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The Association Between Rheumatoid Arthritis And Type 2 Diabetes Mellitus, Magaly Perez Nieves Jan 2015

The Association Between Rheumatoid Arthritis And Type 2 Diabetes Mellitus, Magaly Perez Nieves

Walden Dissertations and Doctoral Studies

A research report from the Centers for Disease Control and Prevention (CDC) indicated that more than 50% of people with diabetes mellitus (DM) in the United States (U.S.) also have arthritis. The diabetes population is disproportionately affected by arthritis, but there has been limited and inconsistent research to confirm the association between type 2 diabetes mellitus (T2DM) and rheumatoid arthritis (RA). The current study aimed to identify an association between T2DM and RA for noninstitutionalized U.S. adults between 1999 and 2012 using a nationally representative sample from the National Health and Nutrition Examination Survey (NHANES) database (n =31,488 ). A …


Awareness Of Diabetes Risk Associated With Individuals 18 And Older, Rebecca Jane Boone Jan 2015

Awareness Of Diabetes Risk Associated With Individuals 18 And Older, Rebecca Jane Boone

Walden Dissertations and Doctoral Studies

The risk of developing Type 2 diabetes is increasing at epidemic proportions, and is 12-17% higher in Marion County Florida than it is across the state, based on Florida Department of Health statistics. The purpose of this DNP project was to determine if awareness of individual risk of developing Type 2 diabetes through a questionnaire would result in high-risk participants agreeing to attend a diabetes prevention program (DPP) at a local medical clinic. The health belief model and Rosswurm and Larrabee's model for change were used as frameworks. The review of the literature showed that prevention programs were highly effective …


Health Care Seeking Behavior And Provider Responses For Hcv-Positive African Americans, Kathleen Susanna Bailey Jan 2015

Health Care Seeking Behavior And Provider Responses For Hcv-Positive African Americans, Kathleen Susanna Bailey

Walden Dissertations and Doctoral Studies

Of the 3.5 million persons infected with chronic HCV in the United States, the African American population is the largest racial group with chronic HCV. Disparities in access to care and treatment involve a complex set of individual, interpersonal, socioeconomic, and environmental factors that influence the course of HCV infection in the African American population, resulting in poorer outcomes and survival. Drawing upon both the theory of reasoned action and the theory of planned behavior, this study was conducted to determine whether the seeking of health care by HCV-positive African Americans and the responses of health care providers to HCV-positive …


Financing School-Based Health Centers: Sustaining Business Operational Services, Ingrid Monique Hayes-Burrell Jan 2015

Financing School-Based Health Centers: Sustaining Business Operational Services, Ingrid Monique Hayes-Burrell

Walden Dissertations and Doctoral Studies

School-based health centers (SBHCs) have faced challenges in securing adequate funding for operations and developing sound business systems for billing and reimbursement. Specifically, administrators often lack strategies to develop and sustain funding levels to support appropriate resources for business operations. The focus of this descriptive study was to explore best practice strategies to develop and sustain funding through the experiences of SBHC administrators. The conceptual framework included Elkington's sustainability theory, which posits that corporate social responsibility, stakeholder involvement, and citizenship improve manager's effect on the business system. Twenty full-time SBHC administrators working in separate locations throughout the state of Maryland …


Diabetes Self-Management Education Program, Lesa Faye Williams Jan 2015

Diabetes Self-Management Education Program, Lesa Faye Williams

Walden Dissertations and Doctoral Studies

Diabetes is a devastating disease in American. The disease can cause chronic health comorbidities, and untreated diabetes has negative consequences for individuals and on our nation's economy. Newly diagnosed diabetics often have a lack of knowledge about the disease process. The purpose of this project was to design and implement a diabetes educational program to enhance participants' knowledge about diabetes management and self-care using the Health Belief Model. Diabetes Self-Management Education (DSME) is critical in improving patient outcomes and the prevention of diabetes related complications. Participation in a standardized diabetic educational intervention will improve patient knowledge, as measured by a …


Diabetes Education Tailored Towards English Speaking Caribbean Immigrants, Joanna A. Dunk Jan 2015

Diabetes Education Tailored Towards English Speaking Caribbean Immigrants, Joanna A. Dunk

Walden Dissertations and Doctoral Studies

The prevalence of diabetes is increasing among persons of Caribbean ancestry in the United States, yet there is little research on the differences in the health and nutrition patterns of diabetics from this population. This study created a culturally-sensitive diabetes education program for the staff of an internal medicine practice that treated patients from the English-speaking Caribbean. The project was guided by the health belief model, as well as Leininger's theory of transcultural nursing. Methodology of project had a quality improvement focus. The comprehensive curriculum included diabetes medications, physical activity, culturally-tailored medical nutrition therapy, complications, self-care behavior, problem solving, and …


Examination Of Adhd Symptoms In Children Of Traveling Armed Services Members, Giovanda Dewette Norman Jan 2015

Examination Of Adhd Symptoms In Children Of Traveling Armed Services Members, Giovanda Dewette Norman

Walden Dissertations and Doctoral Studies

Research has captured a notable increase in the diagnosis of attention deficit hyperactivity disorder (ADHD) in the United States. This increase in ADHD diagnosis is also seen in children in military communities. A gap in the literature exists regarding how military deployment affects the presentation of ADHD symptoms of children aged 3 to 15 in military families. The study examined the effect of military deployment status on children aged 3 to 15 with symptoms of ADHD. Participants were 164 military families, representative of the diversity of the military, from military bases around Southern California. Each participant responded to 2 questionnaires: …


Efficacy Of African American Grandmothers Regarding The Education Of Custodial Grandchildren, Valarie Louise Petty Boyer Jan 2015

Efficacy Of African American Grandmothers Regarding The Education Of Custodial Grandchildren, Valarie Louise Petty Boyer

Walden Dissertations and Doctoral Studies

The roles of grandparents, from occasional helpers to custodial adults in their grandchildren's lives, often raise levels of social discomfort among those involved,; especially when the children are still in elementary school. A disproportionate number of custodial grandparents are African American women. This phenomenological study explored the lived experiences of 8 custodial African American grandmothers in Delaware regarding the education of their school-aged grandchildren. The theoretical foundation was Carter and McGoldrick's theory of families as interconnected systems, and Sands, Goldberg-Glen, Shin, and Robin's theory that life event changes often lead to stress and coping strategies. Data were collected through in-depth …


Planning For A Community Supported Farmers Market In A Rural Usda Food Desert, Carrie Lynn Engelbright Jan 2015

Planning For A Community Supported Farmers Market In A Rural Usda Food Desert, Carrie Lynn Engelbright

Walden Dissertations and Doctoral Studies

A community initiative to develop and sustain a farmer's market can address insufficient access to fresh and affordable fruits and vegetables for individuals working and residing in a United States Department of Agriculture (USDA) designated food desert. This project addressed a particular USDA food desert in South Wood County, Wisconsin. The purpose of this project was to develop and plan for implementation and evaluation of a community-supported farmers market in South Wood County, with the goal to increase access to fruits and vegetables. Project objectives included development of a sustainable community infrastructure to support the market, development of policies and …


Psychosocial Determinants Of Elective Cesarean Section Deliveries In Selected Obstetric Facilities In Nairobi, Kenya, Tom Joseph Oguta Jan 2015

Psychosocial Determinants Of Elective Cesarean Section Deliveries In Selected Obstetric Facilities In Nairobi, Kenya, Tom Joseph Oguta

Walden Dissertations and Doctoral Studies

Cesarean section (CS) rates have generally increased across the world in the past decade. Reducing elective cesarean section (ECS) rates is imperative as many countries aim to maintain threshold CS rates at or below 15%, the level recommended by the United States' National Institutes of Health. Women are believed to consider ECS for various interconnected psychosocial reasons, but few quantitative studies have investigated these factors. This prospective cohort study was based on the social ecological model (SEM) and the theory of planned behavior (TPB) models, and identified the psychosocial predictors of ECS among 1,268 expectant women in 2 hospitals in …


Herpes Virus Infections, Inflammatory Markers And Risk Of Developing T2dm And Cvd: An Analysis Of Nhanes With Adults, Aged 20-49, 1999-2010, Margarita Irizarry-De La Cruz Jan 2015

Herpes Virus Infections, Inflammatory Markers And Risk Of Developing T2dm And Cvd: An Analysis Of Nhanes With Adults, Aged 20-49, 1999-2010, Margarita Irizarry-De La Cruz

Walden Dissertations and Doctoral Studies

Herpes simplex viruses (HSVs), are among the most virulent and widespread pathogens; they affect 60-90% of the population worldwide. Substantial evidence indicates a possible association between pathogens and chronic disease. HSVs, among other viruses, have been associated with increased risk for inflammatory diseases. However, prior findings have been inconsistent on the role of infection in triggering autoimmune response and chronic disease. This study builds on the premise that pathogens can induce an inflammatory response and increase the risk for disease development. A representative U.S. sample from NHANES, a national population-based cross-sectional survey, was used to examine the relationship between HSVs …


Caregiver Status And Self-Reported Health Status Among African American, Phanta Soko Sackor Jan 2015

Caregiver Status And Self-Reported Health Status Among African American, Phanta Soko Sackor

Walden Dissertations and Doctoral Studies

African American women (AAW) are at a high risk for type 2 diabetes, a debilitating and potentially fatal disease for which there is no cure. The purpose of this study was to extend the research of Mosca et al. (2012) by examining the relationship between caregiver status and self-reported health status for AAW 18 years or older diagnosed with type 2 diabetes. The chronic care model (CCM) provided the theoretical framework for this study. The CCM promoted routine care for patients with chronic illnesses to migrate from acute care to proactive, planned, and risk-based protocols. A binomial logistic regression investigated …


Vitamin D Deficiency And Immune Function In African American, Hiv-Infected Men, Rana H. Ismail Jan 2015

Vitamin D Deficiency And Immune Function In African American, Hiv-Infected Men, Rana H. Ismail

Walden Dissertations and Doctoral Studies

Vitamin D deficiency is common in individuals diagnosed with HIV and is known for its detrimental health effects. Its recognition as a potent immune-modulator with possible immune health implications in HIV disease progression was the main impetus for this study. The association between Vitamin D and CD4 count falls short of being consistent and is too weak to allow conclusions. Similarly, the literature is inconsistent with regard to the impact of Vitamin D supplementation on CD4. This observational, retrospective chart review study aimed to explore the relationship between Vitamin D deficiency and CD4 count/percent, and to evaluate whether changes in …


Food Policy: Urban Farming As A Supplemental Food Source, Bessie Didomenica Jan 2015

Food Policy: Urban Farming As A Supplemental Food Source, Bessie Didomenica

Walden Dissertations and Doctoral Studies

The distance between farms and cities and the limited access that some residents have to fresh foods can be detrimental to a city's capacity to feed people over time. This study addressed the under-studied topic of urban farming as a secondary food source, specifically by exploring the opportunities and limitations of urban farming in a large Northeastern city. Brundtland's food policy was the pivotal theory supporting food production to end global starvation, and was the link between environmental conservation and human survival. The research question for this study examined the potential food policy opportunities and limitations that assist urban farms …


Impact Of Whole Grain Consumption Compliance On Gluten Sensitivity And Bowel Health, Sarah Anne Roberts Jan 2015

Impact Of Whole Grain Consumption Compliance On Gluten Sensitivity And Bowel Health, Sarah Anne Roberts

Walden Dissertations and Doctoral Studies

While many health benefits have been associated with increased whole grain consumption, current researchers have not considered if the consumption of whole grains in currently recommended or higher amounts actually leads to health problems, specifically to a correlated increase in gluten sensitivity. The purpose of this study was to determine if diets high in whole grains or those that met the recommended daily intake of whole grains help minimize or increase gluten sensitivity, and when whole grains are consumed as recommended if they cause more harm than good. The theoretical basis for this quantitative, cross sectional design was the precaution …


Relationship Between Whole-Person Learning And Growth Mindset In First-Generation Learners, Marian Willeke Jan 2015

Relationship Between Whole-Person Learning And Growth Mindset In First-Generation Learners, Marian Willeke

Walden Dissertations and Doctoral Studies

Growth mindset is an important component for a journey towards self-actualization. It is unknown if whole-person learning can assist development of that growth mindset for first-generation learners. The purpose of this quasi-experimental study was to examine if exposure to whole-person learning positively influences a growth mindset by exploring the relationship between whole-person learning and a growth mindset in first-generation learners. Whole-person learning was presented as a vehicle for developing that growth mindset towards self-actualization. Dweck's Mindset Survey scores were collected from first-generation learners who participated in orientation courses either with or without whole-person learning in 4 institutions (n = 177) …


Support Of Maternity Care Practices To Increase Breastfeeding Among First-Time Mothers, Jessica Strauch Jan 2015

Support Of Maternity Care Practices To Increase Breastfeeding Among First-Time Mothers, Jessica Strauch

Walden Dissertations and Doctoral Studies

Breastfeeding offers numerous health benefits to both the mother and infant, yet it is not routinely practiced due to a number of internal and external factors that influence the mother's decision. Guided by the social ecological model, the purpose of this study was to examine the effect of required reporting to The Joint Commission on perinatal measures, a proxy measure for maternity care practices, and those professional effects on breastfeeding initiation and exclusivity for first-time mothers. The hypotheses were that the mandatory reporting, and thus an increase in maternity care practices, would increase the initiation of breastfeeding and exclusive breastfeeding …


The Impact Of Immigration Variables On Tuberculosis Rates In South Carolina, Lisa J. Dimitriadis Jan 2015

The Impact Of Immigration Variables On Tuberculosis Rates In South Carolina, Lisa J. Dimitriadis

Walden Dissertations and Doctoral Studies

After HIV/AIDS, tuberculosis (TB) is the deadliest single infectious agent worldwide; globally in 2013, 1.5 million people died of the disease. Although TB infection rates in the United States are low compared to that of other countries, TB still remains a threat to public health in the U.S., especially among immigrant populations. The main purpose of this study was to investigate the correlations between the independent variables of immigration status, years of residence, and race/ethnicity and the dependent variable of TB infection within South Carolina between 2006 and 2012. To examine these possible relationships, this quantitative study employed the ecological …


Predictors Of Knowledge Of Stroke And Intent To Call 911 Among African Americans, Hyacinth Idu Hyacinth Jan 2015

Predictors Of Knowledge Of Stroke And Intent To Call 911 Among African Americans, Hyacinth Idu Hyacinth

Walden Dissertations and Doctoral Studies

Stroke is associated with significant health disparity and predominantly affects the elderly. Stroke outcome is significantly improved if an individual is able to get "clot-bursting" medication. A significant predictor of an on-time arrival to the emergency room for treatment in the event of a stroke is the ability to accurately recognize stroke signs and symptoms. The purpose of this study was to determine the factors (demographic, socioeconomic, and educational) that predict the knowledge of stroke signs/symptoms and intent to call 911 in the event of a stroke. The study was grounded in the social ecological theoretical model and analyzed archived …


A Proposal For The Development And Validation Of A Diabetic Self-Management Education (Dsme) Program, Melissa Sue Garrison Jan 2015

A Proposal For The Development And Validation Of A Diabetic Self-Management Education (Dsme) Program, Melissa Sue Garrison

Walden Dissertations and Doctoral Studies

The World Health Organization has estimated that by 2030, approximately 350 million people will be diagnosed with Type 2 diabetes mellitus (T2DM). Currently, 18.8 million people are diagnosed with T2DM. An additional 7 million people have high blood sugar but have yet to have an official diagnosis of diabetes. The literature supports early identification and prevention are key to reducing the severity of T2DM its complications. The Health Belief Model, the Chronic Care Model and Orem's Theory of Self-Care guided the current proposal, whose purpose was to develop and validate a new T2DM DSME module. A validation of the DSME …


Exploring Yoga As A Holistic Lifestyle For Sustainable Human And Environmental Health, Julia A. Leischner Jan 2015

Exploring Yoga As A Holistic Lifestyle For Sustainable Human And Environmental Health, Julia A. Leischner

Walden Dissertations and Doctoral Studies

Improved health indicators, mental and physical health outcomes, and sustainable lifestyle practices have been found among yoga practitioners. The purpose of this study was to examine the impact of mixed styles of yoga practice on the health and behaviors of yoga practitioners. The relationship between yoga and body mass index (BMI), self-reported disease diagnosis, participation in other types of physical activity, adoption of healthy and sustainable lifestyle and dietary behaviors, perceived improvements in medical conditions that yoga was used to treat, quality of life resulting from yoga practice, and the reasons for beginning and continuing yoga were observed and tested …


Correctional Nurses' Knowledge And Perceptions Of Methicillin-Resistant Staphylococcus Aureus, Deborah Winbush Jan 2015

Correctional Nurses' Knowledge And Perceptions Of Methicillin-Resistant Staphylococcus Aureus, Deborah Winbush

Walden Dissertations and Doctoral Studies

Since 1999, Methicillin-resistant Staphylococcus aureus (MRSA) outbreaks have occurred in many correctional facilities. Even after the Federal Bureau of Prisons developed clinical practice guidelines on the management of MRSA within correctional facilities, the prevalence of MRSA decreased only insignificantly. Other researchers suggested infection control compliance was equally as important as developing clinical practice guidelines in reducing the incidence of MRSA. Several studies identified the healthcare professionals' nonadherence and inconsistencies to clinical practice guidelines as contributors to MRSA transmission. Accordingly, this project was designed to develop evidence-based recommendations for improving nurse professionals' adherence to MRSA practice guidelines in correctional settings. Using …


Why Some Women Eat Too Much: A Qualitative Study Of Food-Dependent Women, Gigi Van Ostrand Jan 2015

Why Some Women Eat Too Much: A Qualitative Study Of Food-Dependent Women, Gigi Van Ostrand

Walden Dissertations and Doctoral Studies

Obesity has become a worldwide epidemic and limiting one's food intake, or dieting, is usually unsuccessful. The purpose of the study was to explore the effect of food addiction (FA) on the current clinical and behavioral epidemic of obesity. FA, synonymous with food-dependency, is tentatively defined as an eating disorder based on substance dependence, as defined by the Diagnostic and Statistical Manual of Mental Disorders. Measurement of FA has been operationalized by the Yale Food Addiction Scale (YFAS) by applying the diagnostic criteria of substance dependence to eating behaviors. This study was based on the biological theory of chemical addiction …


The Association Of Maternal Health Literacy Levels And Preterm Birth, Aimee Moynihan Jan 2015

The Association Of Maternal Health Literacy Levels And Preterm Birth, Aimee Moynihan

Walden Dissertations and Doctoral Studies

According to the CDC, each year approximately 0.06 % of the world's population dies in infancy. The March of Dimes indicated that the leading causes of infant mortality include birth defects, preterm birth, low birth weight, sudden infant death syndrome, maternal complications of pregnancy, and respiratory distress syndrome, most of which are considered preventable with access to adequate prenatal care by mothers. The goal of this study was to examine the association between maternal health literacy levels and preterm birth. This research was based on the theoretical framework of the Interaction Model of Client Health Behavior. The hypothesis for this …


A Transition-To-Practice Residency That Supports The Nurse Practitioner In A Critical Access Hospital, Nancy Jean Stock Jan 2015

A Transition-To-Practice Residency That Supports The Nurse Practitioner In A Critical Access Hospital, Nancy Jean Stock

Walden Dissertations and Doctoral Studies

Access to health care in rural communities is challenged by workforce shortages. Nurse practitioners (NPs) have been filling the gap created by physician migration into specialty areas. Flex hospital legislation allows critical access hospitals (CAHs) to staff the emergency department with NPs or physician assistants without on-site physicians. NP education often lacks emergency and trauma curriculum, resulting in gaps in education and practice expectations and leading to significant role transition stress and turnover. The purpose of this project was to construct an evidence-based transition-to-practice residency program to support NPs providing emergency department care in the CAH. Theoretical frameworks used to …


Technology As A Health Intervention And The Self-Efficacy Of Men, Karen Denise Maxwell Jan 2015

Technology As A Health Intervention And The Self-Efficacy Of Men, Karen Denise Maxwell

Walden Dissertations and Doctoral Studies

Mortality rates in the United States are higher for men than they are for women as a result of chronic diseases such as heart disease, cancer, and diabetes. Despite these disproportionate rates, few health interventions are targeted to men, and limited knowledge exists regarding the specific components needed to design technology health tools to appeal to men. The purpose of this quantitative study was to examine the relationship between the use of technology health tools and the role of self-efficacy in men and the influence on participation in healthy lifestyle behaviors. A quasi-experimental design was used to analyze data collected …


Practice Guidelines For Self-Management Of Osteoarthritis Pain In The Home-Based Settings, Oyesola Omowunmi Akintan Jan 2015

Practice Guidelines For Self-Management Of Osteoarthritis Pain In The Home-Based Settings, Oyesola Omowunmi Akintan

Walden Dissertations and Doctoral Studies

Osteoarthritis (OA) is a debilitating chronic illness that can prevent older adults from accomplishing their activities of daily living or ambulate without pain. The project's purpose was to develop and disseminate multidisciplinary educational practice guidelines to nurses for use in older homebound male Veteran's Administration OA patients to improve home-based pain management and self-care preventative strategies. Orem's theory of self-care management constituted the theoretical framework. The design was a quality improvement project and involved formation of 6 panels of interdisciplinary teams who reviewed the American Society of Anesthesiologist (ASA) and Osteoarthritis Research Society International (OARSI) guidelines. The ASA and OARSI …


Facilitating Weight Tolerance Among Health And Fitness Majors Toward Obese Persons, Stephanie Boss Jan 2015

Facilitating Weight Tolerance Among Health And Fitness Majors Toward Obese Persons, Stephanie Boss

Walden Dissertations and Doctoral Studies

Weight bias exists in some health-related degree programs. Overweight and obese persons who experience weight bias in health-related services often delay or avoid medical attention altogether. Guided by the attribution theory, the purpose of this sequential explanatory study was to examine weight bias among health majors at a southwest regional university to illuminate how attitudes can affect the level of care provided to overweight persons. The Attitudes toward Obese Persons (ATOP) scores from a convenience sample of 184 health majors revealed that participants' scores were found to be significantly lower than the midpoint (60) of the ATOP scale, M = …


Best Predictors Of A Person's Long-Term Success With Quitting Tobacco, Nhu-Tam P. Villar Jan 2015

Best Predictors Of A Person's Long-Term Success With Quitting Tobacco, Nhu-Tam P. Villar

Walden Dissertations and Doctoral Studies

Smoking relapse rates among tobacco users remain high after quit attempts, with or without interventions. Though researchers have examined stress-related factors contributing to high relapse rate, little empirical research has concentrated on variables predicting long-term quit maintenance. The purpose of this study was to determine the predictability of stress management tools, including exercise motivation, eating behaviors, social support, and self-compassion, as well as the significant combined variance of these variables, in a person's long-term maintenance with tobacco use abstinence. Bandura's social cognitive theory was used to highlight the factors contributing to health behavior such as tobacco use. This study involved …


Correlations Between Childhood Obesity And Obesogenic Environmental Variables Within Durham County, North Carolina, Eureka Capri Daye Jan 2015

Correlations Between Childhood Obesity And Obesogenic Environmental Variables Within Durham County, North Carolina, Eureka Capri Daye

Walden Dissertations and Doctoral Studies

The application of geographic information systems was used to map obesogenic conditions by zip code tabulation areas in Durham County, North Carolina and evaluated associations between those conditions and the understudied area of early childhood obesity. Of the thirty one percent of the children in Durham County, North Carolina who were considered obese in 2010, four hundred and thirty three (1:5) 2 - 4 year old children who received supplemental nutrition services for women, infants and children were obese with BMI levels greater or equal to the 95th percentile and were used as the criterion variable in the study (N=433). …