Digital Commons Network^™

Relationship Between Exposure To Phthalate And Obesity In The United States, Gladys Chidiebere Ezem

Walden Dissertations and Doctoral Studies

Obesity is a public health problem. The global obesity problem has been attributed to unhealthy diet, inactivity, and hereditary factors. However, phthalates may also contribute to the obesity epidemic. The purpose of this cross-sectional study was to examine whether there was a relationship between exposure to phthalates and obesity among adults 18 years and older in the United States. The theoretical framework was based on the socioecological model. The quantitative, cross-sectional design, and data analysis were based on the National Health and Nutrition Examination Survey, 2011-2012 database. Descriptive statistics and multiple regression analysis were used to analyze the association between …

Examining Health Disparities And Childhood Obesity In Florida And Georgia, Jennifer Wesley

Walden Dissertations and Doctoral Studies

Childhood obesity is a major issue in the United States. The rates of obesity vary among racial and ethnic groups in the U.S. South. The purpose of this quantitative cross-sectional study was to investigate significant state health disparities differences in childhood obesity in the South region between Florida and Georgia. To steer this study, the social cognitive theory was used. The associations between neighborhood safety and support, physical activity, family health and activities on body mass index were examined in this study. Data was obtained from the National Survey of Children's Health 2011-2012 on 1,688 children aged 10-17 years residing …

Healthy Lifestyle Changes And Academic Improvement, Yvette Gail Williams

Walden Dissertations and Doctoral Studies

Many children in U.S. K-12 schools struggle with childhood obesity. A healthy lifestyle taught in a child's early years is essential for student learning, and it can set the pace for healthy choices to be made in adulthood. The purpose of this exploratory case study was to explore the experiences of parents in Montgomery County, Ohio, who successfully improved their children's health and academic grades. The transtheoretical model of behavior change grounded this study to evaluate the willingness of children and adults to take action on new health and wellness behaviors that can lead them through the stages of change …

Educating Oncology Nurses On The Benefits Of Patient Exercise, Roberta Anderson

Walden Dissertations and Doctoral Studies

Exercise benefits patients with cancer during and after treatments. A formalized educational program is lacking at the project's site for oncology nurses on the benefits of exercise for their patients during and after treatment. The purpose of the project was to address the identified gap in practice at the project's site by providing education to oncology nurses on the benefits of exercise for their patients during and after treatment. The ARCS model of motivational design was used as a theoretical foundation to develop and guide the educational program presented to the oncology nurses. The question addressed in the project was: …

Health Literacy As A Measure To Reduce Cost, Improve Health And Access, Vivian Dee

Walden Dissertations and Doctoral Studies

The United States dedicates greater than 17% of its gross national product to healthcare. This percentage is expected to go up to 20% by 2018. Despite the high cost of care, the health care system remains inefficient and ineffective. Barriers include reduced access to care related to low health literacy. Complicating low health literacy is the high readability score of patient education materials. The high readability score is in part due to tools that are not standardized and measure different aspects of education materials creating varying readability scores. The purpose of this quality improvement project was to adopt a tool, …

Emergency Department Use For Nontraumatic Dental Conditions And Adult Oral Health, Cheryl Anne Lassiter-Edwards

Walden Dissertations and Doctoral Studies

Nontraumatic dental-related emergency department visits has resulted in a financial burden to hospitals across the United States. This study investigated whether there is a relationship between adult preventive dental care and emergency department visits for nontraumatic dental conditions by comparing specific states. Guided by Andersen's behavioral model of health services utilization, this retrospective quantitative study also investigated associations between state-specific community water fluoridation and dental-related emergency department visits. The population of interest was adult Medicaid enrollees who visited the emergency department for non-trauma-related dental conditions in the top 5 most populous states as identified in the 2012 NHAMCS survey. These …

Levels Of Income And Quality Of Care For Adults With Type 2 Diabetes, Lorna Bowen

Walden Dissertations and Doctoral Studies

Type 2 diabetes impacts the lives of adults in the low-income, middle-income, and high-income brackets in the United States and globally. More research was needed on how adults 45 years and older in Marion County managed their diabetes and the care they received based on their income. This case study involved investigating how adults 45 years and older in Marion County self-managed their diabetes and the quality of care they received based on their income. The health belief model supported the conceptual framework for the study. Data were collected through face-to-face and telephone interviews with 15 purposefully selected participants. Data …

Adolescent Girls' Nutrition And Physical Activity Habits By Grade, Obesity, And Race/Ethnicity, Natasha Nicks

Walden Dissertations and Doctoral Studies

An urban southern school district located in the United States identified adolescent obesity as a problem. District records showed that 37% of adolescent girls and 29% of adolescent boys were obese which exposed them to short-term and long-term health consequences. The purpose of this archival multivariate survey study was to gain an in-depth understanding of the problem by exploring the problem nutritional and physical activity habits of eighth and eleventh grade adolescent girls (n=3320) of various races/ethnicities and obesity levels to determine how their nutritional and physical activity habits differ. The research questions asked whether there were significant differences between …

Predictors Of Readmission To Youth Counseling Services Among Adolescents In Saskatoon Canada, Felicia Lawal

Walden Dissertations and Doctoral Studies

Anxiety, depression, and substance use disorders are some of the frequently occurring mental illnesses among Canadian children and adolescents that can result in debilitating short and long terms outcomes. The rise in readmission rates for recipients of mental illness in Saskatchewan, coupled with the high incidences of suicide-related deaths, necessitates a patient outcome evaluation for predictors of readmission to youth counseling services among adolescents. The purpose of this secondary data analysis study was to explore the associations between anxiety, depression, substance use disorder, individual counseling, family counseling, group counseling, and the outcome of readmission within 1 year following discharge from …

The Relationship Between Transformational Leadership Behaviors And Employee Engagement And Turnover Intent, James Bruce Bright

Walden Dissertations and Doctoral Studies

The fast food industry is experiencing issues related to employee engagement and retention. Researchers have shown that managers' transformational leadership behaviors impact employee engagement and turnover intent in various work environments; however, no research to date has evaluated its influence on the fast food industry's hourly-wage, nonmanagement workforce. Building on the theoretical research of Burns and Bass, this study was conducted to examine the relationships among managers' 5 transformational leadership behaviors of idealized influence attributes, idealized influence behavior, inspirational motivation, intellectual stimulation, and individualized consideration and employee engagement and turnover intent. The Multifactor Leadership Questionnaire , the Utrecht Work Engagement …

Evaluation Of The Bedside Swallow Screen, Ruby Ben

Walden Dissertations and Doctoral Studies

Dysphagia is a leading complication of a stroke. A nurse-driven bedside swallow screen can identify dysphagia and decrease the risk for complications such as aspiration pneumonia. At the project site, the use of the bedside swallow screen was at 33%; there was noncompliance with the use of the bedside swallow screen by the emergency department nurses. The purpose of the doctoral project was to increase the use of the bedside swallow screen. Published outcomes, research, and reports generated from archived data were the sources of evidence. The six sigma methodology was used to inform the quality improvement doctoral project. At …

Etiology Of Water Quality Perceptions And Beverage Preferences Of Black Children And Adolescents, Forkpayea K. Johnson

Walden Dissertations and Doctoral Studies

The purpose of this phenomenological qualitative study was to examine the etiology of water quality perceptions and beverage preferences of Black children and adolescents, which addressed a current gap in the literature on this topic. This study was guided by Festinger's social comparison theory, which supports the notion that children and adolescents' perceptions and preferences are influenced by their social network and those with whom they have a close association. In this study, children and adolescents' water quality perceptions were examined as well as the development and factors affecting those perceptions. Whether social factors such as peer or parental influence …

Oral Glucose Insulin Secretion Test For Identifying Patients With Insulin Resistance, David Kershner

Walden Dissertations and Doctoral Studies

Insulin resistance is an increasing public health issue with the current literature, suggesting reduced sensitivity of insulin leads to adult onset diabetes and associated downstream pathologies that reduce life expectancy. The main objectives of this study were to evaluate the ability of the Oral Glucose Insulin Secretion Test (OGIST) to identify insulin resistance and examine differences in the insulin sensitivity based on gender, age, and ethnicity. This study was supported by the insulin resistance theory which focuses on the reduced ability of insulin to bind to the cellular insulin receptor, reducing the sensitivity of insulin. The OGIST lab results of …

Relative Effectiveness Of Nutritional And Physical Programs On Young, Rural, Impoverished Students, Dora Ida Justice

Walden Dissertations and Doctoral Studies

Over the past several decades, childhood obesity has continued to rank as an epidemic, particularly in rural, impoverished areas in the United States. Therefore, researchers have affirmed the necessity of exploring solutions to the epidemic, including the need to develop and implement programs that target at-risk behaviors of childhood obesity. In this quantitative, quasi-experimental study, the focus was to determine whether public school-based programs teaching nutrition, physical education, and dietary choices could increase the nutritional knowledge, physical activities, and dietary behaviors of students attending second and third grade in rural, impoverished communities of West Virginia. The theories that served as …

Race, Gender, And Retention In A Diabetes Self-Management Program, Marcia Kaye Bygrave

Walden Dissertations and Doctoral Studies

Diabetes has quickly become an epidemic in the United States and affects all genders and races. Some ethnic groups are at greater risk for being diagnosed and face devastating health consequences due to poor diabetes self-management. Diabetes self-management education (DSME) is considered to be a positive step toward patient self-efficacy and diabetes management. The benefits of diabetes self-management education can only be realized if patients diagnosed with diabetes not only enroll, but complete the program. The purpose of this research study was to investigate the association between race and gender and dropout rates among participants enrolled in a DSME program. …

Teachers' Knowledge, Perceptions, And Practices About Mindset In The Northern Mariana Islands, Bobby Cruz

Walden Dissertations and Doctoral Studies

The problem studied was the poor academic achievement of middle school students in the Commonwealth of the Northern Mariana Islands (CNMI). Research indicates that a growth mindset positively affects a student's academic achievement and motivation to learn. However, despite the importance of mindset in fostering student success and enhancing learning, mindset remains underexplored in the CNMI. The purpose of this generic qualitative study was to fill this gap in knowledge by investigating teachers' knowledge, perceptions, and practices concerning mindset in the CNMI. Three research questions examined teachers' knowledge and perceptions of mindset in the CNMI and how teachers described and …

Health Care Services For Child Survival And Performance-Based Management In Three Kosovo Municipalities, James Mugaju

Walden Dissertations and Doctoral Studies

After the Republic of Kosovo's declaration of independence in 2008, new municipal structures were created with the charge of monitoring the delivery of health care services; yet, no mechanism for monitoring performance was ever implemented. With the public value theory as the foundation, the purpose of this multiple case study of 3 Kosovo municipalities was to understand issues surrounding the capacity of local government health department to monitor their performance related to the delivery of services. Relevant data were collected through focus-group discussions with 10 nurses, 9 directors of family medicine centers, and 12 municipal program managers. Purposeful semistructured interviews …

Latent Tuberculosis Infection Treatment Completion And Predictors Of Noncompletion Among Visa Holders In The Rural Setting, Scott Hutton

Walden Dissertations and Doctoral Studies

Latent tuberculosis infection (LTBI), a product of exposure to Mycobacterium tuberculosis (Mtb), can lead to tuberculosis (TB) and further cause death if untreated. Fortunately, TB can be prevented with LTBI treatment. Targeting newly arrived visa holders for LTBI screening and treatment is an effective strategy for decreasing future TB burden. However, LTBI treatment completion rates are low, and researches had primarily focused on the nonrural U.S. setting. This study, using a retrospective cohort design under the epidemiological disease triangle framework evaluated (a) the treatment completion rates for 2 cohorts of visa holders (i.e., immigrants, N = 31 and refugees, N …

Factors Impacting The Financial Independence Of Women Who Were Teenage Mothers, Jeanette Parker

Walden Dissertations and Doctoral Studies

Teenage pregnancy in the United States is a national concern because of negative outcomes for teen mothers and their children of teen mothers. There is ample research on the negative outcomes associated with teen pregnancy: however, there is little research on the success of teenage mothers. This transcendental, phenomenological study examined how former teenage mothers overcame challenges of teen pregnancy to become financially independent adults. The research question for this study was: What factors enabled former teen mothers to overcome challenges of teen pregnancy to become financially independent adults? Principles from social learning theory and resilience theory provided the conceptual …

Perceptions Of Chiropractors In Mississippi Regarding Obesity, Phelesia Nakita Foster

Walden Dissertations and Doctoral Studies

Obesity continues to be a growing problem across the United States. Chiropractors have made claims of providing health promotion services within their treatment protocol; however, there is a lack of empirical research regarding a need for the chiropractic profession to train chiropractors to address Healthy People 2020 public health initiatives. The purpose of this qualitative study was to examine the perceptions of Mississippi Delta Region chiropractors regarding their role in obesity management as nonmedical practitioners that implement public health objectives in their practice. The research questions aimed at addressing possible barriers and limitations that influenced chiropractors' perceptions regarding their role …

Assessment And Treatment Of Postpartum Depression Among Mothers In Imo-State, Nigeria, Allison Chinyere Nnaka

Walden Dissertations and Doctoral Studies

Postpartum depression affects many postpartum mothers. When postpartum depression is not timely assessed, identified, and treated, it can lead to problems with mother child bonding and cause family problems, negligence, and infant death. The purpose of this phenomenological study was to understand Imo State women's lived experiences and perception on sufficiency of the assessment and treatment received for their postpartum depression. The conceptual theory for this study was the empowerment theory. In-depth, face-to-face interviews were conducted to examine 10 Imo State postpartum mothers' lived experiences of assessment processes and to understand if their psychological desires were addressed. The interviews were …

A Qualitative Study Of Factors Related To Weight Regain Following Roux-En-Y Surgery., Samone Renee Marion

Walden Dissertations and Doctoral Studies

During the past decade, obesity has become a worldwide epidemic, and bariatric surgery has been used to treat obesity. Previous researchers have addressed the success of the Roux-en-Y bariatric (RYGB) surgery within 12 months or later of the surgical procedure; however, a lack of research exists regarding participant success in maintaining their post-surgery weight loss long term. The current qualitative, phenomenological study was based on the conceptual framework of social learning and examined the beliefs, experiences and perceptions of women who underwent RYGB weight loss surgery but did not maintain their ideal weight during the 1st year and later following …

Health Disparities Among Hispanic Americans With Type 2 Diabetes, Nelson Sitton

Walden Dissertations and Doctoral Studies

The ongoing increase in Type 2 diabetes among Hispanic Americans challenges the American public health system, particularly with health issues arising from not following appropriate health directives for the disease. This quantitative, cross-sectional, correlational study used primary data to assess the relationship between diabetes knowledge (as measured by the Diabetes Knowledge Questionnaire), health literacy level (as measured by the Short Assessment of Health Literacy-Spanish and English), education level, self-efficacy (as measured by the Diabetes Self-efficacy questionnaire), and self-reported diabetes self-care behaviors (as measured by the Summary of Diabetes Self-care Activities) among a sample of Hispanic Americans with Type 2 diabetes. …

Effective Strategies For Venture Capital Evaluations Of Organizations' Drug Development Capabilities, Roslyn Chand

Walden Dissertations and Doctoral Studies

Undercapitalization is a major impediment for the growth and survival of Canadian life sciences firms. Proficient management teams are the 'sine qua non' criteria in the venture capital decision-making processes. The purpose of this multicase study was to explore strategies successful venture capitalists use to improve their evaluation processes of life sciences management teams' drug development capabilities. The conceptual framework for this study was based on business process management. The purposeful sample consisted of 10 venture capitalists located in the United States and Canada who had expertise evaluating life sciences management teams. The data were triangulated from semistructured interviews, annual …

Community Public-Private Partnership Leadership Synergy In Tanzania, Hawa Yatera Mshana

Walden Dissertations and Doctoral Studies

Although the public-private partnership (PPP) concept in health and social health has been politically accepted as the best pathway to improving health outcomes in many developing nations, implementation lacks leadership synergy. Lack of awareness and engagement of community leaders about PPP interventions and their benefits affect accountability and ownership of health and social care interventions. The purpose of this study was to better understand factors that could promote partnership leadership synergy to enhance ownership and accountability for community health and social welfare initiatives in Tanzania. A qualitative empirical case study design was used; diffusion of innovation and the public-private integrated …

Association Between Genetic Ancestry And Body Mass Index Among A Cohort Of Hispanic American Children, Sahel Hazrati

Walden Dissertations and Doctoral Studies

Childhood obesity is disproportionately higher among children from Hispanic backgrounds. Ethnicity is a social and cultural construct and does not capture true ancestral heterogeneity. Hispanic Americans have a wide variety of genetic admixture proportions of European (EUR), Native American (AMR), and African (AFR) ancestry. The objective of this cross-sectional study was to assess the contribution of ancestral genetic composition to body mass index (BMI), and to evaluate the relationship of obesity risk factors to BMI among 154 2-year-old Hispanic American children. The theory of Evolutionary Developmental Biology was utilized to investigate the relationship between children's growth process and ancestral background. …

Kono Members' Perceptions Of Burial Practices And The Spread Of Ebola Virus Disease, Comfort Kenyeh Panda

Walden Dissertations and Doctoral Studies

Sierra Leone was heavily affected by the West African Ebola virus disease (EVD) epidemic from 2013 to 2016. Ongoing EVD transmission during the epidemic was connected to several factors including unsafe traditional burial practices. This phenomenological qualitative study addressed Kono members' perceived knowledge, attitudes, and beliefs regarding how burial practices influenced EVD transmission. Rosenstock's health belief model provided the framework for the study. The participants purposefully selected from various religions and professions were interviewed individually and in focus group settings. Similar phrases and comments were identified from the interview responses resulted which resulted in the following 5 main themes: (a) …

The Influence Of Parental Perceptions On Early Childhood Educational Choices In Nigeria, Magdalene Uwadiogbu Okobah

Walden Dissertations and Doctoral Studies

The influx of women of childbearing age into the labor force, family dynamics of dual working parents as a result of economic factors, and weakening of extended family supports have increased demand for early childhood care and education programs in Nigeria. Consequently, a problem emerged in increased enrollment in ECCE programs that are deficient in terms of structural and process factors of child-caregiver ratio, group size, staff qualifications, health and safety practices, curriculum implementation, and parental engagement. The purpose of this study was to explore the factors that influenced parents' in their decision process for ECCE placement for their children …

Type 2 Diabetes Management For Geriatric Veterans, Fachecia L. Fort

Walden Dissertations and Doctoral Studies

Managing diabetes in the geriatric long-term care population can be challenging, yet important because diabetes is a chronic, progressive disease. The purpose of this project was to identify clinical practice guidelines for managing Type 2 diabetes in geriatric veterans and to develop a class to educate providers on diabetes management in the geriatric long-term care population at a community living and rehabilitation center. The practice focused question asked if providing education to providers about the clinical practice guidelines for managing Type 2 diabetes in geriatric long-term care veterans would improve knowledge as measured by a pre- and posttest. The project …

Impact Of Free Maternal And Child Health Services On Health Care Utilization In Jigawa State, Nigeria, Nura Ibrahim Kazaure

Walden Dissertations and Doctoral Studies

In spite of a decrease globally, the maternal mortality rate (MMR) in Nigeria and its

Jigawa State has remained persistently high. Few efforts to address the MMR in Nigeria have been undertaken. The purpose of this study was to investigate the impact of Jigawa State's Free Maternal and Child Health Program (JSFMCHP), education, employment, and parity of pregnant women on health care utilization (the outcome variable), as measured by antenatal care (ANC) visits. Anderson's behavioral model served as the study's theoretical framework. The sample size included 400 antenatal records of pregnant women who were randomly selected from the state's Health …