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Sociodemographic Factors Associated With Childhood Vaccination Status In Sokoto State, Nigeria, Dauda Milgwe Madubu

Walden Dissertations and Doctoral Studies

Immunization remains one of the most successful and cost-effective public health interventions worldwide. Despite the critical role of vaccines in improving childhood and maternal health, Sokoto state recorded the lowest childhood vaccination completion rate among the 37 states in Nigeria with only 5% of children aged 12-23 months having had full childhood vaccination based on data from the 2018 demographic and health survey. The factors associated with the state’s low childhood vaccination status have not been explored. The study examined the relationship between the sociodemographic factors including parents’ socioeconomic and ethnoreligious factors, place of residence, and children’s biological characteristics and …

Associations Between The Use Of Bed Nets And Malaria Infection On The School Performance Of Juveniles In Ghana, Ans Bumbokuri

Walden Dissertations and Doctoral Studies

Millions of malaria cases are reported yearly in sub-Saharan Africa, events which adversely influence children’s school performance. The purpose of this quantitative, cross-sectional study was to investigate the effectiveness of major malaria control policies in reducing malaria cases as a means of improving academic performance among school children in the greater Accra region of Ghana. A secondary data set was obtained from the 2014-2016 data from the Ghana Malaria Indicator Survey (GMIS). Findings indicated that bed net use and malarial episodes in children of participant recorded a p-value of 0.43 which is a significant association between the variables. The likelihood …

Surgical Site Infection Rates After Implementation Of The Surgical Care Improvement Project Initiative, Victor Lao De Guzman Jr

Walden Dissertations and Doctoral Studies

Surgical site infections (SSIs) reflect a serious complication in modern healthcare and are a substantial burden to healthcare systems and service payers worldwide in terms of patient morbidity, mortality, and additional costs. The Surgical Care Improvement Project (SCIP), introduced in 2006, was developed by the Centers for Medicare and Medicaid Services to reduce SSI rates by 25%. However, SCIP was retired in 2015. Given the considerable financial burden of SSIs and because SSIs may be prevented using evidence-based measures, it was worth revisiting and re-evaluating the quality improvement efforts brought about by the success of the evidence-based SCIP initiative. This …

The Experience Of Women With Opioid Use Disorder Accessing Methadone Treatment, Lizette Cristine Keenan

Walden Dissertations and Doctoral Studies

The number of women experiencing opioid use disorder (OUD) in Canada has increased exponentially. In Canada, healthcare is socialized and free for all citizens and often medications like methadone are free as well, yet few individuals with OUD access treatment services. The purpose of this study was to describe the lived experiences of Canadian women with OUD who were receiving methadone treatment. Interpretive phenomenology was used to investigate the treatment experiences of seven women with OUD. The conceptual framework of self-care of chronic illness was used examine this phenomenon. Data was analyzed using a seven step process of interpretive phenomenological …

Determinants Of Substance Abuse Among Users With Mental Health Issues In Ogun State, Nigeria, Michael Olusegun Adejimi

Walden Dissertations and Doctoral Studies

In Nigeria, about 14.3 million people use drugs without physician prescription and approximately 30% of Nigerians suffer from mental illness, some of which is due to substance abuse. This study examined the associations between (a) socio-demographic factors and substance abuse among users with mental health issues in Ogun State Nigeria, (b) clinical variables and substance abuse among users with mental health issues, (c) negative life events and substance abuse among users with mental health issues, and (d) social supports and substance abuse among users with mental health issues. This study theoretical framework was based on the definition of mental health …

Reducing Infection Rates Through Handwashing Education, Maureen N. Osegbe

Walden Dissertations and Doctoral Studies

AbstractHealth care-associated infections (HCAIs) affect millions of people worldwide, causing morbidity and mortality among hospitalized patients. Hand hygiene is the single most effective way to prevent HCAIs. This project addressed a gap in practice regarding nurses’ knowledge on the effective use of hand hygiene in a medical/surgical unit in a hospital located in northeastern Maryland. This project addressed the question of whether an educational program on handwashing for nurses reduced HCAI rates. A literature review was conducted to support the development of the educational program; relevant sources included peer-reviewed journal articles, systematic reviews, and guidelines that supported the practice-focused question, …

Antibiotic Stewardship: Decreasing Antibiotic Use For Viral Upper Respiratory Infections, Merkessie Taresa Redix

Walden Dissertations and Doctoral Studies

AbstractOverprescribing antibiotics for viral upper respiratory infections is a common practice in the United States. This overprescribing of antibiotics can cause several health issues and increase health care costs. Despite the current guidelines recommended by the Centers for Disease Control and Prevention (CDC) the overprescribing of antibiotics by providers remains an issue. The purpose of this project was to educate providers on antibiotic stewardship for viral upper respiratory infections. The practice question was used to explore whether an educational program using concepts from Lewin’s change theory and Kolb’s learning theory would increase provider’s knowledge about the current evidence- based prescriptive …

Blood Culture Staff Education To Improve Knowledge And Contamination Prevention, Christina Michelle Harvey

Walden Dissertations and Doctoral Studies

AbstractThere was an underlying issue with nurses improperly drawing blood cultures resulting in false results that impact patient care. The project examined the question whether a staff education program for Veteran’s Affairs Registered Nurses on the effects of correct blood culture specimen collection can demonstrate an increase in knowledge in the VA’s collection procedure leading toward increasing compliance. The purpose was to correct a knowledge deficit leading to a lack of compliance of the VA nurses on the target unit. The project was directed by the principles of the Knowles’ adult learning model. The sources that generated evidence for the …

Evaluating Compliance With The Produce Safety Rule And Managing Mycotoxins, Yvette May Molajo

Walden Dissertations and Doctoral Studies

Foodborne diseases are the cause of many illnesses that occur from foods that contain mycotoxins. Mycotoxins are produced from fungi and are environmental and carcinogenic agents that contaminate agricultural foods during preharvest and postharvest conditions. While researchers have conducted many studies on mycotoxin occurrence and production, there is a significant gap in the current literature regarding which environmental factors could put farmers’ ability to remain in compliance with the Food Safety Modernization Act’s Produce Safety Rule at risk. Therefore, the purpose of this quantitative study was to investigate which environmental factors could put farmers’ ability to remain in compliance with …

Misuse Of Prescription Pain Relievers Among Pregnant Women In The United States, Winnie Chebet Rono

Walden Dissertations and Doctoral Studies

The non-medical use of prescription pain relievers has increased remarkably, posing social and public health concerns particularly in developed countries such as the United States. The management of pain experienced by pregnant women poses a challenge to clinicians considering the effects of the regimen on unborn babies. Guided by the health belief model, which aims to predict health-related behavior in terms of certain health beliefs and explain change and behavior maintenance as well as to guide health behavior interventions, this cross-sectional study aimed to understand the associations between misusing pain relievers and social determinants of health such as education level …

Predictors Of Obesity Among Young Adults In The State Of Maryland, Kala Shahi

Walden Dissertations and Doctoral Studies

AbstractObesity has become a global wellness concern for young adults. In the past, there were very few studies conducted on predictors of obesity among young adults, even though there have been several studies on the potential predictors of obesity on the general population. The social ecological model was used to guide this quantitative cross-sectional study to identify the possible predictors of obesity among young adults. The Behavioral Risk Factor Surveillance System was used to analyze the potential predictors of obesity among young adults between the ages 18 – 34 years old in Montgomery County, Frederick County, and Princess Georges County, …

Social/Cultural Factors In Preschool Immunizations, Mozambique, Kristine Gayle Bernabe

Walden Dissertations and Doctoral Studies

Immunizations are scientifically proven, effective global health interventions that prevent infectious diseases and save lives. Yet, in Mozambique at the national level, less than 65% of children are fully immunized, i.e., received all the basic/routine vaccinations. The overall purpose of the doctoral study was to conduct quantitative research examining the sociocultural factors that may impact childhood immunization status in the context of the social ecological model. The study examined the relationship between child’s gender, mother’s and her husband/partner’s educational level, household wealth index, religion, ethnicity/language, urban-rural residency, and province/region with the child’s full immunization status in Mozambique. Secondary analysis of …

The Exploration Of Clinical Supervision For Substance Abuse Social Workers In Bermuda, Steva Aria Bean

Walden Dissertations and Doctoral Studies

As specialists who bridge the gap between the social work and substance abuse treatment fields, substance abuse social workers are expected to develop themselves as social workers by designation, substance abuse counselors by occupation, and deliver competent therapeutic services that align both professions seamlessly. As documented in the National Association of Social Workers Code of Ethics, their support in achieving this feat is clinical supervision. Despite this documentation, a review of the social work literature revealed an absence of information on clinical supervision between the social work and substance abuse fields, their supervisory alliance, and outcomes. Accordingly, this project was …

The Combined Impact Of Race And Education On Obesity Among U.S. Adults By Fidelis Okoye, Fidelis Chidi Okoye

Walden Dissertations and Doctoral Studies

Walden University

College of Health Professions

This is to certify that the doctoral dissertation by

Fidelis Okoye

has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made.

Review Committee Dr. Vasileios Margaritis, Committee Chairperson, Public Health Faculty Dr. Srikanta Banerjee, Committee Member, Public Health Faculty Dr. James Rohrer, University Reviewer, Public Health Faculty

Chief Academic Officer and ProvostSue Subocz, Ph.D.

Walden University2021

AbstractThe Combined Impact of Race and Education on Obesity Among U.S. Adults by Fidelis Okoye

MA, Walden University, 2009BS, Marygrove College, 2001

Dissertation …

Operation Enduring Freedom And Operation Iraqi Freedom Veterans In The Veterans Health Administration, Exekiel Montoya Aranez

Walden Dissertations and Doctoral Studies

The Veterans’ Health Administration (VHA) has faced critical issues regarding the deaths of war veterans, the result of which stakeholders raised questions about the quality of health care given within the VHA. Through patient-centered care standards of health care, the VHA worked diligently to end such horrific events that more than 300,000 veterans may have died while waiting for health care service. This study examined five core concepts of the health care system and whether VHA has utilized its five core concepts of patient-centered care to deliver proper health care to war veterans. This study used qualitative research in the …

Improving Nursing Knowledge On Antibiotic Therapy To Prevent Pneumonia Readmissions, Muskuda Deen

Walden Dissertations and Doctoral Studies

Lack of education on the appropriate use of antibiotic therapy can lead to an increase in early readmissions for patients with community-acquired pneumonia (CAP). The purpose of this project was to educate medical-surgical nurses at an inpatient hospital in the southern region of the United States on the appropriate use of antibiotic therapy to decrease early CAP readmissions. The project practice question was whether the infection control clinical practice guidelines would increase the medical-surgical nurses’ knowledge on the appropriate use of antibiotic therapy to decrease the 30-day readmission rates for patients diagnosed with CAP. The staff education development was guided …

Reproductive Health Factors And Maternal Mortality Of Internally Displaced Women In Nigeria, Fatima Mahmood Jibirilla

Walden Dissertations and Doctoral Studies

Approximately 529,000 women die from pregnancy-related causes every year, with 99% of these maternal deaths occurring in developing countries. Each year, about 59,000 maternal deaths occur in Nigeria, with a mortality rate of 576 deaths per 100,000 births. Women constitute about half of the 33.2 million internally displaced persons (IDPs) worldwide. The purpose of this retrospective cross-sectional study was to explore the association between the reproductive health factors and maternal mortality of internally displaced women in Borno state, Nigeria. McCarthy and Maine’s model for determinants of maternal mortality informed this study. A secondary dataset of 400 women (age 14-49 years) …

The Causes And Control Measures Of Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae In Long-Term Care Facilities, Ismaila Olatunji Sule

Walden Dissertations and Doctoral Studies

Due to extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE), infections among residents are increasing in long-term care facilities (LTCFs), resulting in high rate of morbidity and healthcare costs. ESBL-PE resists empirical antibiotics and reduces treatment options, and a designated infection control team is unavailable to prevent the prevalence of the disease. Ecological theory guided this study. A systematic review and meta-analysis were conducted to characterize the causes of ESBL-PE and evaluate the infection control strategies within LTCFs. Multiple regression analysis (MRA) was included as supplementary statistical analysis to identify relationships between LTCFs, geographical locations, infection control measures (ICMs), and ESBL-PE. A systematic search …

Lived Experiences Of Lassa Fever Survivors In Southsouth Nigeria, Albert Oamen Oyeribhor

Walden Dissertations and Doctoral Studies

AbstractLassa fever, a viral disease, was first isolated in the late 1960s and affects 300,000 to 500,000 people, causing 5,000 to 10,000 fatalities annually across West Africa. Although there are studies on the causes and prevalence of Lassa fever, there is a paucity of studies regarding the quality of life (QoL) and lived experiences of survivors. The purpose of this qualitative study, guided by Leininger’s culture care theory, was to describe the QoL and meanings of the lived experiences of Lassa fever survivors in the Southsouth region of Nigeria. Fifteen survivors of Lassa disease were interviewed. Data were analyzed using …

Post-Conflict Mental Health Policy And Substance Use Among Liberian Adults, Ekua Amonoo-Lartson

Walden Dissertations and Doctoral Studies

AbstractThe objective of post-conflict countries after an extended period of war and trauma is to maintain peace and stability. However, the physical and psychological effects of substance use to cope with the devastation of war remains long after the crisis has ended. The purpose of this qualitative phenomenological study was to examine substance use among Liberian working-age adults, including their substance use habits, experiences with substance use, and access to mental health rehabilitative treatment. The access to medical care theoretical framework was used to guide the study. Data were collected from face-to-face semistructured interviews with 15 individuals regarding their experiences …

Leadership, Quality Improvement, Team Functionality, And Hiv Viral Load Suppression In Uganda, Esther Karungi Karamagi Nkolo

Walden Dissertations and Doctoral Studies

Low viral load suppression rate is a significant public health issue in Uganda and similar countries. A nationwide quality improvement (QI) initiative was implemented from January 2019 to improve viral load suppression. Although QI team characteristics have been shown to influence the success of such QI initiatives, no studies have been found to understand how they influence the success of QI efforts to improve HIV viral load suppression in Uganda. The purpose of this cross-sectional, quantitative study was to determine whether there is a significant association between HIV clinic leader involvement in QI teams, QI team functionality, QI team diversity, …

Evaluating Integrated Treatment On Recidivism For Female Offenders In Criminal Justice System, Oyin T. Popoola

Walden Dissertations and Doctoral Studies

The burden of co-occurring disorders (CODs) among offenders in the criminal justice system (CJS) in the United States, particularly among the female population, is threatening the communities. About 80% of women in the CJS were diagnosed and treated for CODs, and 63% tend to be rearrested. The study examined the possible influence of CODs, integrated treatment of CODs, and gender, on recidivism while controlling for other demographic factors. The study was based on the conceptual framework of integrated dual disorder treatment (IDDT) and feminist criminology theory. Cross-sectional quantitative study design was applied on a secondary dataset from the 2017 Treatment …

The Association Between Central Line Insertion Practices And Central Line-Associated Bloodstream Infections, Mona Elgowainy

Walden Dissertations and Doctoral Studies

Healthcare-associated infections, specifically central line-associated bloodstream infections (CLABSI), continue to remain a serious public health concern in the United States. Though CLABSI can often be prevented, healthcare professionals struggle to have a positive impact on CLABSI rates. The primary purpose of this study was to determine whether CLIP Bundle adherence has an impact on CLABSI standardized infection ratio (SIR) rates in various patient care areas in California. The research questions were focused on assessing whether there was an association between patient care areas, CLABSI rates, and CLIP Bundle adherence scores. A quantitative, cross-sectional study design utilizing secondary data was used …

Tuberculosis Diagnostics In Ethiopia: Assessment Of Laboratory Procedural Capabilities And Limitations, Yeshimebet Retta

Walden Dissertations and Doctoral Studies

Abstract

Tuberculosis (TB) is a curable and preventable disease; however, in 2015, 10.4 million people were diagnosed with TB, making it one of the top 10 causes of mortality. A major part of the TB disease burden is carried by low and middle-income countries. In Ethiopia, which ranks 15th among 22 countries with a high burden of TB and multidrug resistant TB (MDR-TB), important diagnostic and treatment gaps persist. This quantitative descriptive study was primarily aimed to determine levels of adherence to standardized TB laboratory procedures by calculating and reporting the number of sputum samples, and reporting valid and documented …

Sex Differences In Lyme Disease Symptomatology In The Northeast United States, Jeanine Scotti

Walden Dissertations and Doctoral Studies

Guided by the gender-analysis-matrix theoretical framework, 3 key areas of research inquiries focused on the relationship between sex and Lyme disease, symptoms of Lyme disease and sex, and severity of Lyme disease symptoms on sex. A quantitative secondary data analysis was used to address the research questions. A clinician specializing in caring for individuals with Lyme disease provided the dataset, containing responses to the Horowitz Multiple Systemic Infectious Disease Syndrome Questionnaire for Lyme disease. A cross-sectional, comparative research design incorporating 2 statistical techniques for analysis—the independent samples t test and multivariable regression analyses—was used to examine symptom counts and the …

Improving Nursing Knowledge Of Heart Failure Discharge Self-Care Instructions, Maria Patricia Picar Deza

Walden Dissertations and Doctoral Studies

Patients with heart failure (HF) have recurrent symptoms that lead to frequent hospital readmissions. Moreover, HF is one of the leading causes of 30-day hospital readmissions. Evidence shows that patients with a high level of HF self-care have decreased readmissions. HF self-care education is commonly delivered by the nurse at hospital discharge, and the patient’s transition to self-care is a critical point in the continuum of care. However, nurses must be knowledgeable of patient self-care in HF to effectively convey this information to the patient upon discharge. Therefore, this staff education project question asked whether nursing knowledge of HF patient …

Prevention Practices And West Nile Virus Infection Among Ethnic Minorities, Texas, Bayabel Debebe Mengistu

Walden Dissertations and Doctoral Studies

Abstract

West Nile virus (WNV) is a major public health problem and the cause of nearly 25% of the world's economic burden of disease. While the risk factors for developing West Nile fever and West Nile disease from WNV infection have been identified, it is not known how knowledge, attitude, behavior (KAB), access to health care (AHC), and comorbidities are associated with prevention practices of WNV infection among ethnic minorities. The aim of this study was to examine the association between KAB, AHC, comorbidities, and prevention practices of WNV infection among ethnic minorities in Texas. KAB, AHC. Comorbidities were used …

Hiv Prevention: Pre-Exposure Prophylaxis, Sexual Decision Making, Risk Taking, And Condoms, Jonathan D. Spencer

Walden Dissertations and Doctoral Studies

HIV is an infectious disease that continues to have new cases each year within high-risk populations, such as men who have sex with men (MSM). To help in the fight against new HIV infections within the MSM population, new medications such as pre-exposure prophylaxis (PrEP) are being used. The purpose of this cross-sectional online survey study was to address whether PrEP use had any relationship with (a) sexual decision-making, (b) risk-taking, and (c) condom use in the MSM population 18-64 years of age, after controlling for socioeconomic status, race, and age while using the behavioral disinhibition and risk compensation models. …

Improving Nursing Knowledge Of Heart Failure Discharge Self-Care Instructions, Maria Patricia Picar Deza

Walden Dissertations and Doctoral Studies

Patients with heart failure (HF) have recurrent symptoms that lead to frequent hospital readmissions. Moreover, HF is one of the leading causes of 30-day hospital readmissions. Evidence shows that patients with a high level of HF self-care have decreased readmissions. HF self-care education is commonly delivered by the nurse at hospital discharge, and the patient’s transition to self-care is a critical point in the continuum of care. However, nurses must be knowledgeable of patient self-care in HF to effectively convey this information to the patient upon discharge. Therefore, this staff education project question asked whether nursing knowledge of HF patient …

Behavioral, Demographic, And Clinical Determinants Of Hiv Serostatus In Zambian Women, Debebe Masresha Gebreyohannes

Walden Dissertations and Doctoral Studies

The rate of human immunodeficiency virus (HIV) infection shows a diminishing trend at the global level while it shows increasing in intensity of mortality, morbidity, and burden in Sub-Saharan Africa. The intertwined behavioral, demographic, and clinical determinants fueled the incidence of infections in Zambian women. The purpose of this study was to determine the association between demographic, behavioral, and clinical determinants with HIV serostatus in Zambian women. With the conceptual framework of the World Health Organization’s Commission for Social Determinants of Health (CSDH) and quantitative method of MANOVA, this study examined Zambian Demographic Health Survey data for Zambian women of …