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Decreasing Hiv Stigmatization For Care Of Young Men Of Color Who Have Sex With Men, Alethea Arnett Miller

Walden Dissertations and Doctoral Studies

HIV-related stigma from healthcare provider attitudes, beliefs, perceptions, or misconceptions has been a barrier to healthcare delivery. This project was conducted to examine whether an HIV-related stigma education provided to healthcare clinic staff with a focus on advance practice registered nurses can improve knowledge and empathy toward young men of color who have sex with men (MSM), which can lead to improved overall quality of healthcare through increased health behaviors and retention in care. An educational intervention was conducted utilizing a blended-learning environment focused on social cognitive theory to influence social behavior change among healthcare professionals, increasing their exposure, knowledge, …

Antibiotic Stewardship And The Quality Of Life For Residents Over 65 Years, Reshma Beharry-Guest

Walden Dissertations and Doctoral Studies

Antibiotics were often over-prescribed in long term care facilities (LTCFs) and antibiotic stewardship guidelines, established by the CDC were not followed. The nursing home administrator was responsible for the quality of care for the residents and ensured that the facility met and/or exceeded the CMS antibiotic stewardship standard of care. The purpose of this quantitative study was to analyze operational secondary data collected from a Texas LTCF regarding antibiotic utilization for male and female residents over 65 years. The theoretical framework of the social cognitive theory was applicable for quality improvement in the LTCF setting. The data analysis showed that …

Best Practices For Screening And Early Treatment For Hiv In The Hispanic Community, Juliana Deboviel

Walden Dissertations and Doctoral Studies

The Hispanic community is among the ethnic minorities that are adversely affected by HIV/AIDS in the United States. HIV transmission rates and rates of death are high among Hispanic communities because of delays in HIV testing and late participation in HIV treatment, especially in the state where this study was conducted. However, advanced practices for screening and early treatment of HIV can improve patient outcomes and inform practice. Thus, this systematic review was conducted to identify the best available evidence for HIV screening and care in the Hispanic population in the Western United States that shares a border with Mexico. …

Impact Of Demographic Characteristics And Therapy On Tuberculosis Incident Cases, Iliedor Garcon

Walden Dissertations and Doctoral Studies

For more than two decades, tuberculosis (TB) has ranked second among the top killers of infectious diseases, with an estimated 10.4 million incident cases in 2018. Demographic characteristics and drug susceptibility influence TB incidence worldwide. Using a retrospective cohort design, the purpose of this quantitative study was to investigate whether race/ethnicity, age, sex (gender), therapy completion within one year (COT), and testing for isoniazid and rifampin susceptibility (TIRS) were predictors of 672 cases of TB in New York-Newark-Jersey City from 1993 to 2017. Guided by the epidemiological triad theory, this research was conducted using a secondary TB dataset from the …

Comparison Of Health Factors And Outcomes Between Accredited And Nonaccredited Health Departments, Deborah Koester

Walden Dissertations and Doctoral Studies

The launch of the Public Health Accreditation Board in 2012 established national public standards. This study examined possible correlations between the accreditation status of local health departments and specific indicators for health, including communicable disease, disease prevention and health promotion, and maternal child health factors, and outcomes of premature death and infant mortality. The population for the intervention group included all 212 local health departments accredited from September 2012 through December 2017. Accredited health departments were matched with nonaccredited health departments based on population, rurality, agency type, governance authority, and state public health structure. Linear regression analysis was performed on …

Bioterrorism: Exploring Factors For Improving Nurse Preparedness, Policies, And Practices, Leone Okey Tom-James

Walden Dissertations and Doctoral Studies

Ebola virus release/attack in New Jersey could go unnoticed but have immediate and long-lasting effects on the broader population and security. The risk underscores the need to prepare and enhance the state’s efforts to deal with a release and treat the confirmed cases. This descriptive single case research explored factors for improving nurses’ preparedness, policies, and practices for a bioterrorism release/attack. The epidemiological triangle conceptual framework was used descriptively in exploring, and developing a knowledge base of Ebola virus pathogenicity, characteristics, routes of transmission, and infection. The unit of analysis was Summit Ridge Genesis Healthcare Center. The theory of robust …

Perception Of Breast Cancer Screening Among African Immigrant Women In Dallas., Phillipa Akuwa Anuwe

Walden Dissertations and Doctoral Studies

Breast cancer is the leading cause of cancer-related deaths in women, and mammography is proven to detect breast cancer at its earliest stage; however, studies show that Black women have the lowest rate of breast cancer screening. The purpose of this descriptive, qualitative study was to explore the perceptions of African-born immigrant women about breast cancer screening. Data were collected by conducting individual interviews with 10 purposefully selected, African, immigrant women in Dallas, between 35 to 65 years old. Data were analyzed using NVivo software and coded based on the conceptual framework, which was the health belief model. Participants’ perception …

Practitioners’ Perceptions Of Medical Compliance Among Homeless Clients With Hiv And A Mental Health Diagnosis, Kyle Samuel Berkley

Walden Dissertations and Doctoral Studies

Previous research on HIV medical adherence has focused on incentive-based interventions, while previous research with the chronically homeless has focused on substance abuse, mental illness, and health disparities. This qualitative study focused on the experiences and perceptions of medical providers in a metropolitan area who work on medical adherence with homeless people living with HIV and mental illness. Ecological systems theory provided foundation to explore how medical providers form interventions based on clients’ ecosystems. The data were collected via audio-recorded, semi-structured interviews with 15 case managers, mental health therapists, nurses, and primary care physicians who worked at outpatient medical centers. …

Clostridium Difficile Incidence In Acute Care Hospitals: Patient And Hospital Characteristics, Angela Nwachuku

Walden Dissertations and Doctoral Studies

Hospital acquired infections (HAIs) calls for the attention of public research because it allows for investigation of the health practices, resources, and barriers of different health facilities and their surrounding communities. This research study examined the relationship between hospital acquired clostridium difficile infection (CDI) and patient, socioeconomic, and hospital characteristics in the state of New Mexico to determine their correlation with the increased incidence of CDI between 2013 and 2015 and if significant differences exist. The research questions were explored with the implication of the fundamental cause model and the pathways model. New Mexico patients over the age of 18 …

Educational Program For Decreasing Catheter-Associated Urinary Tract Infections, Josephine Crentsil

Walden Dissertations and Doctoral Studies

Catheter-associated urinary tract infection (CAUTI) is the most common hospital-acquired illness. Insertion and maintenance of urinary catheters are critical factors that predispose patients to CAUTI. Studies have shown that many nurses have a knowledge deficit regarding evidence-based practices in the insertion and management of urinary catheters, which can help prevent CAUTI. This is a concern because nurses are typically the first point of contact with patients and are responsible for the promotion of evidence-based practice and preventative measures. Therefore, this project aimed to develop an educational intervention for nurses with a focus on proper insertion and maintenance of indwelling urinary …

Association Of Landfall Atlantic Tropical Storms And Human Cases Of Locally Acquired West Nile Virus Infection In Florida, Jackson G. Mosley

Walden Dissertations and Doctoral Studies

West Nile virus (WNv) is the most widely distributed flavivirus and considered a vector-borne pathogen of global significance. During the study period from 2002 to 2018, WNv had the highest incidence of locally acquired human cases when compared to any other mosquito borne illness in Florida with 373 cases documented during the study period. The purpose of the study is to determine if there is an association between Florida landfall tropical storms (LTS) and the incidence of locally acquired human WNv cases from 2002 through 2018. The study used a retrospective ecological study design guided by the epidemiological triad model …

Population-Level Determinants Of Cholera Incidence In African Countries, Ngoy Nsenga

Walden Dissertations and Doctoral Studies

Cholera remains endemic in Africa, with limited access to safe drinking water and inadequate sanitation as 2 of the main drivers of its dissemination. Few studies have examined the impact of health system capacity, even though it plays an important role in prevention, early detection, and response to a cholera outbreak. Grounded in the ecosocial theory of infectious disease dissemination, this quantitative ecological study explored the effect of social vulnerability (as measured by access to safe drinking water and sanitation, rate of open defecation, poverty, income inequality, gender inequality, and adult literacy) and health system (as measured by health financing …

Educational Program On Human Immunodeficiency Virus For Clinic Staff, Margaret Ayoade

Walden Dissertations and Doctoral Studies

Medical assistants (MAs) and nurses provide primary care to patients infected with the human immunodeficiency virus (HIV). However, differences in their standard workflow were observed to affect the provision of preventive care. This warranted intervention due to prevalence of ongoing HIV-related stigma that affects HIV prevention and care. The practice-focused question asked whether an educational program could fill an identified gap in knowledge to assuage the fears of MAs and nurses providing care to HIV-positive patients. The project was guided by Kolb’s experiential learning theory and Lewin’s change theory. The purpose was to develop an educational program to educate the …

Evaluation Of Inappropriate Use Of Antibiotics In The Long-Term Care Community, Charlene A. Hughes

Walden Dissertations and Doctoral Studies

The number of antibiotics prescribed in the 65 and older population significantly increased related to the diagnosis of urinary tract infections (UTIs). Although empiric treatment is necessary at times, it can lead to antibiotic resistance; therefore, clinical symptomology with an active infection verified by diagnostic testing is the requirement for the treatment of a UTI. This project addressed the practice-focused question of how the implementation of an evidenced-based antibiotic stewardship program (ASP) in a nursing home on the East Coast may impact the overuse of antibiotics in that clinical setting. The project, guided by the theory of planned behavior, was …

Public Health Leadership In The Philippines: Effective Approaches In Malaria Surveillance, Gethro Nullan

Walden Dissertations and Doctoral Studies

Leadership traits that affect and shape cost-effective practices ensure the long-term

growth and success for any organization. The purpose of this single case study was to explore leadership traits that may contribute to cost-effective approaches in a malaria surveillance program in the Philippines. The National Health Service Leadership Framework provided the conceptual framework for this study. The participants included 12 public health leaders/managers who have worked or been involved in malaria surveillance programs with budgetary oversight. Data were collected through in-depth interviews and document analysis. Values coding was used for data analysis, in which participants’ perspectives were coded using the …

Predictors Of Condom Use Among High School Students In North Carolina, Danielle Cierra Robinson

Walden Dissertations and Doctoral Studies

The spread of sexually transmitted diseases is a major ongoing public health issue in North Carolina. Adolescents between the ages of 13 and 19 years have consistently contributed to this trend. Researchers have found that condom use among high school students has decreased. High school students continue to engage in sex with multiple partners, with lack of knowledge about sexually transmitted diseases, even though sex education and prevention programs have been recommended. The purpose of this quantitative study was to evaluate the predictors of condom use among adolescents. The socioecological model theoretical framework was applied to guide this research involving …

Attitudes And Beliefs Related To Risk Of Sexually Transmitted Infection In Swingers Who Do Not Use Condoms, Deborah Brown

Walden Dissertations and Doctoral Studies

Sexually transmitted infection (STI) affects the public as a hidden epidemic of contagious disease with significant economic and health impacts. There are 110 million living with STI in the United States, with 20 million new infections annually. Condom use can reduce STI, but some people have sex without condoms, with risk for contracting or transmitting STI increasing when a person is in the same sexual network. Swingers are a growing sexual network and are a group at high risk of developing and spreading STI. The purpose of this generic qualitative study was to develop an understanding of the attitudes and …

Prevention Of Care Of Catheter-Associated Infections In Long Term Care, Maureen Edozie

Walden Dissertations and Doctoral Studies

The incidence of catheter-associated urinary tract infections (CAUTI) in long-term care settings ranges from 1.5 to 3.3 per 1,000 catheter days for adult. Over 380,000 nursing home residents are hospitalized due to infections each year. Staff education using Agency for Healthcare Research and Quality (AHRQ) practice guidelines showed knowledge gained. The use of an evidence-based practice guideline developed AHRQ has been shown to significantly reduce the rate of CAUTI in the long-term care residents. The clinical practice problem was a CAUTI rate higher than the national average in the long-term care facility of interest due, in part to inconsistent nursing …

Predictors Of Hiv Testing Among African American Men Who Have Sex With Men, Jeanette Marie Higgins

Walden Dissertations and Doctoral Studies

Human immunodeficiency virus (HIV) infections affect more than 1.2 million people living in the United States and disproportionately affect African Americans (AA) men who have sex with men (MSM). The numbers of those who have HIV infections are likely higher due to lack of HIV testing by all individuals living at risk for HIV in the United States. Prior research has been inconclusive in determining the exact cause of the disparity among AA MSM. Therefore, the purpose of this quantitative secondary data study was to explore barriers to HIV testing within the AA MSM population. The sample for this study …

Demographic, Environmental, And Clinical Variables Associated With Dengue In Saint Lucia, Brendan Lee

Walden Dissertations and Doctoral Studies

Dengue is the most important arboviral disease of public health concern on the world stage. In Saint Lucia, the disease has been endemic for years. Little research has been published on the specific epidemiology of dengue in Saint Lucia, and this study sought to identify the risk factors associated with the disease specific to the island. This study was underpinned by ecological theory, which is used to explain the possible relationships between risk factors and the occurrence of dengue. This three-manuscript study was used to evaluate the relationship between demographic, environmental, and clinical variables and the occurrence of dengue as …

Optimizing The Use Of Antibiotics:Evaluation Of A Quality Improvement Project, Elaine Marie Summers

Walden Dissertations and Doctoral Studies

The overuse and inappropriate use of antibiotics for residents in long-term care facilities (LTCFs) is associated with significant unintended treatment harm with 50% to 70% of residents prescribed an antibiotic at least once in 12 months. The purpose of this project was to evaluate data from a quality improvement quality improvement initiative conducted at a 168-bed LTCF to implement a protocol of an antibiotic stewardship program (ASP) to reduce the overuse of antibiotics. The John Hopkins nursing evidence-based practice model guided this project to analyze health care provider compliance with implementation of protocol guidelines before and after the ASP program …

Socio-Economic Determinants Of Risky Sexual Behavior In Sub-Saharan Africa, Frida Tende

Walden Dissertations and Doctoral Studies

Risky sexual behavior (RSB) is a major public health concern due to health outcomes, such as HIV/AIDS, sexually transmitted infections, and unwanted pregnancies. RSB has been identified as 1 of the main components contributing to the high HIV incidence rate in sub-Saharan Africa. The purpose of the current research was to investigate RSB and its association with education and economic status among men and women in 3 sub-Saharan African countries (i.e., Rwanda, Zimbabwe, and Cameroon) while controlling for gender, age, religion, and place of residence. The social cognitive theory provided the framework for this cross-sectional study that included data from …

Access To Healthcare For American Indians Residing In The Northeast United States, Kristine D. Thomas-Jones

Walden Dissertations and Doctoral Studies

Urban American Indians/Alaskan Natives (AIs/ANs) have limited access to health care in comparison to non-Hispanic Whites (NHWs), which furthers health disparities for indigenous communities. The purpose of this quantitative, nonexperimental study, which was guided by the socioecological model, was to examine the relationship between access to health care and healthcare utilization among urban AIs/ANs and urban NHWs in the Northeast United States. The research questions addressed the difference in access to healthcare based on health insurance, difference in healthcare utilization, and whether there is an association between health care access and health care utilization for AIs in the Northeast United …

Retail Pharmacy Clinic Antibiotic Stewardship Program And Guidelines, Abdulrahman Sudi Amiri

Walden Dissertations and Doctoral Studies

Overuse of antibiotics poses serious consequences for patient's well-being, including the risk for antibiotic resistance and adverse effects from inadequate and timely treatment. The emergence and frequency of multi-drug resistant bacteria are alarming global public health care experts, as these strains are resisting effective management of life-threatening infections. The gap in practice was that a retail pharmacy clinic did not have a practice guideline for the implementation of a wait-and-see prescription program as part of an antimicrobial stewardship program. The purpose of this project was to coordinate an interprofessional team to develop guidelines for this primary care setting. The practice-focused …

Relationship Between Clostridium Difficile Testing Method, Antibiotic Treatment, And Clinical Symptoms, Jennifer L. Sanguinet

Walden Dissertations and Doctoral Studies

Clostridium difficile (C. difficile) infection is a leading cause of morbidity and mortality in the United States, making the infection a top public health priority. Early and accurate identification of disease is a critical factor in successful management, including clinical symptomology. The testing methods for C. difficile have improved in efficiency and sensitivity, which potentially causes over- or underprescribing behavior. Guided by the symbolic theory, the purpose of this study was to examine the association between C. difficile testing method by case year (2015 and 2018) and antibiotic treatment with the potential moderation of clinical symptoms. The secondary correlational analysis …

Perception Of Stress Observed By Family Members Of Dentists Who Have Committed Suicide, Lillian D. Williams

Walden Dissertations and Doctoral Studies

Research aimed at the observed stress from being a dentist, and how it may have

impacted the occurrence of their suicide did not appear to be prevalent among empirical

suicide studies. The purpose of this basic, qualitative study was to explore how the

family members perceived occupational stress as precursor events in dentists who

committed suicide. Using the interpersonal theory of suicide as the conceptual basis, 4

family members of dentists who committed suicide were interviewed to understand how

family members perceived occupational stress in the dentist using semi structured

interviews. Through a series of precoding and recoding, interview data …

Association Between Mentoring Interventions And Drug Abuse Among African Americans Aged 10-24 Years, Anthonia Ifeyinwa Dunkwu

Walden Dissertations and Doctoral Studies

Drug abuse represents a significant public health problem worldwide, with socioeconomic consequences shaped by a cluster of behavioral, cognitive, and physiological phenomena and serious social, physical, emotional problems. The purpose of this study was to assess the association between mentoring interventions and drug abuse among African American young people. The health belief model was the theoretical framework. The secondary data analysis was done using the data set from the 2014 National Survey on Drug Use and Health. The dependent variable was drug abuse, while the independent variable was mentoring interventions. The Chi-square analysis revealed an association between participation in school-based …

Predictors Of Use Of Pap Tests Among Ghanaian Immigrant Women In Ohio, Baaba Forson

Walden Dissertations and Doctoral Studies

In the United States, cervical cancer disproportionately affects members of ethnic minorities, including immigrant women from Ghana. Overall cervical cancer incidence and mortality rates have declined in the United States due to opportunistic screening with Pap tests; however, rates have not declined for Black women and immigrant women, who continue to experience higher than average mortality rates. Immigrant women, including Ghanaian women, use screening less than nonimmigrant women. Several factors including poor acculturation, low educational level, certain personal attitudes, and lack of health insurance are known to reduce participation in screening. Using the theory of planned behavior as a guide, …

Relationship Between Clostridium Difficile Testing Method, Antibiotic Treatment, And Clinical Symptoms, Jennifer L. Sanguinet

Walden Dissertations and Doctoral Studies

Clostridium difficile (C. difficile) infection is a leading cause of morbidity and mortality in the United States, making the infection a top public health priority. Early and accurate identification of disease is a critical factor in successful management, including clinical symptomology. The testing methods for C. difficile have improved in efficiency and sensitivity, which potentially causes over- or underprescribing behavior. Guided by the symbolic theory, the purpose of this study was to examine the association between C. difficile testing method by case year (2015 and 2018) and antibiotic treatment with the potential moderation of clinical symptoms. The secondary correlational analysis …

Microvascular Disease And Chronic Kidney Disease In Persons With Diabetes In Grenada, Jennifer Elizabeth Lewis

Walden Dissertations and Doctoral Studies

Chronic kidney disease (CKD) is a set of pathophysiological reactions that impact the functionality of the kidney. The association between microvascular disease (MVD) and CKD as it relates to diabetes is important to the evaluation of organizational effectiveness in-hospital services planning as well as improving health outcomes. The purpose of this quantitative, cross-sectional study was to determine if there is an association between MVD and CKD severity in persons with diabetes. Using the socioecological model, the association between gender, age group, cigarette smoke, cigarette smoke frequency, alcoholic drink, alcoholic drink frequency, hypertension, albumin-to-creatinine ratio (ACR) severity, cholesterol, sickling (i.e. persons …