result in antibiotic-resistant organisms, allergic reactions to antibiotics, and secondary infections such as clostridium difficile. The purpose of this DNP project was to provide an evidence-based education intervention regarding management of ASB and UTIs with the hope of increasing the knowledge among nurse practitioners (NPs) that could be translated into practice and result in a decreased antibiotic use in LTC patients. The DNP project was grounded in Knowles’ adult learning theory and …

Physicians’ Perceptions And Intent To Use Mcdonald Guidelines For Diagnosing Multiple Sclerosis, Daniel E. O'Brien

Walden Dissertations and Doctoral Studies

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system that affects close to 400,000 patients in the United States and roughly 2.3 million people around the world. Because this is a growing global public health concern, researchers and clinicians are calling for a more efficient adoption of these McDonald MS guidelines in clinical practice as outlined in newly diagnosed guidelines. The purpose of this quantitative correlational study was to examine the relationship between the independent variables gender, guidelines knowledge, years in practice and intent to use the McDonald MS guidelines for diagnosing MS among physicians. …

Marital Status And Human Immunodeficiency Virus Mortality In A Southern County, Javis Nkwanwoh

Walden Dissertations and Doctoral Studies

Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) remains a substantial cause of mortality, particularly among U.S. segments of the population. Marriage is protective of HIV/AIDS mortality due to monogamy; however, the increased risk of HIV/AIDS mortality among other marital subgroups is understudied. The purpose of this study was to examine the association between marital status and HIV/AIDS mortality among a cohort of HIV infected individuals in a southern county. Mills' behavior theory guided this research as it posits that all behaviors are acquired through conditioning, which occurs through the interaction with the environment. The study had a quantitative research design …

Insecticide Treated Nets And Malaria Control Strategy In Sierra Leone, Henry Nk Biayemi

Walden Dissertations and Doctoral Studies

AbstractMalaria is a deadly disease and endemic in Sierra Leone. It is the leading cause of morbidity and mortality amongst children younger than five years in Sierra Leone. Insecticide treated nets (ITNs) are not used widely despite free distribution, low health risks, and proven ability to reduce malaria. The purpose of this quantitative crosssectional study was to investigate the association between a set of independent variables (parental education, parents' economic status, household size, and residence) and the use of ITNs among children under five years of age in Sierra Leone. The study used a secondary dataset from the Ministry of …

Citizens' Perspectives On Accountability Of Nongovernmental Organizations Providing Drinking Water In Northern Ghana, Abdul-Nashiru Mohammed

Walden Dissertations and Doctoral Studies

AbstractAccountability is an important concept in public administration and across multiple sectors. NGOs work towards achieving their social purpose and yet, they are perceived to be accountable only to their donors but not to citizens. The purpose of this qualitative case study was to explore perspectives of citizens in three districts: Bongo, Wa, and Sagnarigu in Northern Ghana on how NGOs demonstrate accountability in fulfilling their commitments in drinking water provision. It specifically investigated the lived experiences of citizens: local government authorities, traditional authorities, and individual citizens from the districts. Research literature emphasized upward accountability resulting in a gap observed …

Association Between Asymptomatic Malaria Infection And Pregnancy Outcome In Delta State, Nigeria, Sadiatu Sally Obi

Walden Dissertations and Doctoral Studies

Pregnant women are vulnerable due to the pregnancy-induced suppressed immunity in malaria-endemic areas. Asymptomatic malaria in pregnancy (MiP) threatens both the mother, fetus, and neonate via chronic placental malaria which impacts maternal-neonatal exchange. Some studies reported that MiP risk factors vary across locations, however, there are few studies on MiP and pregnancy outcome in Nigeria. The purpose of this study was to investigate the association between asymptomatic placental malaria infection and pregnancy outcome among parturients in Asaba, Delta State, Nigeria. This study was developed with a quantitative methodology that utilized primary and secondary healthcare data from 483 subjects aged 18–49 …

A Quality Improvement Evaluation Of A Hospitalist Telemedicine Program, Kelly Marie Awes

Walden Dissertations and Doctoral Studies

Critical access hospitals (CAHs) encounter unique challenges in terms of providingquality resources to their community, often lacking quality measures and continuity comparable to larger regional and tertiary hospitals. One CAH in rural Minnesota implemented an overnight hospitalist telemedicine service to address concerns with provider resources and quality practice. An evaluation of quality improvement implementation was completed to address data regarding ER transfers and inpatient length of stay (LOS). Following the triple aim framework to improve patient care, population health, and decrease costs, Donabedian’s model of quality improvement was utilized. Three months of pre and postimplementation data were collected one year …

Relationship Between Cultural And Religious Practices And Ebola Virus In Freetown, Sierra Leone, Richmond Samuel Kpange

Walden Dissertations and Doctoral Studies

The 2014 Ebola virus epidemic in the West Coast of Africa was a historically unprecedented epidemic with a sustained spread in multiple West African nations, including Sierra Leone. The World Health Organization (WHO) classified Sierra Leone as a high Ebola-affected country as it reported the highest number of deaths (14,124) during the last Ebola outbreak compared to other Ebola-affected countries. Public health experts have given little attention to the impact of sociocultural factors on infectious diseases, especially Ebola. The purpose of this study was to ascertain whether there is a relationship between the spread of EVD and a patient’s gender, …

Relationship Between Cultural And Religious Practices And Ebola Virus In Freetown, Sierra Leone, Richmond Samuel Kpange

Walden Dissertations and Doctoral Studies

The 2014 Ebola virus epidemic in the West Coast of Africa was a historically unprecedented epidemic with a sustained spread in multiple West African nations, including Sierra Leone. The World Health Organization (WHO) classified Sierra Leone as a high Ebola-affected country as it reported the highest number of deaths (14,124) during the last Ebola outbreak compared to other Ebola-affected countries. Public health experts have given little attention to the impact of sociocultural factors on infectious diseases, especially Ebola. The purpose of this study was to ascertain whether there is a relationship between the spread of EVD and a patient’s gender, …

Reduced Recidivism In Drug Offenders By Treatment Involving Motivational Interviewing, Meleeka Clary

Walden Dissertations and Doctoral Studies

AbstractIncarcerated substance users frequently recidivate because of a lack of substance treatment; it was not known whether motivational interviewing (MI) significantly reduces recidivism among substance users. The purpose of this quantitative study was to evaluate the effectiveness of MI as a treatment method for reducing recidivism among incarcerated individuals with substance use disorders. Social cognitive and extrinsic motivation theories served as the theoretical foundation for the study. Motivation is an important factor in offender engagement with treatment and has been linked to improved treatment outcomes. The research questions asked whether the availability of MI in detention facilities was significantly related …