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Fast Food Business Survivability Beyond 5 Years In Nigeria, Victor Ukorebi Jan 2018

Fast Food Business Survivability Beyond 5 Years In Nigeria, Victor Ukorebi

Walden Dissertations and Doctoral Studies

The lack of manager's effective business strategies contributes to the failure of fast food businesses in Nigeria. The size of the fast food industry in Nigeria grows at the rate of 4% annually with rapid rate of return on investment. The annual value of the fast food business in Nigeria was N250 billion in 2015, which is approximately US$700 million. However, approximately 80% of fast food restaurants launched in Nigeria in 2014 failed to persist for longer than 5 years because of lack of survival strategies. Using the human capital theory, the purpose of this multiple case study was to …


Young Female College Millennials' Intent For Behavior Change With Wearable Fitness Technology, Andrea Christine Haney Jan 2018

Young Female College Millennials' Intent For Behavior Change With Wearable Fitness Technology, Andrea Christine Haney

Walden Dissertations and Doctoral Studies

Among young college-aged females, overweight and obesity, type 2 diabetes, uncontrolled hypertension, and high stress levels have increased, causing overall worse health conditions than previous generations. The use of wearable fitness technology (WFT) by young adults assists in fitness and nutrition monitoring, provides feedback in health statistics, and has shown improvements in reducing health-related issues in young college females. A wide body of literature related to physical activity, nutrition, and health issues in young college females exists; however, the experiences and intent of WFT use for behavior change by young college female millennials has not been well researched. The purpose …


Increasing Medication Adherence In Hypertensive Patients With Million Hearts® Health Literacy Program, Tammy Ross Jan 2018

Increasing Medication Adherence In Hypertensive Patients With Million Hearts® Health Literacy Program, Tammy Ross

Walden Dissertations and Doctoral Studies

Healthy People 2020 identified hypertension (HTN) as a controllable risk factor to prevent cardiovascular disease and stroke. Adhering to regular antihypertensive (AHT) medications improves outcomes in patients diagnosed with HTN by controlling blood pressure, reducing hospital visits, and promoting patient wellness. Medication adherence occurs when prescribed medicine regimens are utilized by the patient as directed to manage illness or disease, as evidenced by patients receiving medications at their pharmacy. The practice-focused question for this quality improvement project asked whether implementation of health literacy tools from Million Hearts® HTN Control: Action Steps for Clinicians, increased medication adherence as evidenced by regular …


County Health Leadership And Readiness For Noncommunicable Disease Services, Paul Wekesa Agunga Jan 2018

County Health Leadership And Readiness For Noncommunicable Disease Services, Paul Wekesa Agunga

Walden Dissertations and Doctoral Studies

Premature mortality resulting from the growing global burden of noncommunicable diseases (NCDs) is a contemporary development challenge. Low-income and lower-middle-income countries are disproportionately affected, with the poorest in society considered the most vulnerable. A paucity of literature exists on how leadership practices at the implementation level relate to ensuring readiness for NCD services. The purpose of this study was to investigate whether any relationship exists between leadership practices at the county level and readiness for NCD services in Kenya. Path-goal and adaptive leadership theories were used to guide this quantitative correlational study, using secondary data from a 2013 Service Availability …


Diabetes Management Protocol In The Rehabilitation Setting, Hannah Mottel Jan 2018

Diabetes Management Protocol In The Rehabilitation Setting, Hannah Mottel

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a growing healthcare problem in the United States. Diabetes affects 1.4 million Americans yearly, impacting the lives of individuals of all ages. One of the most challenging aspects about diabetes is that many individuals are not aware of the impact of the disease on multiple organs until the progression of the disease has reached latter stages. Prevention and early detection of diabetes is a key component of lifesaving interventions including proper nutrition counseling, exercise regimens, management, and patient compliance with a treatment plan. The purpose of this doctoral project was to create a standardized diabetes management protocol …


Domestic Violence And Demographic Variables As Predictors Of Resiliency Among Young Adults, Sylvanus O. Abraham Jan 2018

Domestic Violence And Demographic Variables As Predictors Of Resiliency Among Young Adults, Sylvanus O. Abraham

Walden Dissertations and Doctoral Studies

An increased understanding of resilience may determine how human psychological development can result in positive outcomes despite adversarial situations. However, current studies have not provided a relevant predictive model that can adequately predict resilience, particularly among young adults exposed to domestic violence. Based on Bronfenbrenner's ecological systems theory, the purpose of this quantitative noncomparative study was to examine whether domestic violence, age, gender, ethnicity, individual emotional and physical abilities, types of domestic violence exposure, and frequency of domestic violence exposure could adequately predict resilience among young adults. Quantitative data were collected from 118 young adults in the Midsouth region of …


A Chronic Obstructive Pulmonary Disease Self-Management Packet To Reduce 30-Day Readmissions, Josette Askratni Jan 2018

A Chronic Obstructive Pulmonary Disease Self-Management Packet To Reduce 30-Day Readmissions, Josette Askratni

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) signifies a significant public health challenge that is both avoidable and treatable. There was no standardized education offered to the COPD population at the practice location. The scope of the project encompassed standardizing education by developing a self-management packet for the COPD patients. The goal of this project was to examine how the development of a standardized COPD self-management packet enhances the quality of care and strategizes reducing 30-day readmissions compared to nonstandardized delivery of education. Orem's self-care theory and Bandura's self-efficacy concept were used to explain the principle of self-management, while Rosswurm and Larrabee's …


A Nurse-Led Evidence-Based Quality Improvement Program On Childhood Obesity Prevention, Ana Flor Rasonabe Ciocson Jan 2018

A Nurse-Led Evidence-Based Quality Improvement Program On Childhood Obesity Prevention, Ana Flor Rasonabe Ciocson

Walden Dissertations and Doctoral Studies

The increased prevalence rate of childhood obesity in Saudi Arabia is a nationwide health issue. The doctoral project was instituted in the pediatric out-patient clinic (POPC) of a tertiary university hospital in Riyadh, Saudi Arabia. Child obesity clinic and clinical practice guideline (CPG) for primary prevention were not available in the pediatric outpatient clinic with a high incidence of newly diagnose obese children. The focus of this doctoral project was to improve the clinical nursing practice of POPC nurses through the adoption of CPG on primary prevention of childhood obesity. The knowledge translation into action framework provided a summary of …


Cultural And Environmental Determinants Of Dental Discoloration Among School-Aged Children In Nigeria, Ogbudu Gabriel Ada Jan 2018

Cultural And Environmental Determinants Of Dental Discoloration Among School-Aged Children In Nigeria, Ogbudu Gabriel Ada

Walden Dissertations and Doctoral Studies

Dental discoloration from fluorosis is a global public health problem. In Nigeria, 11.4% of the population is impacted by this disorder. Dental discoloration is caused by successive exposures to high fluoride concentrations during tooth development in utero and it is linked to the development of a variety of psychological and physiological problems, from dental aesthetics to a reduction in intelligence and skeletal changes. The purpose of this quantitative, cross-sectional study was to examine the cultural and environmental determinants of dental fluorosis in children in a rural community in Nigeria. A multilevel theoretical model was used to develop possible fluoride exposure …


Perceptions Of Preconception Health And Prenatal Care By Young Adult Women And Men At Risk For Unintended Pregnancies, Broderick Crawford Jan 2018

Perceptions Of Preconception Health And Prenatal Care By Young Adult Women And Men At Risk For Unintended Pregnancies, Broderick Crawford

Walden Dissertations and Doctoral Studies

Among young adults at risk for unintended pregnancies, preconception health and prenatal care programs aimed at positive birth outcomes remain unaddressed. The purpose of this phenomenological study was to explore the lived experiences of young adults in terms of their willingness to use preconception health and prenatal care as a means for increasing both positive birth outcomes and overall health. All study participants met the following criteria: (a) young adult man or woman, (b) age 18 to 25, (c) at risk for unintended pregnancies, (d) sexually active, (e) single or in cohabiting partnerships, and (f) living in the greater Los …


Program To Prevent Subsequent Fragility Fractures, Kathleen Jean Forti-Gallant Jan 2018

Program To Prevent Subsequent Fragility Fractures, Kathleen Jean Forti-Gallant

Walden Dissertations and Doctoral Studies

One out of 2 women and 1 out of 5 men over age 50 will sustain a fragility fracture (FF) in their lifetime. The risk of a 2nd FF increases dramatically after the 1st fracture and can lead to pain, disability, and mortality. Despite the evidence that secondary prevention programs are effective, the local facility did not have a formal mechanism to address this need. The purpose of this project was to design a program for secondary prevention of FFs and to address the need for a program for secondary FF prevention that was sustainable locally. The program was designed …


Neighborhood-Level Predictors And Obesity Among African-American Children, Uche Onyeka Jan 2018

Neighborhood-Level Predictors And Obesity Among African-American Children, Uche Onyeka

Walden Dissertations and Doctoral Studies

The steady raise in childhood obesity is a major public health problem nationally and globally. Childhood obesity is primarily caused by an imbalance between caloric intake and caloric expenditure. The increase in childhood obesity rates over the past 3 decades suggested involvement of environmental and behavioral factors in the obesity epidemic. While childhood obesity is considered a public health crisis in the United States, only limited research is available about the potential impact of neighborhood-level factors such as access to healthy food, neighborhood safety, and risk-free outdoor playgrounds. The purpose of this study was to examine if any relationships existed …


Regression Analysis Of Young Elderly Americans' Needs To Alleviate Poverty, Barbara Ann Parker Jan 2018

Regression Analysis Of Young Elderly Americans' Needs To Alleviate Poverty, Barbara Ann Parker

Walden Dissertations and Doctoral Studies

Demographics are changing for the young elderly population in America, and poverty is a growing concern among this population. The purpose of this correlational study was to examine the relationship between young elderly demographics and income level, and between government programs and economic status. Rawls's theory of justice was useful to examine the relationship between predictor variables and the outcome variable. Secondary data came from the U.S. Census Bureau's Current Population Survey from March 2016. The results of multiple and logistic regressions indicated no statistically significant linear correlation. There was no statistical linear correlation between income level and region, race, …


Relationships Among Vitamin D Deficiency, Metabolic Syndrome, Smoking Behavior, And Physical Activity, Ethan Pham Jan 2018

Relationships Among Vitamin D Deficiency, Metabolic Syndrome, Smoking Behavior, And Physical Activity, Ethan Pham

Walden Dissertations and Doctoral Studies

Aging increases the risk of both vitamin D deficiency and metabolic syndrome. Vitamin D deficiency and metabolic syndrome may be related, although there are mixed findings. Furthermore, literature suggests other factors such as physical fitness activity and smoking behavior are associated with Vitamin D deficiency and the development of metabolic syndrome. A number of studies have documented associations between Vitamin D levels and physical fitness activities, while other studies found correlations between Vitamin D levels, metabolic syndrome, and smoking behavior. However, no previous study has examined the links between physical fitness activity, smoking behavior, Vitamin D levels, and the risks …


A Practice Change In Adult Obesity Primary Care, Jasmine Tinsley Jan 2018

A Practice Change In Adult Obesity Primary Care, Jasmine Tinsley

Walden Dissertations and Doctoral Studies

The rate of obesity in American adults has increased dramatically over the last decade. Obesity has reached epidemic proportions and demands attention to reverse the current trend. This project was developed to evaluate a quality improvement initiative implemented in 2016 to address the problem of obesity in a rural southeastern primary care clinic setting where underserved populations are treated. The quality improvement (QI) initiative was developed using the plan-do-act-check model and the evaluation of the initiative was the focus of the current project. The project question asked if a quality improvement initiative for weight loss monitoring and counseling could improve …


Health Promoting Behaviors Of Young Adults With Chronic Lyme Disease, Patricia D. Bolivar Jan 2018

Health Promoting Behaviors Of Young Adults With Chronic Lyme Disease, Patricia D. Bolivar

Walden Dissertations and Doctoral Studies

Lyme disease is the most prevalent arthropod-borne (tick) disease in North America. The disease is more prevalent in some Eastern and Central states than in Western states. The general problem is that, in southern California especially in Los Angeles County, both patients and practitioners fail to recognize the disease, resulting in misdiagnosis and delayed treatment. Consequently, the patient may develop the long-term, chronic Lyme disease (CLD). The purpose of this phenomenological study was to explore the impact of CLD on the health-promoting behaviors of ethnically diverse young adults from similar educational and socioeconomic backgrounds based on their lived experiences. The …


Hand Expression With Lactation Support: Effect On Self-Efficacy And Breastfeeding Duration, Florence Omekara Jan 2018

Hand Expression With Lactation Support: Effect On Self-Efficacy And Breastfeeding Duration, Florence Omekara

Walden Dissertations and Doctoral Studies

Breastfeeding is the best infant feeding method, and breastmilk has many immunological and anti-inflammatory properties that protect babies against illnesses and diseases. It protects the health of the mother and saves society substantial economic costs, as demonstrated in many studies. Studies show that if 90% of U.S mothers breastfed for 6 months, up to $13 billion in healthcare costs could be saved. Despite the health and economic benefits of breastfeeding, most women stop breastfeeding before 6 months postpartum, which falls short of the recommendations of the World Health Organization, U.S. Surgeon General, and American Academy of Pediatrics. This study explored …


Variables That Impact Incidence Of Diarrhea Amongst Under-Five In Uganda, Anne Ngonde Muli Jan 2018

Variables That Impact Incidence Of Diarrhea Amongst Under-Five In Uganda, Anne Ngonde Muli

Walden Dissertations and Doctoral Studies

Diarrhea in children remains a major public health problem in Uganda and other countries in the region and acts as one of the leading contributors to child mortality. Most of the risk factors for diarrhea in children are preventable. This study, guided by the socioecological model, was conducted to investigate the association between the occurrence of diarrhea in children and length of breastfeeding, coinfection with acute respiratory infection (ARI), and vaccination status of the child. These variables were identified in the literature as risk factors for diarrhea that had not been investigated in Uganda. The source of the data for …


Development Of A Scholarly Educational Intervention To Improve Inpatient Diabetes Care, Sharon.Hasfal Hasfal Jan 2018

Development Of A Scholarly Educational Intervention To Improve Inpatient Diabetes Care, Sharon.Hasfal Hasfal

Walden Dissertations and Doctoral Studies

Advanced practice providers (APPs), consisting of nurse practitioners and physician assistants, face many challenges in the provision of evidence-based practice in their management of hospitalized adult patients with diabetes. Some of the barriers faced by APPs at a Northeast acute care facility are poor communication between disciplines, lack of confidence in initiating insulin, limited understanding of the management of insulin and the insulin pump, and insufficient treatment of the hospitalized patient with diabetes that aligns with current clinical guidelines for the management of inpatient hyperglycemia. This quality improvement project focused on the development of an evidence-based theory supported educational intervention …


A Diabetic Child's Impact On An African American Family, Silvanus Okeke Jan 2018

A Diabetic Child's Impact On An African American Family, Silvanus Okeke

Walden Dissertations and Doctoral Studies

Diabetes, a chronic disease with devastating but preventable consequences, is common in the United States, especially within African American communities. Earlier research has indicated that 21.7% of African American parents have children diagnosed with Type 1 diabetes in the Mississippi Delta Region. Researchers have examined coping, stress, and behaviors of African American parents of children diagnosed with Type 1 diabetes; however, there is a gap in literature regarding how African American parents can cope with stress and how changes in health behavior due to Type 1 diabetes impact African American families. The purpose of this qualitative phenomenological study was to …


Education Models For Teaching Adults About Modifying Dietary Carbohydrate And Controlling Weight, Vincient Cleamons Jan 2018

Education Models For Teaching Adults About Modifying Dietary Carbohydrate And Controlling Weight, Vincient Cleamons

Walden Dissertations and Doctoral Studies

The prevalence of diabetes and other pathophysiological conditions has been correlated with the incidence of obesity. A large portion of an adult community in the northwestern United States suffers from excessive weight that has been linked to premature mortality rates and certain forms of diabetes. Excess calories from carbohydrate have been shown to increase weight. Therefore, diets that are modified in carbohydrate and calories may help mitigate weight and obesity comorbidities. This qualitative, single case study's purpose was to explore the methods health care professionals use for teaching adults about controlling weight. Altheide and Johnson's analytic realism theory, in which …


Instructional Practices In Holistic Education For Patients With Cancer, Alicia Oberle Jan 2018

Instructional Practices In Holistic Education For Patients With Cancer, Alicia Oberle

Walden Dissertations and Doctoral Studies

During the past few decades, holistic education has increasingly emerged in academia. However, limited research has been conducted on how holistic education impacts instructional practices in real life situations like the well-being of cancer patients. The purpose of this qualitative study was to explore how a holistic education program impacts instructional practices designed to improve the well-being of cancer patients. The conceptual framework was based on transformative learning theory and learner-centered teaching. This single case study was conducted at a non-profit cancer center in the Western United States which emphasizes multiple dimensions of well-being for cancer patients, including holistic education. …


Discharge Calls And Avoiding Hospital Readmissions, Wanda Lee Cassavettes Jan 2018

Discharge Calls And Avoiding Hospital Readmissions, Wanda Lee Cassavettes

Walden Dissertations and Doctoral Studies

Hospital readmissions are disruptive and costly for patients and hospitals. As hospital discharge instructions are a key nursing responsibility, this project implemented a nurse follow-up phone call intervention within 12-48 hours of patient discharge from an indigent care facility in the Great Lakes region of the United States. The project was designed to understand whether follow-up phone calls from nurses that clarified discharge instructions, symptom management, and medications would be associated with decreased readmission rates within 30 days post-discharge among chronic care patients. The theoretical framework was the health belief model, which proposes that the patient's knowledge of illness severity, …


Health Promotion Behavior Among Hypertensive And Normotensive Armenian Americans, Zoya Minasyan, Leslie C. Hussey, Kathleen Brewer Jan 2018

Health Promotion Behavior Among Hypertensive And Normotensive Armenian Americans, Zoya Minasyan, Leslie C. Hussey, Kathleen Brewer

Journal of Social, Behavioral, and Health Sciences

Hypertension presents a significant health risk to both developed and developing countries, affecting approximately 78 million Americans of various ethnic backgrounds. Though a great deal of research about hypertension and minority groups has been published, no studies were located about hypertension in the Armenian American population, despite evidence of health disparities in this population. The purpose of the present study was to examine the differences in health promotion behavior between hypertensive and normotensive Armenian Americans. A quantitative approach was used to examine the relationship between hypertensive status and health promotion behavior. With a sample size of n = 204, this …


The Experiences And Perceptions Of African American Women Who Reside In Nursing Homes, Lakeisha De Lon Riley Jan 2018

The Experiences And Perceptions Of African American Women Who Reside In Nursing Homes, Lakeisha De Lon Riley

Walden Dissertations and Doctoral Studies

The purpose of this qualitative case study was to examine the experiences and perceptions of African American women who reside in a nursing home and to understand African American women's decisions for admitting to the facility. Social Learning Theory was applied to answer the question of how African American women's experiences and perceptions toward long-term care influence healthcare decisions and admission to a nursing home. Eleven participants interviewed in the study were at least 60 years old, admitted into the facility within the past two years and who had not previously resided in a nursing home. Yin's five step approach …


Efficacy Of Methods Available To Remove Environmental Tobacco Smoke In Vehicles, Brian Albert Nielson Jan 2018

Efficacy Of Methods Available To Remove Environmental Tobacco Smoke In Vehicles, Brian Albert Nielson

Walden Dissertations and Doctoral Studies

Environmental tobacco smoke (ETS) is a serious public health threat. Residual ETS in vehicles unknowingly exposes future occupants to environmental tobacco smoke. Reducing or removing exposure to ETS has been proven to reduce long-term health complications. This quasi-experimental study investigated 5 cleaning methods and their effect on air particulate matter2.5 (PM2.5) along with the correlation between air nicotine levels and PM2.5 levels. Study variables included cleaning methods as the independent variable, and changes in air nicotine and PM2.5 levels as the dependent variables. This study is framed within primary prevention and risk reduction based on the harm reduction theory. The …


Understanding Feeding Style And Young Children's Consumption Of Food, Mary W. Bean Jan 2018

Understanding Feeding Style And Young Children's Consumption Of Food, Mary W. Bean

Walden Dissertations and Doctoral Studies

Due to increased rates of childhood obesity since 2010, researchers have examined family environmental factors and family influences on children's consumption of healthy foods. While previous research has examined how factors such as food presentation and the food intake of other family members can predict a child's body mass index, there has been little research examining whether parent factors predict the amount of healthy foods children eat. This quantitative survey study examined whether certain parent factors, specifically parents' attitudes about food, parents' feeding styles, and parents' attachment styles, predicted the amount of fruits and vegetables children ate. Understanding the extent …


After-School Mentorship Program And Self-Efficacy Beliefs In Middle-School Students, Atia D. Mark Jan 2018

After-School Mentorship Program And Self-Efficacy Beliefs In Middle-School Students, Atia D. Mark

Walden Dissertations and Doctoral Studies

Middle-school students in Nova Scotia are perceived to have low self-efficacy for achieving learning outcomes. Strong self-efficacy beliefs developed through effective curricula have been linked to improved academic performance. However, there is a need for the formal evaluation of effective curricula that aim to improve self-efficacy. The purpose of this project study was to investigate a 10-week, after-school mentorship (ASM) curriculum that has never been evaluated. The outcomes of the curriculum design are to strengthen self-efficacy beliefs via relationship building exercises, public speaking training, and character education. Bandura's theory on self-efficacy, which states that treatment influences can alter the strength …


Intensive Care Unit Nurse Education To Reduce Sepsis Mortality Rates, Corina Meade Jan 2018

Intensive Care Unit Nurse Education To Reduce Sepsis Mortality Rates, Corina Meade

Walden Dissertations and Doctoral Studies

Sepsis causes major health care problems in the United States, resulting in long hospitalizations, complications, and even patient death. Lack of nursing knowledge regarding sepsis signs and symptoms is a significant problem at a hospital in the northeast. Local hospital data showed a high patient mortality rate for patients diagnosed with sepsis. The purpose of this project was to develop an educational module on sepsis for intensive care nurses. The educational module was developed using current sepsis evidence-based guidelines. The practice-focused question for the project asked whether an educational module on sepsis would increase the intensive care nurse's knowledge on …


Policy Implications Of News Media Coverage Of The Islamic State Of Iraq And Syria., Godfred A. Ababio Jan 2018

Policy Implications Of News Media Coverage Of The Islamic State Of Iraq And Syria., Godfred A. Ababio

Walden Dissertations and Doctoral Studies

The Islamic State of Iraq and Syria (ISIS) garnered global news media attention in Summer 2014 when it seized a significant section of land in Iraq and Syria. The group then mishandled and executed its captives. There is a lack of consensus among the international community, led by Russia and the United States, on how best to address the threat posed by ISIS. An understanding of the function of Russian and U.S. news media coverage of the ISIS threat is an appropriate research topic. The purpose of this qualitative content analysis study was to explore how the U.S, Russian, and …