Digital Commons Network^™

Racial Differences In The Impact Of A Worksite Wellness Program On Cardiovascular Biomarkers, Ceabert Joseph Griffith

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) is responsible for approximately 600,000 deaths in the United States each year, with African Americans (AAs) disproportionately affected. Individual-level approaches to reducing CVD remain ineffective, mobilizing a movement that advocates for population-based solutions. Workplace wellness programs (WWPs) have gained considerable traction as a viable strategy for ameliorating CVD burden among workers in general. However, no studies have looked at the efficacy of WWPs in ameliorating CVD specifically among AA employees--a knowledge gap that this investigation aimed to close. Based on the health belief model and the social cognitive theory, this retrospective cohort study used de-identified secondary data …

Educational Intervention: Effects On Heart Disease Risk Factor Knowledge Among African Americans, Linda M. Smith

Walden Dissertations and Doctoral Studies

Abstract

Fatal coronary heart disease among African Americans is associated with a

disproportionate burden of cardiovascular disease (CVD) risk factors. Research has indicated that CVD risk factor knowledge and the prevalence of ideal CVH both persist at suboptimal levels. However, few researchers have investigated the relationship between culturally-tailored community-based heart health sessions, short-term knowledge acquisition of CVD risk factors, and the awareness of the American Heart Association's (AHA's) CVH construct. The purpose of this cross-sectional, secondary analysis study was to examine the interplay between these variables in an urban African American sample. Guided by social cognitive theory, the study analyzed …

Social Ecological Influences Of Wic Programming Behavior Change Of Former Wic Participants, Joyce L. Terrell

Walden Dissertations and Doctoral Studies

The Special Supplemental Women, Infants, and Children (WIC) Program is one of many United States Department of Agriculture's (USDA) food subsidy programs that serves 8.6 million participants, deemed nutritionally at risk. WIC is designed to influence nutritional and health behaviors to a population least capable of functioning. The purpose of this study was to identify if participation in WIC's nutrition education activities and restricted use of food subsidy benefits had a post-factorial effect on their nutritional behaviors. This study provides data on Bronfenbrenner's social ecological influences and how it impacts on long-term behavioral change. A quantitative causal-comparative design utilizing a …

Effect Of Placard Grading On Food Safety In Retail Food Facilities, Christopher Ogbonna Ogbu

Walden Dissertations and Doctoral Studies

Most people have had an episode of foodborne illness at one time or another; however, the majority of those stricken with foodborne illness fails to associate ill health with something consumed within the past 72 hours. The World Health Organization (WHO) estimates that foodborne diseases affect 30% of the population in developed countries, and that in developing countries, about 2 million people die yearly due to foodborne illness. Previous researchers have indicated that food handlers with poor personal hygiene are potential sources of infection. Although public health agencies in many countries already regularly inspect food facilities to control potential foodborne …

Health Education To Decrease Obesity In Adolescents With Asthma, Mitzie Eumarie Thomas

Walden Dissertations and Doctoral Studies

Obesity increases asthma severity and is costing the health care industry a significant amount of money. Decreasing adolescents' obesity will decrease the risk for chronic health problems, which can have a significant impact in adulthood. Implementing a school-based health education program can decrease the prevalence of obesity amongst adolescents. This program will be implemented by school nurses in the after-school program at Public School 59 (P.S) in New York City. The purpose of this project is to develop adolescents' school-based obesity prevention policies and documentation which will focus on increasing their nutrition education, increasing physical activities, and providing skills to …

Analysis Of Telephonic Pharmacist Counseling, Katherine N. Swift

Walden Dissertations and Doctoral Studies

Medication complexity and nonadherence are significant risk factors for avoidable hospitalizations and health care spending for older adults in the United States. However, limited empirical research has investigated pharmacist-run telephonic medication management programs as a potential solution to the problem of reducing medication complexity while improving medication adherence. This quantitative study employed the behavioral change model to analyze archival data from a sample of 1,148 participants, examining the relationship of a pharmacist-run telephonic consulting program on medication adherence and medication complexity for one pharmacy benefit management firm's Medicare Part D recipients. The primary research questions investigated the relationship of medication …

A Proposal For The Development Of An Exercise Program To Treat Post Thrombotic Syndrome, Christy Jean Hansen

Walden Dissertations and Doctoral Studies

Healthcare costs continue to escalate and hospitals need to use programs that encourage cost effectiveness, reduce resources and staffing, and increase patient accountability for their own healthcare risk factors, comorbidities, and participation in their healthcare decisions. Post Thrombotic Syndrome (PTS) is a debilitating disease with few treatment options. Allowing patients to have shared decision making in a care plan for this disease process that involves an exercise program may be a significant factor in the success or failure of their own healthcare goals and outcomes. The development of a proposal for an exercise program for PTS should provide patients with …

Observations And Teachers' Perceptions Of The Implementation, Benefits, And Challenges Of Breakfast In The Classroom, Dixie Shaffer

Walden Dissertations and Doctoral Studies

The federal government established nutrition assistance programs such as the School Breakfast Program and school districts have implemented Breakfast in the Classroom (BIC) to improve participation rates, yet millions of low-income children do not partake in these programs. Thus, many school districts are failing to meet the nutritional needs of the low-income population, which can have negative effects on a child's healthy development. The purpose of this qualitative case study was to observe and explore teachers' perspectives regarding school breakfast implementation in a small school district in the Mid-Atlantic region of the United States. Research questions examined experiences with implementation, …

Relationships Between A Prenatal Nutrition Education Intervention And Maternal Nutrition In Ethiopia, Divya Lakshmi Selvakumar

Walden Dissertations and Doctoral Studies

In Ethiopia, 17% of pregnant women ages 18-49 are malnourished and have low awareness of prenatal nutrition, which may relate to increasingly high rates of maternal and infant mortality. The purpose of this mixed methods research study was to determine the effects of a community-based prenatal nutrition education intervention program on maternal nutrition knowledge and attitudes in the Alaje district of Ethiopia. The theoretical framework was Sen's capability theory of poverty, in which opportunities can lead to well-being and promote economic development. Research questions focused on the relationships among 8 independent variables-age, income source, degree of program implementation, marital status, …

Impact Of Goodwill Organizations And Community Collaboration On Aids-Orphans' Needs In Nyanza Province, Kenya, Anthonia Nwagbo

Walden Dissertations and Doctoral Studies

A number of researchers have explored the toll of AIDS on the children who have become orphans as a result of the disease; others have investigated the roles of aid-giving agencies on the alleviation of the orphans' situation. However, despite researchers' pointing to the germaneness of community and goodwill agency liaison, no study had examined the impact of such collaboration on the resources available to the orphans. To this end, the heads-of-household of 532 AIDS orphans under 18 years old in Kenya's Nyanza province were surveyed to investigate the impact of community-referral on the state of AIDS orphans with regard …

Perspectives On Hiv/Aids: American-Based Nigerian Women Who Experienced Polygamy In Rural Nigeria, Christianah Oluseyi Olorunfemi

Walden Dissertations and Doctoral Studies

Traditionally, in Nigeria women play a subservient role in relation to men. While a man can practice polygamy by marrying many wives, women cannot marry more than one husband at a time. Although researchers have documented the effects of polygamy on the spread of HIV/AIDS, little is known about the experiences of polygamy by Nigerian women who stopped practicing polygamy by immigrating to the United States without their husbands. It is important to know the experiences of these women as they pertain specifically to the spread of HIV/AIDS so as to develop a preventive intervention for HIV/AIDS among Nigerian women …

Adhd And Multiple Intelligences: Does A Pattern Exist?, Kathleen Mettler

Walden Dissertations and Doctoral Studies

Attention Deficit Hyperactivity Disorder (ADHD) has typically been treated with a deficits-based response while most research has ignored any intelligence differences between the subtypes, despite differing symptomology. This quantitative study explored whether or not a distinct pattern of intelligences existed within each of the subtypes or presentations of ADHD: inattentive (IT), hyperactive (HT), and combined (CT). Using Gardner's multiple intelligences theory, data were collected via an online, self-administered survey from a sample of 132 participants, over 18 years of age, with IT, HT, and CT ADHD. The goal was to identify the most predominant of 8 different strengths or intelligences. …

Obesity And Workplace Injury In Hazardous Occupations Among The Hispanic/Latino Population, Barbara Klyde

Walden Dissertations and Doctoral Studies

Over the past 20 years, adult obesity has increased in the United States, especially among the Hispanic/Latino population. In 2010, the Occupational Safety and Health Administration Environmental and Safety News, reported that younger workers, ages 18 to19 years of age, worked in the most high-risk occupations such as agriculture, construction, fishing, and manufacturing. The reported fatality rates for these occupations were 5.6 times greater for Hispanic workers compared to other race/ethnicity groups reported by the Bureau of Labor Statistics in 2013. This study determined whether obesity contributed to workplace injury or mortality in hazardous occupations, using federal, state, and independent …

Factors Impacting Body Mass Index Of Hispanic Youth In A Weight Loss Program, Elizabeth Maria Hartman

Walden Dissertations and Doctoral Studies

Youth obesity prevalence rates in the United States are trending down; however, for Hispanic youth, rates are increasing despite efforts toward a reduction. The purpose of this study was to evaluate the impact of a culturally focused intervention program on weight reduction of Hispanic youth age 2 to 19 through examination of body mass index (BMI) percentile outcomes comparing age, gender, distance to program, time in program, and season of enrollment. Review of literature supports ecological and cultural approaches requiring behavior modification tailored to family and community as successful in decreasing youth obesity. However, researchers have yet to establish how …

Maternal Depression, Infant Feeding Practices, And Weight Gain Among African American And Hispanic Women, Alphonsus Maduwuba Agbaere

Walden Dissertations and Doctoral Studies

Childhood overweight and obesity are public health concerns that have negative health consequences and affect many children. Efforts are needed to identify children who are at a higher risk of developing overweight and obesity so that early detection and treatment may be offered. The intent of this study was to investigate the differences in the effects of postpartum depression on infant feeding practices and infant weight gain between Hispanic and African American women. Data were obtained from Infant Feeding Practices Study 11, a longitudinal study involving mothers in their third trimester through infants first year of life. The overall test …

Spheres Of Influence: Understanding African American Males' Perceptions And Attitudes Toward Infant Feeding Practices, Makeva M. Rhoden

Walden Dissertations and Doctoral Studies

Although U.S. breastfeeding rates have steadily increased since 2000, there continues to be a disparity in breastfeeding rates for African American (AA) women compared to their non-Hispanic White counterparts. A male partner's perception, specifically his positive attitude toward breastfeeding, may influence breastfeeding initiation and duration rates. This study was an exploration of AA male perceptions and attitudes toward breastfeeding and what effect masculinity ideology (gender norms) has on such attitudes. The socio-ecological model (SEM) was used as the theoretical framework to examine the various environmental levels that intersect with one another to influence these attitudes. A mixed methods study design, …

Differentiating Demographic Factors In Latino Patients With Type 2 Diabetes, Carol Lynne Manning

Walden Dissertations and Doctoral Studies

The American Diabetes Association (ADA) data suggest that Latinos share a greater burden of disease than do non-Latino Whites with type 2 diabetes. As a result of poor glycemic control, Latinos also suffer consequences such as blindness, kidney disease, and limb amputation more often than do other ethnic groups. The purpose of this study was to compare demographic factors of Latinos with well-controlled type 2 diabetes, as measured by a HgbA1c of 7 or less (n = 118) to Latinos not well controlled (n = 105). This cross sectional study used a secondary data set with a sample selected from …

Albumin Levels In Hispanic Dialysis Patients With And Without Type Ii Diabetes, Hector Hernandez

Walden Dissertations and Doctoral Studies

Albumin provides the vital scaffolding for growth and tissue repair and supports oncotic blood pressure and hemodynamics. In hemodialysis patients, albumin aids with fluid removal by drawing excess fluid from edematous tissues back into the blood where it can then be removed by a dialyzer. The hyperglycemia seen in dialysis patients with Type II diabetes progressively damages kidney glomeruli, which permits albumin seepage into the urine, thus lowering serum albumin. The conceptual framework underpinning this research is the van't Hoff theory of osmotic pressure. Under this framework, the solute-solvent relationship largely contributes to the osmotic movement of fluid. The purpose …

Nonattendance Rates And Barriers To Health Care In Outpatient Clinic Settings, Susan Louise Geiger

Walden Dissertations and Doctoral Studies

Lower socioeconomic status, ethnicity, and race are associated with reduced health care use in the United States. Patients who continually miss their appointments suffer significant negative results, including a disruption in continuity of care, complications with their chronic illnesses, and an increase in hospital readmissions. The health belief model was used as the theoretical support for this project that investigated the underlying causes of no-shows at an urban hospital-based outpatient clinic in the United States. It used a quantitative, descriptive design and examined a minority, underserved, and underinsured population that was receiving care at the research site and had a …

Employee Wellness Model For Obesity, Barbara Siebold

Walden Dissertations and Doctoral Studies

Obesity, a condition of having a body mass index (BMI) greater than 30, is a universal epidemic with the greatest prevalence in the United States. The greatest concern with this epidemic health problem is that it presents with many comorbidities and is a risk factor for other chronic diseases. Employee wellness programs (EWP) have been in place for years and incorporate programs on weight management, nutritional education, and smoking cessation to reduce risk factors associated with chronic diseases. These programs utilize the concept of empowerment, often guided by Pender's self-management theory, to encourage employees to take onus for their health …

Primary Factors Affecting Breastfeeding In African American Communities, Lowest Jefferson

Walden Dissertations and Doctoral Studies

Prior research has shown that African Americans are less likely than are Hispanics and Whites to breastfeed their children. Compounding this problem is the scarcity of research that examines African American's culture, perceptions, and beliefs about breastfeeding. This study was conducted to gain a greater understanding of the phenomenon of breastfeeding through the perspectives of African American mothers. Guided by the theories of reasoned action and planned behavior, this ethnographic study elicited African American mothers' perspectives on breastfeeding by examining what influenced their decision to breastfeed or not. This study took place in Washington State. Ten women recruited through purposeful …

Resilience Among Immigrant Adult Learners: Experiences In Postsecondary Education--A Mixed-Methods Study, Sandra Lee Samuels

Walden Dissertations and Doctoral Studies

A human being's resilience refers to his or her abilities to combine internal and/or external resources effectively in response to significant contextual challenges in order to best succeed in a given environment. As such, this concept is vital across the lifespan and has been widely researched. However, few researchers to date have studied resilience as it relates to adult learners, and, significantly, those with immigrant status. Immigrant adult learners are facing compounded risks, which create challenges in various societies to identify this group's unique needs and/or to fully understand their experiences in diverse contexts, such as the Cayman Islands. Informed …

Type 2 Diabetes Prevention Program In The Medical Office Clinic, Jovita Chibuzo Ezirim

Walden Dissertations and Doctoral Studies

The challenge of diabetes prevention is to reduce the financial and human costs of diabetes by preventing new cases and enacting social change. African Americans and Hispanics Americans have a high incidence of Type 2 diabetes because of factors that place them at risk for prediabetes. The purpose of this project was to plan the implementation and evaluation of a Type 2 diabetes prevention program in a medical office clinical setting. The clinic of interest was located in the downtown area of the city and provided care mostly to African American population. The Iowa model of evidence-based practice formed the …

Predictors Of Obesity Among Nigerian Immigrants In The United States, Olawunmi Obisesan

Walden Dissertations and Doctoral Studies

Obesity has been identified as a significant risk factor for chronic diseases, contributing to health disparities in minority and vulnerable populations. Though research has identified an increased risk for obesity in the Hispanic immigrant population, there is little or no research on the heterogeneity of obesity predictors in specific immigrant populations in the United States. This study examined the predictors of obesity in the Nigerian immigrant population in the United States. Guided by the social ecological model and the segmented assimilation theory, this cross-sectional study collected primary data from 205 Nigerian immigrants in the United States using the CDC's Behavioral …

A Qualitative Analysis Of Migrant Women Farmworkers' A Qualit Ative Analysis Of Migrant Women Farmworkers’ Perceptions Of Maternal Care Management, Stacey A. Pilling

Walden Dissertations and Doctoral Studies

The purpose of this phenomenological study was to examine migrant women farmworkers' views of perinatal care management while working in the fields. Like men, women migrant farmworkers are exposed to many physical, chemical, and biological hazards that pose human health risks. However, women of childbearing age are at an increased risk of having reproductive health difficulties and adverse pregnancy outcomes, and the infant mortality rate among migrant farmworkers is estimated to be twice the national average. Perinatal care is a critical factor in reducing adverse outcomes for perinatal and newborn mortality. Face-to-face interviews were conducted with 15 migrant women farmworkers …

Nclex-Rn Predictor Test Scores And Nclex-Rn Success, Annie Ruth Grant

Walden Dissertations and Doctoral Studies

Health care professionals and nurse educators are concerned about increasing percentage of first time test takers failing the NCLEX-RN exam. The purpose of this retrospective study was to examine predictive accuracy of the Assessment Technologies Institute (ATI) RN Comprehensive Predictor for passing or failing the NCLEX-RN exam in a cohort of nursing students (N = 195). South Eastern Technical College in South Carolina is in jeopardy of losing accreditation for their nursing program because of the low percentage of first time test takers failing. The college's pass rate on the NCLEX-RN exam has been below the national and state averages …

Race/Ethnicity, Diet, And Physical Activity Behavior Among College Students, Ronda Herbert

Walden Dissertations and Doctoral Studies

Scarce knowledge exists about the lifestyle of college students from heterogeneous racial/ethnic backgrounds and how race/ethnicity may influence their diet and physical activity behaviors. College students, especially those who are members of minority groups, are at risk for unhealthy lifestyles resulting in negative health outcomes. The purpose of this quantitative study was to examine the role of racial diversity on dietary and physical activity habits. The study was guided by social cognitive theory, and the research questions examined the relationship between race/ethnicity on diet and physical activity in a multiracial ethnic population. The study research design was a quantitative cross-sectional …

Effect Of A Lifetime Health And Fitness Class On College Students, Tiffany Tara Young Klockziem

Walden Dissertations and Doctoral Studies

Physical inactivity and obesity, both of which are modifiable cardiovascular disease (CVD) risk factors, increase substantially during the transition from adolescence to young adulthood. CVD is the 5th leading cause of death in people ages 18 to 29. This disease has enormous social and financial repercussions; however, many college age students do not see chronic disease as a personal threat. Few researchers have examined chronic disease risk in young adults or used a consistent, objective measurement of physical activity. A pre-post, quasi-experimental study was conducted to evaluate the association between a health and fitness class, physical education 215 (PHED 215) …

Association Of Bisphenol A And C-Reactive Protein Concentrations With Cardiovascular Diseases, Hassan Salim Naji

Walden Dissertations and Doctoral Studies

Bisphenol A (BPA), a widely used chemical in plastic, has drawn wide attention due to its presence in many consumer products and the environment. The purpose of this study was to examine the association between urinary BPA and the reporting of cardiovascular diseases (CVD), and then to examine the effect of C-reactive protein (CRP) as a moderating variable. The data used in this research were extracted from the National Health and Nutrition Examination Survey collected in 2009-2010. Guided by the advanced epidemiological triangle, analysis involved 2 stepwise binary logistic regressions. The first step suggested that the controls were significant in …

Can Nurse-Facilitated Support Groups Foster Self-Awareness?, Althea Lenore Phillips

Walden Dissertations and Doctoral Studies

Students with learning disabilities (LDs) represent 9% of students attending college, and college administrators must comply with a large number of federal requirements outlining the provision of educational services for students with LDs, including offering support groups. Nurse-facilitated support groups, held within the university setting, could provide effective social support, increasing likelihood of college success among students with LDs. The purpose of this project was to develop a plan for implementing nurse-facilitated support groups for students with LDs within the student health services (SHS) department at a university designed to improve their coping skills on personal, social, and academic levels. …