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Differences In Treatment-Seeking And Treatment-Adherence Factors For Tuberculosis In Armenian Versus Non-Armenian Populations Of Los Angeles County, Tanya Marie Ferguson

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) is a deadly, yet curable, infectious disease that continues to be a global health threat. Armenia suffers from rising TB incidence and mortality rates. Armenians living in Los Angeles (LA) County, where TB incidence is higher than national averages, is the second largest Armenian community in the world; therefore implications are that many TB cases are attributed to this group. Using the social ecological model as a theoretical framework, this concurrent, mixed-methods study compared Armenians to non-Armenians in LA County about their knowledge of TB and perceived barriers to seeking and adhering to treatment. Bivariate chi-square analysis from …

African American Single Mothers' Perceptions Of Physical Activity, Sheryl Lynn Richard

Walden Dissertations and Doctoral Studies

Insufficient physical activity detracts from healthy living and has a disparate impact on African American women and their female children. The extensive body of prior research addressing preventable chronic disease and other consequences of insufficient physical activity includes limited information specific to African American single mothers. The purpose of this descriptive phenomenological study was to gain an understanding of African American single mothers' perceptions of physical activity. Specifically investigated were African American women's familial influences and potential effects of these influences on their children's health behaviors. The health belief model served as the theoretical framework for this study and provided …

Oral Health Status And Oral Hygiene Knowledge, Attitudes, And Practices Of Jail Inmates, April Lee Wendling

Walden Dissertations and Doctoral Studies

The oral health and hygiene of incarcerated populations, both in the United States and globally, is known to be poorer than that of the general population. This study examined the prevalence of dental caries and periodontal disease and the relationships between oral health status and the oral health knowledge, attitudes, and practices of jail inmates housed in a large metropolitan jail located in the midwestern United States. This cross-sectional study collected data from 100 inmates using a 21-item closed-ended questionnaire in addition to oral examinations conducted by the jail's dentist to determine the extent of dental caries and periodontal disease …

Improving Self-Management In Patients With Chronic Conditions, Jeryl Yvette Horton

Walden Dissertations and Doctoral Studies

Care Coordination Home Telehealth (CCHT) maintains a positive impact on the delivery of patient care in the primary care clinic at the Department of Veterans Administration Medical Center (VAMC). This quality improvement initiative targets patients with chronic conditions such as diabetes, hypertension, heart failure, and chronic obstructive pulmonary disease. These patient are frequently seen in the emergency room, and are often admitted to the hospital, where they saturate the outpatient clinics' waiting room with multiple walk-ins. CCHT has, to some extent, reduced walk-ins, emergency room visits, and hospitalization while minimizing the strain on access to care at the VAMC. Sustaining …

Water Management Efficiency In The Food And Beverage Industry, Maria Del C Reyes Torres

Walden Dissertations and Doctoral Studies

Water is critical for food production, food security, and health. Water quality management influences freshwater sustainability, land, and energy administration. Global agriculture accounts for more than 70% of all water consumption; the fertilizer, manure, and pesticide overspills are chief sources of water pollution worldwide. On a global scale, food-related waste directly impacts local food production and water resource management. The purpose of this multiple-case study on the food and beverage (FB) industry in the State of Georgia was to identify successful strategies for improving water management efficiency. The concepts of systems thinking, adaptive resource management, and integrated water resource management …

Poverty, Food Insecurity, And Obesity Among Urban And Rural Populations, Tameka Ivory Walls

Walden Dissertations and Doctoral Studies

Over 17 million food-insecure households are associated with increasing obesity rates across the United States. Although food insecurity and obesity are distinct social concerns, the two are linked and may be influenced by poverty and geographic location. Public health authorities and state leaders responsible for the health and nutrition of rural populations in particular would benefit from this information. The purpose of this quantitative cross-sectional study was to examine whether poverty mediated the relationship between food insecurity and obesity among urban and rural adults. The study was guided by the poverty, food insecurity, and obesity conceptual framework. The study addressed …

Socioeconomic Status As A Predictor Of Chronic Obstructive Pulmonary Disease, Hilaire Saint-Pierre

Walden Dissertations and Doctoral Studies

While epidemiological research has generated new knowledge about the treatment and prevention of chronic obstructive pulmonary disease (COPD) through smoking secession, the socioeconomic status (SES) of people with the disease has been under investigated. Thus, the purpose of this study was to determine the predictability of association between SES and COPD. This study was based on the ecological theory, which states that health and disease may have multiple underlying factors. This study was a secondary analysis of archived data from the Inter-University Consortium for Political and Social Research (ICPSR). The dataset was collected for the National Survey of Midlife Development …

Methylmercury Exposure Via Canned Tuna Fish Consumption And Breast Cancer, Jennifer Bodenrader

Walden Dissertations and Doctoral Studies

Widespread consumption of canned tuna fish since the 1950s may explain some of the increase in breast cancer prevalence in the United States and Europe. Although canned tuna is the primary source of human exposure to methylmercury, its role as an estrogen activating metalloestrogen has been overlooked in the etiology and incidence of breast cancer. Carcinogenic theory asserts that increased exposure to estrogen elevates the risk of breast cancer. The purpose of this population-based, case control study was to examine the association between canned tuna consumption, total blood mercury, and breast cancer in the NHANES 2003-2006 surveys. A multivariable logistic …

The Ability To Purchase Organic Food Items Among Participants Of The Women, Infants, And Children Program In Los Angeles County, Brenna Colleen Doran

Walden Dissertations and Doctoral Studies

Lack of accessibility to healthy foods is a factor associated with the increase in obesity, diabetes, and other negative health consequences. While programs such as WIC (Women, Infants, and Children) provide supplemental nutritional access to healthy foods, few organic food items are included in the WIC authorized food list. Government programs and policy makers that provide to the most vulnerable populations are concerned about equal availability of healthy foods. The purpose of this study was to compare variability and cost of organic food items in 24 large chain grocery stores located in high- and low-income areas. The theoretical concepts of …

Socioeconomic Responsibility And Its Effect On Hypertension Among West African Immigrants In The United States, Chryss Arekhandia Okonofua

Walden Dissertations and Doctoral Studies

Native-born African Americans (NBAA) bear a disproportionate burden of the effect of hypertension (HTN) in comparison to other racial groups in the United States. West African immigrants (Foreign-born African Americans) appear to carry a heavier burden than the NBAA in the United States. Using the social support theory as a guide, this study examined the association between the need to meet socioeconomic responsibility of financial and familial obligations (SERFFO) and perceived stress and the increased likelihood of HTN among West African immigrants, aged 25-54 years, in the United States. In this quantitative, cross-sectional design, self-reported data were collected from a …

Self-Efficacy, Perceived Skills, And Real Knowledge Of Speech-Language Pathologists, Meredith Lynn Baker-Rush

Walden Dissertations and Doctoral Studies

Although speech language pathologists' (SLPs) knowledge of communication and swallowing has been undisputed, their knowledge and skills related to tracheostomy and mechanical ventilation (MV) seem varied. The consequences associated with the presence of tracheostomy or MV demonstrate the necessity of training. Guided by Bandura's social cognitive theory, this study was designed to determine if SLPs' training influenced self-efficacy and real knowledge, and to evaluate trends associated with SLPs' pursuit of specialized training. A total of 236 SLPs practicing in the United States responded to a researcher-developed knowledge and confidence test for tracheostomy and mechanical ventilation (KCT-TMV). Data were analyzed via …

Understanding A School's Response To Childhood Obesity, April Dawn Goins-Jones

Walden Dissertations and Doctoral Studies

Childhood obesity has become a national epidemic. Although many of the consequences of childhood obesity are known, such as physical, social, emotional, and academic effects on a student's development, there is a lack of literature on the topic of childhood obesity in Native American tribes. The purpose of this case study was to explore how school personnel address the effects of obesity on students' social, emotional, academic, and physical development in an elementary school in the southwest United States where 90% of the students are Native Americans. Bronfenbrenner's socioecological model served as the theoretical foundation. The research questions explored strategies …

The Development And Content Validation Of An Adult Obesity Educational Program, Abel Okuma

Walden Dissertations and Doctoral Studies

Overweight and obesity in patients with intellectual and developmental disabilities (IDD) are at epidemic levels in the United States. The problem identified for this DNP project is the incidence of overweight and obesity in IDD. The framework used involved the quality model for improvement. For this DNP project a new program called the Daily-Enhanced Physical Activities Program (DEPA) was developed to promote weight loss, reduce sedentary activities, and optimal body mass index (BMI) for IDD patients. Local experts consisting of two registered nurses, two physical therapists, and one direct support personnel working with IDD patients were recruited. Each expert reviewed …

Professional Development To Enhance Instructional Leadership And Practice Of Central Office Administrators, Cheryl A. R. Mccue

Walden Dissertations and Doctoral Studies

Professional Development to Enhance Instructional Leadership and Practice of

Central Office Administrators

by

Cheryl A. R. McCue

M. Ed., Lehigh University, 1990

BS, Kutztown University, 1987

Doctoral Study Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Education

Walden University

June 2016

Decades of research and practice suggest that educational administrators need to experience opportunities for professional development and continuous learning. This project study addressed the problem regarding the lack of a formal or systemic plan for professional development of central office administrators in a large suburban school district in northeastern United States. Supported by Lave …

Parental Perceptions Of Childhood Overweight And Obesity In Four-Year-Olds In Northeastern North Carolina, Crystal Keyes Terry

Walden Dissertations and Doctoral Studies

Childhood obesity has increased due to factors such as more television time, less outside play, parents' lack of education about nutritious meals, and eating more fast food versus home cooked meals. Research has been performed on many school-aged children; however, there is a gap in research as it pertains to preschool children. Preschool age learning is when children are most receptive to habit-forming activities. The purpose of this transcendental phenomenological study was to assess the parental perceptions of 11 preschool parents in rural Northeastern North Carolina of 4-year-old children who have been told by a health care professional that their …

Motivation For Volunteering With Older Adults In A Rural Community, Tonia Maria Truesdell

Walden Dissertations and Doctoral Studies

The Baby Boomer generation in the United States is growing older, and the number of adults age 65 years or older is expected to double by 2050. The increase in older adults combined with the reduction in services to older adults has created a gap in available social services and volunteers are needed to fill those gaps. This quantitative, nonexperimental study was designed to identify the motivations of volunteers who served the socialization needs of isolated older adults in a rural U.S. community. The functional approach theory was utilized to explain how volunteers engage in the same volunteer activity for …

Determinants Of Obesity Among Deaf And Hard Of Hearing Adults, Lindsay Buchko

Walden Dissertations and Doctoral Studies

Trends of obesity increased over the last 3 decades with the obesity rate doubling from 1980 to 2010. People with disability are more likely to experience health disparities including obesity compared to the general population. Yet research on the determinants of obesity such as self-efficacy, hearing levels, and deaf acculturation styles among those who are deaf or hard of hearing (HoH) is limited. This cross-sectional study, using the social cognitive theory framework, examined BMI and self-efficacy differences between deaf/HoH adults and hearing adults, aged 20 years and older. This study also examined the associations between BMI or self-efficacy and factors …

Perceived Barriers To Oral Health Care Access For Massachusetts' Underserved Parents, Doudelyne Cenafils-Brutus

Walden Dissertations and Doctoral Studies

Poor oral care is detrimental to the overall health of the population. In the United States, oral health diseases affect millions of individuals, especially children and adolescents. Guided by the health belief model, the purpose of this study was to identify parents' perceived barriers to oral health care access among their 5- to 10-year-old children. A phenomenological approach was used to gather data and thematically analyze interview data from 20 parents who were recruited from a health center in the northeastern United States. All participants had at least one child between 5-10 years old and all identified as under-served. Data …

Risk Factors For Hypertension Among African-Born Immigrants In The United States, John Ojih

Walden Dissertations and Doctoral Studies

Essential hypertension (HTN) has been and continues to be a serious public health problem across the globe, particularly among Black races, with an estimated morbidity rate of over 1 billion people and an estimated mortality rate of 9.4 million people worldwide. Essential HTN can lead to a host of chronic diseases including cardiovascular disease (CVD), stroke, myocardial infarction, brain damage, kidney failure, and retinopathy. The main purpose of this quantitative, descriptive, nonexperimental study was to investigate the association of physical inactivity, length of stay in the United States, immigrants' health status, and food security as risk indicators in the development …

The Perception Of Obesity Among African American Women 35 Years And Older In Houston, Texas, Bernadette Ebere Osuji

Walden Dissertations and Doctoral Studies

As obesity has reached an epidemic level, the female population age 35 years and older is struggling with increased risks of death from type 2 diabetes, hypertension, coronary heart disease, stroke, and certain cancers. The purpose of this study was to explore the perception of overweight and obesity among African American women 35 years and older in Houston, Texas. A phenomenological approach was adopted for this study to explore the perception of overweight and obesity among African American women 35 years and older in Houston, Texas. This study was also guided by the Health Belief Model as a conceptual framework …

Rural Obese African American Women And Depression, Food Culture, And Binge Eating, Tracee Tamiko Smith

Walden Dissertations and Doctoral Studies

The rural African American population has a high incidence of severe psychosocial problems and a skewed perception of obesity, despite obesity's extremely high prevalence rate in this population. Despite the acknowledgements of these problems, there is a gap in literature relative to the effective treatments for obese African Americans diagnosed with depression. This study measured correlations between obesity and depression, binge eating, and food culture amongst African American women residing in Jefferson County, MS. The health belief model was used to guide an assessment of beliefs, perceptions, susceptibility, cues to action, and self-efficacy. A cross-sectional design was used based on …

Fresh Fruits And Vegetables In A Rural Elementary School: A Mixed-Methods Program Evaluation, Patricia Marie Moore

Walden Dissertations and Doctoral Studies

The Fresh Fruits and Vegetables Program is a federally funded program intended to increase public school students' fruit and vegetable consumption. The purpose of this mixed-method study was to evaluate the implementation of this program at a rural southwestern Title 1 elementary school to determine teacher perceptions of the program and whether the program met federal goals. Social ecological model and social cognitive theory grounded the investigation. The mixed method design included semi-structured interviews with 11 teachers accompanied by an anonymous web-based open response questionnaire and document reviews. Descriptive statistics were reported for Likert scale survey items and invoice documents …

Exploring Obesity Risk Factors In Five Regions Of Virginia, Karen Toth Carpenter

Walden Dissertations and Doctoral Studies

Obesity continues to weaken our nation physiologically, psychologically and financially with an overall prevalence rate of 34.9% or 78.6 million Americans affected. Variance in obesity prevalence rates, in the state of Virginia, account for over a 15% difference from one health district to the next. The purpose of this research was to better explore the regional obesogenic factors that may exist among five health districts in the state of Virginia. The socio ecological theory provides the conceptual framework of the study to understand the variance in regional obesity rates, as a function of the contributing risk factors that a region …

After-School Activities Policy And The Atlanta Fulton Public Library System, Vincent Chukumah

Walden Dissertations and Doctoral Studies

Public libraries are evolving from their traditional role as promoters of literacy to a new role as providers of community resources, including after-school activities for teenagers. A policy mandate for such activities appears to be lacking though, which might impact negatively their effectiveness. The purpose of this study was to get a better understanding of the existing policy and implementation mechanisms of after-school activities offered by the Atlanta Fulton Library System in Georgia to at-risk teenaged patrons. Moore's theory of innovation and public value provided the theoretical framework for the study. An embedded case study research design was used to …

Facilitators And Barriers To Physical Activity Among People With Spinal Cord Injury, Laura Nicole Richardson-Smith

Walden Dissertations and Doctoral Studies

Research has shown that people with physical disabilities are at risk for developing secondary health conditions. Many of these secondary health conditions may be reduced by engaging in physical activity, yet people with physical disabilities are less likely to participate in physical activity. Information gaps remain regarding facilitators and barriers to physical activity. The purpose of this phenomenological study was to understand the experiences with physical activity among adults with a spinal cord injury (SCI). Research questions asked were about exercise experiences, barriers and facilitators, and the role of the natural and social environment. The theoretical framework used was the …

Evaluating The Role Of Nurses In Educating Women During The Preconception Period, Oluwatoyin Ottun

Walden Dissertations and Doctoral Studies

Nurses play a crucial role in promoting educational programs aimed at informing women about their reproductive health. However, the role of nurses in providing the health related information is not well defined. Guided by the continuum model, this project evaluated nurses' perceived role in promoting the reproductive health of women during the preconception period. Twenty nurses from 2 outpatient offices wrote responses to an open-ended questionnaire. A summary of the responses indicated that 70% of the participants refer women to community-based programs to enhance awareness for preconception care. Twenty percent of the nurses indicated that they have an educational program …

Comparative Memory/Behavioral Symptoms Of Alzheimer's Disease: Eoad Vs. Load, Marcia Gale Roberson

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is a fatal disorder with no apparent cure. Early-onset AD (EOAD) occurs in individuals before the age of 65, and late-onset AD (LOAD) occurs in individuals age 65 and older. Past studies have proven that AD is fatal among Americans age 65 and older. The disease is characterized by impairments in memory and executive function as well as other cognitive and behavioral problems. The research questions addressed by this sequential, mixed-method study compared EOAD and LOAD by exploring common behavioral/cognitive symptoms and stage levels of AD. Research participants were recruited from the Alzheimer's Association who were members …

Using Nutrition And Fitness Awareness To Reduce Overweight And Obesity In Adolescents, Allissa.Johnson Johnson

Walden Dissertations and Doctoral Studies

In the United States, adolescent obesity rates continue to increase unabated, yet there is a paucity of programs to address these conditions for this population. The current study evaluated an after-school program in California high schools that uses a mentoring model with youth to promote regular exercise and healthy food choices. It is grounded in Social Cognitive Theory which focuses on both the impact of the environment on shaping behaviors and the ability of an individual to construct his or her own suitable environment. A quantitative single-group pretest-posttest design using archived participant responses was utilized in order to determine whether …

Characteristics Of Adult Icu Patients With Device Associated Nosocomial Infections, Doramarie Arocha

Walden Dissertations and Doctoral Studies

Nosocomial infections are a cause of concern for hospital patients and the incidence rates of these infections are greater in intensive care units (ICUs) due to the invasive nature of treatments, additional risk factors and comorbidities, and therapies used. Invasive devices, such as vascular central lines, Foley catheters, and mechanical ventilators pose a risk for critically ill patients in the ICUs to develop device-related, healthcare-associated infections (HAI). The purpose of this study was to describe the epidemiological characteristics of patients who developed device-related HAIs within 3 ICU units (medical-surgical, cardiovascular, and neurosurgical) of an academic medical facility. The ecosocial theory …

A Comparative Analysis Of Meals Offered At Child Care Centers By Participation In A Child And Adult Care Food Program, Melissa Lynn Williams

Walden Dissertations and Doctoral Studies

Nearly 70% of preschool children in the United States are enrolled in child care facilities. This means that they eat many meals away from their homes. Despite government support for childhood nutrition through the Child and Adult Care Food Program (CACFP), research that measures the nutritional value of meals served in child care facilities has been lacking. The purpose of this quantitative study was to determine if there are differences in the calories and nutritional value of lunch meals offered to preschool children in facilities that participate in CACFP and in facilities that do not participate in CACFP. Ajzen's theory …