Digital Commons Network^™

Socioeconomic Characteristics Of Farmers And Agrochemical Use In Grenada, Lindonne Marcia Glasgow

Walden Dissertations and Doctoral Studies

The World Health Organization classified carbaryl, glyphosate, and paraquat as hazardous to human health. In the Agriculture Health Study in the United States, health problems were associated with the use of these 3 agrochemicals 12 or more times per year. These 3 agrochemicals were commonly used in Grenada. The purpose of this quantitative cross-sectional study was to investigate the relationship between the social and economic characteristics of the farmers who participated in the 2012 agriculture survey and the use of agrochemicals at frequencies that could pose health risks. Five constructs of the social cognitive theory were used as the premise …

Life Stress, Coping, Perceived Health, And Health Outcomes Among Eastern Orthodox, Athina-Eleni Goudanas Mavroudhis

Walden Dissertations and Doctoral Studies

Clergy exhibit higher stress and mortality rates in relation to their nonclergy counterparts. Despite current research on clergy stress and mortality rates, health perceptions and health outcomes of Western religious oriented clergy have been understudied. Even less is known about health perceptions and health outcomes of Eastern religious oriented clergy. The role of stress, coping, and health perceptions in predicting actual health outcomes is important to study in clerical populations because of the impact their health might have on serving their parishioners. The purpose of this nonexperimental correlational study was to determine the relative strength of life stress, coping styles, …

United States-Mexico Dual Resident's Perceptions Of Heritage And Acculturation, Alisia N. Muir

Walden Dissertations and Doctoral Studies

United States' policy makers have been challenged creating understandable nutrition labels and effective healthy food campaigns for consumers of mixed heritage. Previous studies explored the sociocultural factors that influence Hispanics' abilities to navigate consumer food education programs, but little was known about how Mexican culture impacts those programs. The purpose of this study was to better understand those factors. Research questions focused on the experiences of residents of a west Texas town regarding their food decision-making process about food choices and their understanding of food education information. The purpose of this phenomenological research was to explore how Mexican culture effected …

Predictive Relationship Between Treatment Adherence, Glycated Hemoglobin And Diabetic Complications Among Jamaicans, Christian Anaba Nwaukwa

Walden Dissertations and Doctoral Studies

Patient nonadherence to physicians' prescribed therapeutic regimen is the greatest challenge in the effective treatment of patients with diabetes worldwide. Scientific evidence has revealed that nonadherence to prescribed medication could result in diabetic complications such as cardiovascular disease, retinopathy, nephropathy, and neuropathic diabetic foot ulcers. The purpose of this study was to explore predictive relationships between levels of adherence to antidiabetic medications, patient HbA1c levels, and diabetic complications among Jamaicans, an understudied population. The research question that guided this study was: Do the patient level of adherence and HbA1c levels have any predictive relationship with the severity of diabetic complications …

An Evidence-Based Clinical Practice Guideline For Childhood Obesity, George Peterson

Walden Dissertations and Doctoral Studies

Childhood obesity is a national problem in the United States and has known implications as a potential cause of chronic illnesses as the child transitions into adulthood. A primary care clinic in the southwestern United States had a high percentage of obese Hispanic children within its population; therefore, the nurses and the pediatrician needed an evidence-based clinical practice guideline (CPG) to manage Hispanic children with a body mass index greater than the 95th percentile for their age. The purpose of the project was to develop a culturally competent CPG to manage childhood obesity in this primary care practice. The social …

Health Literacy And Hypertension Management In Haitian Immigrants, Suzie Jean

Walden Dissertations and Doctoral Studies

Patient compliance and health care communication are impacted by health literacy. Poor health choices, frequent hospital visits, noncompliance with health regimens, and higher health costs are all associated with low health literacy. The purpose of this cross-sectional study was to determine whether there was an association between health literacy as measured by primary language spoken in the home (Creole vs. English) and hypertension self-management as measured by regular use of medication and cutting down on foods high in salt, and whether there was an association between Haitian men, women, their education level, or level of poverty in relation to health …

A Qualitative Grounded Theory Approach To Reducing Breast Cancer Disparities In The Latina Population, Dbora Schrett

Walden Dissertations and Doctoral Studies

Breast cancer is the leading cause of death among Latinas. Several barriers persist when accessing health care and utilization of healthcare services such as annual mammograms, leading to a late-stage diagnosis or death related to breast cancer illness. Consequently, this study was important to further examine potential risk factors such as beliefs, cultural context, health insurance, and socioeconomic status for this population. Further, gaps in research provide limited evidence of risk factors adversely influencing high morbidity and mortality incidence. The purpose was to focus on disparities in breast cancer experiences within Latina communities in the United States. A qualitative foundation …

Problem Behavior Of A Child With Autism And Problem Behavior Of A Typically-Developing Sibling Moderated By Maternal Parenting Stress, Jennifer Torchetti

Walden Dissertations and Doctoral Studies

Drawing on Bowen's family systems theory, this study was designed to fill a gap in research regarding how raising a child with autism impacts the systemic functioning of a family unit, and provide evidence of the need for more comprehensive resources and support for families of children with autism. In this study, families of children with autism were invited to complete the Parenting Stress Index and the Strengths and Difficulties Questionnaire. These measures were used to determine the relationship between the level of problem behavior of a child with autism and the level of problem behavior of a typically-developing sibling …

Mindfulness Meditation: A Self-Awareness Approach To Weight Management, Michelle Brown

Walden Dissertations and Doctoral Studies

Obesity is a crucial health care issue that has a global effect on the health care industry. Not only does obesity decrease the patients' quality of life, it also places an astronomical burden on health care delivery systems. The purpose of this quality improvement project was to establish a weight management program derived from evidence-based research. The research question is can the utilization of mindfulness meditations and practices with traditional weight loss methodologies produce sustainable weight loss? Pender's health belief model was the conceptual framework utilized to guide and provides structure for this project. The health belief model has been …

Implementation Of A Diabetic Resource Toolkit In A Veterans Administration Emergency Department, Caroline Hairston

Walden Dissertations and Doctoral Studies

Diabetes is the 7th leading cause of death in the United States. Uncontrolled diabetes and lack of self-care knowledge leads to increased emergency department (ED) visits, utilizing limited health care resources. The practice-focused question asked whether a patient-focused diabetic self-care toolkit could decrease the number of diabetes-related ED visits. The purpose of this project was to reduce the number of diabetes-related ED visits and was supported by the social cognitive theory. The sources of evidence included the facility's ED Information System (EDIS) data and a patient survey developed by the project lead. There were 149 participants (135 males and 14 …

Effects Of Micronutrients On The Status Of Hiv-Infected African American Women, Veronica Alicia Graham

Walden Dissertations and Doctoral Studies

Weight loss among HIV-infected African American women (AAW), results in the fall of the cluster of differentiation (CD4) cell count and an increase in the viral load. There are 48,126 HIV-infected AAW who reported weight loss within the first year. AAW who report more than 10% weight loss within the first year progress to AIDS due to a deficiency in micronutrients and poor linkage to care. The phenomenon that occurs with individuals living with HIV does not necessarily occur among individuals who have cancer, heart disease, or some other life-threatening illness, and this phenomenon indicates a direct threat to the …

Diabetic Adult Access To Medical Care And Race And Ethnicity In Connecticut, Natacha Bertine Jerome

Walden Dissertations and Doctoral Studies

Diabetes is among the leading causes of death in Connecticut. An approximate of 330,000 adults in Connecticut have diabetes (diagnosed and undiagnosed). Those with diabetes have almost twice the risk of premature death throughout various age groups. The purpose of this cross-sectional study was to investigate whether disparities exist in access to medical care due to race and ethnicity; among adults with diabetes in the state of Connecticut. Furthermore, this study used the Andersen's behavioral model framework. Survey data from the behavioral risk factor surveillance system (BRFSS) were also analyzed. The research study covered 3 years (2013 to 2015) of …

Chronic Care Management Services At A Clinical Medical Group, Sharon Guccione

Walden Dissertations and Doctoral Studies

The purpose of this project was to design a chronic care plan using the chronic care management (CCM) framework to improve health services at lower healthcare costs. The practice-focused question explored whether the operationalization of the CCM model would impact progress toward the management of chronic illness for the target population of Medicare beneficiaries with 2 or more chronic illnesses in an urban acute care agency located in the western United States. The middle-range theory, logic rational plan model, Lewin’s change theory, and the CCM’s coordination care and collaborative care concepts were used to guide the project. Data were collected …

Quality Of Nutrition Services For Children And Pregnant Women In Ntungamo District, Uganda, Church Tophill

Walden Dissertations and Doctoral Studies

Inadequate nutrition during infancy and early childhood seriously interferes with brain development, leading to neurological and behavioral disorders. Such effects are detrimental to children under 2 years of age. The purpose of this cross-sectional study was to better understand the quality of nutrition services offered to children and pregnant women in Ntungamo District in southwestern Uganda. The cross-sectional design facilitated comparison of different variables, using a research-question-driven approach, assessing existing secondary data from SPRING Uganda database. Stepwise, backward multiple logistic regression was used to identify the independent variables that influenced the provision of quality nutrition assessment, counseling, and support (NACS) …

Association Between Age Of Women When Diagnosed With Endometriosis And Infertility, Whitney Kennedy

Walden Dissertations and Doctoral Studies

Abstract

Because endometriosis is considered to be the primary cause of infertility in women and

the diagnosis is known to be delayed by many years, it is important to understand the

association between endometriosis and infertility. The purpose of this cross-sectional,

secondary data analysis study was to determine whether there was an association between

the age of women when diagnosed with endometriosis and infertility. Using the general

model of total patient delay (i.e., the Andersen model) as a theoretical foundation, data

for this study was collected by assessing patient medical records of women with

endometriosis at multiple OB-GYN clinics in …

Evidence-Based Pulmonary Rehabilitation Reduces Hospital Readmissions In Adults With Copd, Christiana Otuwa

Walden Dissertations and Doctoral Studies

Many patients are affected by chronic obstructive pulmonary disease (COPD), a progressive lung disease that obstructs air flow, resulting in dyspnea and inability to carry out daily activities. Despite optimal pharmacological management, COPD patients make frequent emergency room visits and are hospitalized due to exacerbations of COPD. Literature has suggested that pulmonary rehabilitation (PR), a nonpharmacological treatment, could help to decrease the symptoms that lead to illness exacerbation, hospital readmissions, and decreased quality of life in patients with COPD. The purpose of the project was to increase the quality of life and reduce admission rates for patients diagnosed with COPD …

Early Detection Of Neonatal Abstinence Syndrome By Neonatal Intensive Care Unit Nurses, Ebele Oraka

Walden Dissertations and Doctoral Studies

Neonatal abstinence syndrome (NAS) is a public health concern that is increasing in the United States due to the use of illicit drugs by pregnant women, which exposes the fetus to these substances. NAS results in increased infant morbidity and prolonged stay in the hospital, which can lead to increased cost of care. The inability of the nurses to care for at-risk infants can lead to inconsistent NAS scores, which can affect the infant's care treatment. The project examined the effectiveness of educating the neonatal intensive care unit (NICU) nurses on the correct use of the modified Finnegan Neonatal Abstinence …

Understanding Use Of Care For African Immigrants With Autistic Children, Leahnata Davies

Walden Dissertations and Doctoral Studies

The number of African immigrants in the United States is increasing. The incidence of children diagnosed with autism spectrum disorder in the United States is also on the rise. Despite these increases, little information exists about the adequacy of care for African immigrants with autistic children in the United States. The purpose of this grounded theory study was to understand the factors that affect use of care for African immigrants with autistic children in the United States. Using Aday-Anderson model of health care utilization framework, this study focused on African immigrants in the United States who had children with Autism …

Public Service Announcements To Promote Physical Activity, Jennifer Erickson

Walden Dissertations and Doctoral Studies

The World Health Organization (WHO) promotes physical activity as a primary way to maintain health, but many individuals do not participate in this health-promoting behavior. Despite the potential for public service announcements (PSAs) to communicate health information and promote behavioral change, no prior research on developing video PSAs to promote physical activity was found. The purpose of this quasi-experimental study was to examine how affective and information video PSAs for a public health campaign affect future levels of intention to engage in physical activity. The PSAs were developed and filmed specific for this study using the model of goal directed …

Non-Nursing Courses' Impact On Nclex-Rn Pass-Rates In Associate Degree Nursing Programs, Nicole A. Garner

Walden Dissertations and Doctoral Studies

Nurse educators make decisions regarding the inclusion or exclusion of non-nursing courses in a curriculum. The current literature lacks research regarding which courses have the most impact on first-time nursing licensing examination pass-rates. The purpose of this quasi-experimental study was to investigate if there is a specific combination of courses that enhance first-time licensing examination pass-rates, using 161 randomly selected accredited associate degree nursing programs. General systems theory applied to nursing education was the framework for the study. ANOVA and independent t-tests were used to address the questions of non-nursing courses or discipline-specific set of non-nursing courses' impact on first-time …

Physician-Patient Relationships And Their Effect On T2dm Patient Treatment Adherence, Cindy Schmidt

Walden Dissertations and Doctoral Studies

Type 2 diabetes (T2DM) is a health epidemic that continues to worsen. A major concern is that treatment adherence rates hover around 50%, despite the introduction of new medications, treatments, and technology. Lack of adherence by patients can lead to complications like blindness, kidney disease, and amputations. While there have been many studies conducted to evaluate patient factors related to adherence, fewer studies have been conducted to evaluate the role of the physician-patient relationship. The purpose of this study was to examine the correlation between the physician-patient relationship and patient treatment adherence, and examine the moderators of age, education, ethnicity, …

Development Of A Staff Education Module On Adolescent Obesity, Deborah Ann Stallworth

Walden Dissertations and Doctoral Studies

Adolescent obesity is a growing health concern in the United States due to its increasing prevalence and comorbidities that can reduce longevity and increase morbidity. Advanced practice nurses (APNs) providing care in school-based health centers (SBHC) located in marginalized communities are uniquely positioned to work with adolescent students challenged with obesity. The management of adolescent obesity requires advanced skills and knowledge to promote healthy lifestyles, prevent obesity, and to directly address the many factors that contribute to the condition. The purpose of this project was to develop an education program for APNs to prepare them to work with students in …

Barriers To Daiy Blood Glucose Self-Monitoring In Type 2 Diabetes Mellitus, Sylvain N. Tientcheu

Walden Dissertations and Doctoral Studies

Routine blood glucose monitoring by patients with Type 2 diabetes mellitus (T2DM) is needed for effective management of T2DM; however, 75% of monitoring logs are returned incomplete during monthly provider follow-up appointments. As a result, effective management of the patient's medical condition is limited. To better understand the reasons for noncompliance, a quality improvement project (QIP) was initiated between July 01, 2017 and September 30, 2017, to identify barriers that prevented patients from self-monitoring of blood glucose (SMBG). No formal assessment of the patients' responses had been done, and, as a result, the deidentified, qualitative responses from the QIP were …

Improving Nutrition Among Supplemental Nutrition Assistance Program Recipients Using A Monetary Incentive Model, Jezabel Urbina

Walden Dissertations and Doctoral Studies

The Supplemental Nutrition Assistance Program (SNAP) is the United States' largest government assistance program that aims to alleviate food insecurity. The SNAP program allows low-income individuals and families the ability to purchase nutritious foods through a monthly benefit. However, the current body of literature presents evidence of the program's counterproductive effect. The purpose of this study was to determine whether incentivizing SNAP recipients to purchase additional fruits and vegetables was beneficial in increasing such purchases. Social cognitive theory was used as a theoretical framework to address research questions associated with shopping patterns and attitudes and beliefs. This quantitative study used …

Evaluation Of The Effectiveness Of An Established Glycemic Monitoring Program In A High School Setting For Adolescents With Type I And Type Ii Diabetes Mellitus, Tabatha Lee Obeda

Walden Dissertations and Doctoral Studies

Adolescents with Type I and Type II diabetes need to monitor blood glucose and food intake, administer insulin, and participate in activities including physical education during school hours to maintain glycemic control. Glycemic management programs (GMPs) exist for the improvement of diabetes management during school hours. The purpose of this project was to evaluate a GMP in a school system in a rural area in the Southeastern United States. The goal was to determine if the existing GMP met objectives and to make recommendations for continuation, revision, or discontinuation of the GMP. The logic model provided the basic framework for …

Maternal Characteristics And The Risk Of Cleft Lip And Palate In The United States, Letha Thomas

Walden Dissertations and Doctoral Studies

Cleft lip with or without cleft palate (CLP) is an ongoing public health issue across the globe, and in the United States. The estimated number of babies born each year in the United States with cleft palate (CP) is about 2,650, while CLP affects approximately 4,440 babies. The purpose of this quantitative cross-sectional study was to determine if there is a relationship between CLP and maternal characteristics such as reproductive history (advanced maternal age, maternal obesity, prenatal visits, month prenatal care began, number of pregnancies, gestational age at birth, assisted reproductive technology used, gestational diabetes, and hypertension), socioeconomic status of …

Adherence To The Icu Liberation Abcdef Bundle Improves Patient Outcomes In The Icu, Jennifer Sweeney

Walden Dissertations and Doctoral Studies

Delirium is a frequent complication of intensive care unit (ICU) admissions manifesting as acute confusion with inattention and disordered thinking. Patients in the ICU who develop acute delirium are more likely to experience long term disability and mortality. The purpose of this doctoral project was to evaluate an existing organizational quality improvement project to guide recommendations on improving care in the ICU. The practice-focused research question was: Does improving adherence to the ICU Liberation ABCDEF bundle for patients admitted to the ICU decrease incidence of delirium compared to outcomes prior to implementation? The Program Logic Model served as a framework …

Childhood Lead Exposure And Attention-Deficit/Hyperactivity Disorder Symptoms: A Meta-Analysis, Megan Glenn Brown

Walden Dissertations and Doctoral Studies

Lead exposure during childhood is a significant global public health concern as the potential effects of exposure can result in the need for long-term treatment, diminished productivity in society, and financial strain on the health care system. There is strong evidence of a relationship between lead exposure and attention-deficit/hyperactivity disorder (ADHD); however, there is a gap in the current literature regarding the relationship between lead exposure and specific symptoms of ADHD and the strength of that relationship. The purpose of this meta-analysis was to examine and help quantify this relationship. Cohen's d was used as the standardized mean effect size …

Parental Alcoholism, Triangulation, And Self-Differentiation In The Sibling Relationship, Tiffany Latrice Graham

Walden Dissertations and Doctoral Studies

Exposure to parental alcohol use disturbs important family relationships and may influence self-differentiation and triangulation, especially among siblings. The sibling relationship provides a foundation for future relationships, yet researchers know little about how parental alcohol abuse influences the sibling relationship. The purpose of this descriptive phenomenological inquiry was to explore the influence of parental alcohol abuse on triangulation and self-differentiation in the sibling relationship in families of origin. Purposeful sampling and semistructured, face-to-face interviews were used to gather information from 12 self-identified adult children of alcoholics to explore triangulation and self-differentiation among siblings. The research questions guided the study to …

Using Diabetes Self-Management Education To Enhance Adolescent Transition, Jessica Adkins

Walden Dissertations and Doctoral Studies

Type 1 diabetes is a long-term diagnosis, the prognosis of which is directly related to the patient's ability to self-manage the disorder. Adolescents are not currently taught how to manage diabetes; instead, parents and educators expect self-management to be more of a learned behavior from their parents. The purpose of this project was to create a quality improvement plan which the regional pediatric diabetes center study site could implement to improve adolescent glycemic control. Orem's self-care theory was used as theoretical framework for the design and evaluation of the project. The practice-focused question for this doctoral project was: Can a …