Digital Commons Network^™

Factors Impacting Hiv Post Exposure Prophylaxis Among Health Care Workers, Ulunma Njemanze

Walden Dissertations and Doctoral Studies

Health care workers are at risk of contracting HIV as a result of occupational exposure while treating infected patients. HIV postexposure prophylaxis (PEP) is an effective antiretroviral treatment course used in preventing potential HIV infection following an accidental occupational exposure to HIV. The objective of this cross sectional study was to identify the factors that impact the practice of HIV PEP among health care workers at the National Hospital, Abuja, Nigeria. A cross-sectional survey using self-administered, structured questionnaires was conducted on 182 health care workers at the National Hospital comprising of medical doctors, nurses, and laboratory scientists. A chi-square test …

Geospatial Analysis Of Spatial Patterns Of U.S. Hospital Readmission Rates, Yamei Wang

Walden Dissertations and Doctoral Studies

Unplanned hospital readmission after a recent hospitalization is an indication of poor healthcare quality and a waste of healthcare resources. The Centers for Medicare and Medicaid Services (CMS) initiated the Hospital Readmission Reduction Program (HRRP) to improve healthcare quality and reduce costs; however, studies found the risk adjustment method used in calculating the standardized readmission rate was less accurate without hospital region or community factors. Accordingly, this cross-sectional quantitative study was designed to examine spatial patterns in hospital readmission rates following Andersen's behavioral model of health service utilization. This study was the first geospatial analysis on risk standardized hospital readmissions …

Body Piercing And Health Complications Among College Students In Puerto Rico, Elsie Goicochea

Walden Dissertations and Doctoral Studies

The incidence and prevalence of body piercing health complications among students is a public health matter that has not been researched in Puerto Rico. College students are the most consistent participants in body piercing activities and have reported health complications resulting in visits to medical offices and emergency rooms. Based on the health belief model, which is used to explain and predict health attitudes, the purpose of this quantitative nonexperimental study was to analyze the health risks and possible complications occurring after body piercing and to investigate the association between sex and age and medical complications. Data were collected from …

Compliance Of Caregivers With Polio Vaccine Dosages And Timelines In Lagos State Nigeria, Grace Olubunmi Salako Smith

Walden Dissertations and Doctoral Studies

Caregivers' compliance with polio vaccine regimens and timely receipt of the recommended 4 doses of polio vaccine are pivotal to eliminating polio. This cross sectional study, conducted in Lagos State, Nigeria, examined polio vaccine compliance and demographic attributes of caregivers' for statistically significant associations. Using an adapted health belief model theoretical framework, 1,200 participants were recruited from well-baby clinics in 8 local government areas in Lagos State. Participants completed a brief demographic survey providing data on caregivers' age, gender, residence (rural or urban), and their level of education as well as records from their children's immunization cards. Data obtained were …

Cardiovascular Disease Risk Factor Assessment And Lifestyle Adjustments In African Americans, Biruk Nigatu Nigatu

Walden Dissertations and Doctoral Studies

Multiple studies have indicated a higher burden of overweight/obesity and exposure to environmental toxins, such as alcohol and tobacco smoke, in association with higher prevalence of cardiovascular disease (CVD) in the African American population. Thus, the purpose of this research was to determine if there was a significant difference in the use of lifestyle adjustments such as moderating alcohol consumption, weight loss, and smoking cessation on the prevalence of CVD in the African American population. The theoretical foundation was social cognitive theory and the social ecological model that posits the interplay of individual, social, and environmental factors. This cross-sectional quantitative …

Attitudes And Perceptions Of Mental Health Treatment For Native American Clients, Beverly Elaine Johnson

Walden Dissertations and Doctoral Studies

The need for mental health service is increasing in American Indian/Alaska Native (AI/AN) communities. While research has examined the availability, access, and effectiveness of provided services to the AI/AN, very little is known about the influence of the attitude and perceptions of both clinicians and clients in their therapeutic relationship in the treatment process. Using the frameworks of liberation, oppression, and trauma theory, this qualitative phenomenological study explored mental health service delivery and utilization issues within an AI/AN community. Data were collected through semistructured interviews with 14 clinician and client participants. The data were sorted into themes and subthemes and …

Predictors Of Uti Antibiotic Resistance For Female Medicaid Recipients In U.S. Ambulatory Care Settings, Wendy Denise Wiesehuegel

Walden Dissertations and Doctoral Studies

Urinary tract infections are diagnosed in female populations primarily in ambulatory care settings in the United States. Yet, published evidence documents that many of the antibiotics prescribed in these settings are unnecessary, erroneous, or, inappropriately prescribed. Improper management of uncomplicated urinary tract infections in nonpregnant women has resulted in higher morbidity rates due to antibiotic resistance. The purpose of this retrospective observational cohort study was to explore a current national database for associations between nonpregnant American female patients who were exposed to poverty and at risk for urinary tract infection antibiotic resistance in an ambulatory care setting. Krieger's ecosocial theory …

Using Multi-Theory Model To Predict Low Salt Intake - Nigerian Adults With Hypertension, Christine Adekemi Dokun-Mowete

Walden Dissertations and Doctoral Studies

Hypertension is a chronic non-communicable disease and a major risk factor for cardiovascular diseases, renal malfunction, disability, and premature death. One of the public health recommendations for the management of hypertension is the reduction of sodium/salt intake. There is need to develop and implement new evidence-based theoretical interventions to initiate and sustain behavior change in health education and promotion. Therefore, the quantitative cross-sectional method and design was used to investigate the adequacy of multi-theory model (MTM) constructs for the initiation and the sustenance of low sodium/salt intake behavior in hypertensive Nigerian adults. In addition, the impact of the MTM (initiation) …

Dietary Acculturation And Obesity In African Immigrant Adults, Stella Chinyere Onuoha-Obilor

Walden Dissertations and Doctoral Studies

Racial/ethnic groups are disproportionately affected by obesity and other risk factors for chronic diseases. African immigrants are an increasing segment of the U.S. population at greater risk for obesity than other immigrants living in the United States. Public health organizations that aid immigrants could benefit from information about changing dietary patterns. The purpose of this study was to explore the association between dietary acculturation and obesity among African immigrant adults living in the United States, controlling for length of stay, English proficiency, region of residence, and other sociodemographic factors. Acculturation theory guided this study. The research design was quantitative cross-sectional …

Coping With The Threat Of Ebola In Monrovia: A Case Study, Augustine M. Sumo

Walden Dissertations and Doctoral Studies

In early 2014, 3 West African states of Guinea, Liberia, and Sierra Leone made news headlines when Ebola virus disease (EVD) ravaged the sub-region. The Liberian government was ill-equipped to efficiently contain EVD outbreak due to inadequate training for hospitals and healthcare workers. The government's mandatory cremation policies and the banning of public gatherings significantly contributed to the spread of EVD. EVD infected 10,666 and 4,808 died from the disease in the first 6 months of the epidemic. Using Bandura's Social Cognitive Theory (SCT) as the theoretical framework, the purpose of this case study research was to examine the social, …

Designing And Evaluating An Educational Initiative Promoting Condom Use Among Hiv+ Hispanic Men, Gilberto Andino

Walden Dissertations and Doctoral Studies

In 2013, the Centers for Disease Control and Prevention estimated that between 252,000 and 312,000 Hispanic men and women in the United States were unaware of their risk for transmitting HV/AIDS. Guided by the logic model and Leininger's theory, the purpose of this project was to design a culturally sensitive HIV/AIDS educational program for HIV+ Hispanic males and to evaluate the program content with the staff at a medical center in South Florida, with the goal of implementing the program at that center. The educational program content focused on increasing the knowledge of Hispanic HIV+ men on the effectiveness of …

Racial Ethnic Health Disparities: A Phenomenological Exploration Of African American Adults With Diabetes Complications., Florence A. Okombo

Walden Dissertations and Doctoral Studies

Racial/ethnic minority groups experience a higher mortality rate, a lower life expectancy, and worse mental health outcomes than non-Hispanic in the United States. There is a scarcity of qualitative studies on racial/ethnic health disparities. The purpose of this hermeneutic phenomenological study was to explore the personal experiences, attitudes, and perspectives of 6 African American adults with chronic health issues related to diabetes through a face-to-face interview. Social cognitive theory and health belief model guided the study. The participants were recruited through purposeful sampling. The data were coded using axial and thematic coding and subsequently analyzed through phenomenological interpretive inquiry. The …

Attitudes Of Women Offenders Towards Medicaid Enrollment And Coverage Under The Affordable Care Act, Morrisa Barbara Rice

Walden Dissertations and Doctoral Studies

Although women offenders face barriers to successful reentry into their communities, as yet, no research has explored their experiences in accessing health care reentry services. Medicaid enrollment, the process of applying for Medicaid coverage, can be offered as a health care reentry service. Women offenders in jails have shorter sentencing times compared to those in prison, which presents Medicaid enrollment opportunities before release. The Second Chance Act provides the opportunity for reentry services, and the Affordable Care Act provides the opportunity for Medicaid coverage for women offenders. This phenomenological study explored the attitudes of women offenders about Medicaid enrollment and …

Re-Educating Healthcare Providers On Hand Hygiene Practice, Veronica Ihuoma Ubah

Walden Dissertations and Doctoral Studies

The Centers for Disease Control (CDC) and the World Health Organization (WHO) estimate that there are approximately 1.4 million cases of hospital acquired infections (HAIs) at any given time worldwide. Recent reports indicate that 722,000 patients acquire HAIs, with 75,000 or more succumbing to the infections and dying. This quality improvement project focused on the value of re-educating practicing nurses on hand hygiene practices as an approach to reduce the incidence of HAIs. Pre-intervention rates of HAIs were compared with post-intervention rates of HAIs across 2 units (Unit A and Unit B) in an acute care setting to determine if …

Measuring Determinants Of Oral Health Behaviors In Parents Of Low-Income Preschool Children, Josefine Ortiz Wolfe

Walden Dissertations and Doctoral Studies

Dental decay is a preventable disease, but it remains the most unmet healthcare need of American children. Untreated dental decay has adverse and long-lasting effects on a child's quality of life. Healthy oral habits among preschool children are essential for a healthy permanent dentition and are achieved primarily by 3 oral health related behaviors: proper dental hygiene, a healthy noncariogenic diet, and regular dental visits. This quantitative study, based on the theory of planned behavior, explored the relationship between these 3 oral health behaviors and 4 determinants: attitude, subjective norms, perceived behavioral control, and intention, using a 71-item questionnaire. The …

Roles Of Community Pharmacists In Improving Oral Health Awareness In Plateau State, Northern Nigeria, Olaniyi O. Taiwo

Walden Dissertations and Doctoral Studies

There is poor oral health awareness in Nigeria. This is mainly attributed to limited access to correct information on oral health as well as a lack of oral health care providers. The impact of the poor oral health awareness is worse in Northern Nigeria due to the uneven distribution of oral health care workers and training facilities. The purpose of this cross-sectional study was to describe the roles of community pharmacists (CPs) in Plateau State, Nigeria as sources of oral health information. Theoretical framework for this study was the theory of planned behavior (TPB). Background knowledge and practices of oral …

Gender Inequality In Women's Knowledge And Awareness Of Hiv/Aids In Port Harcourt, Maureen A. Wagbara

Walden Dissertations and Doctoral Studies

In Nigeria, gender inequality significantly impacts women's knowledge and awareness of the transmission of the human immunodeficiency virus (HIV) and the proliferation of acquired immunodeficiency syndrome (AIDS). Early marriage, traditional beliefs, religion, and polygamy all contribute to gender inequality. This study explored the role of these and other sociocultural practices in the gender inequalities that increase vulnerability of contracting HIV/AIDS among women in Port Harcourt, Rivers State, Nigeria. The study employed a phenomenological design, collected data through a semistructured interview approach, which was managed using NVivo software. The purposive sample comprised 20 female students from a college in Port Harcourt. …

Leadership Among Directors Of Social Services At Rehabilitative Healthcare Chains, John Paul Tuanqui Abenojarj

Walden Dissertations and Doctoral Studies

Rehabilitation and healthcare centers (RHCs) provide ongoing care to the elderly and chronically ill. To maximize the quality of this care, RHC staff must be properly trained to respond to patient care crises and communicate across departments. Although researchers have studied the leadership styles, strategies, and interactions of facility administrators and nursing directors, there is a substantial gap in the literature on the leadership styles and strategies employed by directors of social services (DSSs). The aim of this phenomenological study was to address this gap in the research by exploring how DSSs influenced leadership policies, prepared subordinates for crisis intervention …

Differences In Survival Times, By Gender, Among Those Diagnosed With Necrotizing Fasciitis, Ashley Elizabeth Hill

Walden Dissertations and Doctoral Studies

Necrotizing fasciitis infections have high mortality rates especially when treatment is delayed. Despite the abundance of research in many areas of necrotizing fasciitis infection, there are limited and conflicting studies focusing on gender-related outcomes for those diagnosed and died with necrotizing fasciitis infection. The purpose of this study was to determine the association that gender plays on survival time of patients who have been diagnosed with necrotizing fasciitis using a cross-sectional study design. Succeeding the conceptual design of the life course model, the research question tested whether there was a significant difference in survival time between the genders while in …

Rural Haitian Women's Experiences With Poor Health Through Poverty, Geralda Felix

Walden Dissertations and Doctoral Studies

People living in rural Haiti lack access to basic health care services due to poverty. Rural poverty in Haiti particularly affects women's health because Haiti has had the highest maternal mortality and infant mortality rates in the Americas, in addition to some of the worst health statistics in the Western Hemisphere. The purpose of this phenomenological study was to cultivate a greater understanding of the poverty factors that affect access to health care services specifically among poor women living in rural Haiti. This study was based on the social ecological model for population health development, theorizing that a person's health …

Chronic Kidney Disease Awareness And Quality Of Care In Abuja Nigeria, Patience Eze

Walden Dissertations and Doctoral Studies

Chronic kidney disease (CKD) is a non-communicable progressive disease that can lead to kidney failure or end-stage renal disease. In Nigeria, many people do not have access to health care due to extreme poverty, which means that those suffering from diabetes or high blood pressure, or both diseases, which have been identified as the 2 main risk factors, may not know their health status. The purpose of this phenomenological study was to explore the level of CKD awareness among Nigerians and if cultural beliefs affect individuals' health seeking behaviors because of the diverse nature of the Nigerian population. The protection …

U.S. Young Adults Stds, Risk Perception, Risk Behaviors, And Health Information Seeking, Amanda Robison-Chadwell

Walden Dissertations and Doctoral Studies

Sexually transmitted diseases (STD) are preventable conditions for which treatment failure (specifically in gonorrhea) is becoming problematic. U.S. young adults (20-29 years) have high rates of STD incidence and prevention of these diseases, but reaching them to provide primary prevention educations is challenging due to low perceived susceptibility to infection and lack of knowledge about how young adults seek health information. The purpose of this quantitative survey study was to assess the association between perceived susceptibility to STDs, sexual risk behavior, and the acquisition of health information as it pertains to sexual health topics in young adults. The Health Belief …

Predictors Of Compliance With The Food Safety And Inspection Service's Listeria Rule, 2012-2015, Amadou Samb

Walden Dissertations and Doctoral Studies

Since 1987, the Food Safety and Inspection Service (FSIS) has implemented a zero-tolerance policy for Listeria monocytogenes (Lm) in ready-to-eat (RTE) meat and poultry products, which culminated with the implementation of the Listeria rule in 2003. While researchers have extensively examined human listeriosis and its causative agent, Lm, there remained a significant gap in the current literature regarding how, singly or in combination, establishment size, RTE product type, Listeria alternative used, and FSIS district of production predict compliance with the Listeria rule. Therefore, the purpose of this quantitative study was to investigate the relationship between establishment size, RTE product type, …

Professional Development And Self-Efficacy Of Nurses Who Care For Patients Requiring Biocontainment, Denise Occhiuzzo

Walden Dissertations and Doctoral Studies

Increasing global occurrences of highly infectious, easily transmissible diseases unfamiliar to nurses affect the learning environment and the required skill set for professional nurses. The global threat of Ebola Virus Disease and other high-risk diseases requiring biocontainment necessitates competency in the management of complex patient needs, while ensuring safety measures that prevent spread of the potentially fatal disease. Guided by Bandura's social cognitive theory, this quantitative correlational study addressed the relationships between nurses' professional characteristics and their perceived self-efficacy when providing care to highly infectious patients requiring biocontainment. A full census of 92 nurses was used to recruit participants from …

Improving Depression Screenings For Adults Living With Hiv/Aids Through Education And Training, Shermanda Brumfield

Walden Dissertations and Doctoral Studies

People living with HIV/AIDS (PLWHA) are 4 times more likely to have a diagnosis of depression than persons without HIV. The specific problem at a rural clinic in a southern region of the United States, was a lack of continuity in the Patient Health Questionnaire 9 (PHQ-9) screening procedures that made sure that PLWHA were screened, identified, and referred. Early identification and treatment can help patients cope with barriers that affect health outcomes. The purpose and goal of this project was to develop and implement an evidence-based depression screening protocol to improve clinical staff practices and adherence to the PHQ-9 …

Risk Perception Of Hiv Infection Among The Nigerian African- Immigrant Population In Houston, Texas, Esther Titilayo Ogunjimi

Walden Dissertations and Doctoral Studies

HIV/AIDS studies mostly lack distinction between the US-born Blacks and non-US-born Blacks while African Americans (AAs) continues to represent the group with the heaviest burden of AIDS deaths and new diagnosis of HIV. A review of studies on HIV infection in the US, Europe, and other Western countries revealed a knowledge gap on HIV infection with non-refugee African immigrants (NRAIs), especially the Nigerian African Immigrants (NAIs) who are non-US-born Blacks. The purpose of this descriptive phenomenological study is to address this gap by exploring the expressed views of NAIs, a sub-group of the NRAIs living in Houston, Texas, on the …

Risk Factors For Tuberculosis And Multidrug-Resistant Tuberculosis Complications Among Foreign-Born Persons In Houston, Texas, James N. Isaboke

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) is a leading public health problem across the world. For various reasons, TB and multidrug-resistant tuberculosis (MDR-TB) have increased. Clarification on TB/HIV co-infection and homelessness as risk factors for TB and MDR-TB is required to inform policy interventions to reduce TB-related morbidity, mortality, and healthcare costs. In this quantitative study, data from the Houston Health Department (N = 341) were analyzed to explore the relationship between TB and MDR-TB outcomes and TB/HIV co-infection and type of housing/homelessness. Foreign-born persons are disproportionately affected in the United States. The socio-ecological model provided a theoretical framework for the investigation. Multiple and …

Factors Associated With Harm Reduction Model Use Among Substance Abuse Counselors, Tiffany Madden

Walden Dissertations and Doctoral Studies

Drug overdose death rates in the United States have more than tripled since 1990 with more than 36,000 dying in 2008. In 2007 the estimated cost of drug use to U.S. society due to lost productivity, increased health care, and criminal justice costs was over $193 billion. Previous researchers have found that harm reduction is a viable treatment option within the field of addiction. The guiding premise in the harm reduction approach is that all people can achieve improved psychological and physiological health even if they are unable to be substance-free. However, there remains an important gap in the current …

Evaluation Of Low Immunization Coverage Among The Amish Population In Rural Ohio, Christine Marie Kettunen

Walden Dissertations and Doctoral Studies

Amish communities have persistently low childhood immunization rates. Prior to this study, reasons for low rates had not been clearly identified. Researchers have speculated that access to health care, religious factors, and fear might be reasons that Amish parents refuse childhood immunizations, but more empirical evidence was warranted.The purpose of this study was to gather that empirical evidence regarding the knowledge, attitudes, opinions, and beliefs of Amish parents residing in Ashtabula County Ohio, an additional purpose was to examine how these factors influence timely immunizations of Amish children. The theoretical framework was the PEN-3-Cultural Model, focusing on cultural influences, beliefs, …

Health Literacy Program Proposal For Health Care Workers, Shevon Naomi Howard

Walden Dissertations and Doctoral Studies

Health information literacy influences patient health outcomes, yet almost 90% of adults

struggle to understand health information. This study explored the impact of an education course in health literacy on healthcare professionals' methods of providing information to patients in order to increase effective communication and improve patient outcomes. This study drew from an integrated theoretical framework that suggests development and validation of tools to measure health literacy. Access to and understanding of reliable, high-quality health care information equalizes many other variables that impact health outcomes, including age, economic class, and cultural background. This study analyzed survey data collected from 2 …