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A Retrospective Analysis Of Integrative Group Medical Visits For Low-Income Patients With Anxiety Disorders In Primary Care, Annamma Udaya Thomas

Walden Dissertations and Doctoral Studies

High utilization of the emergency department (ED) by patients with anxiety symptoms has brought attention to mental health access disparities among low-income racially/ethnically diverse populations. The health system in this study attempted to increase access to mental health care with integrative group medical visits (IGMVs), a nonpharmacological intervention with biomedical care consultation, health education, and peer support. The purpose of this retrospective comparative analysis, guided by integrative health equity in primary care framework, was to determine whether patients with diagnoses of anxiety who attended four or more IGMVs had reduced nonemergent ED utilization, reduced prescribed doses of benzodiazepine (BZD), and …

Fetal/Infant Mortality: Understanding Race And Ethnicity, Birthing Location, And Prenatal Care, Chelsea Collum

Walden Dissertations and Doctoral Studies

This study addressed whether race and ethnicity, birthing location, the month the mother begins prenatal care, and pregnancy risk level impact fetal/infant mortality. Infant mortality is a gauge by which the efficacy of the healthcare system and the overall health of the country is measured. The United States falls behind most other developed countries in terms of infant mortality rates. The ecological perspective was used as the theoretical framework. The study design was a cross-sectional cohort design using a sample of births and infant deaths from U.S. Vital Statistics data. Binomial logistic regression analyses were carried out to calculate odds …

Developing A Lifestyle Modification Tool To Prevent And Manage Elevated Blood Pressure Among African Americans, Magdalene Oziwo

Walden Dissertations and Doctoral Studies

Hypertension is a national medical problem that has been predominantly seen amongst African Americans. Within this community, hypertension has been associated with obesity, a sedentary lifestyle, and poor nutrition. It is for this reason that lifestyle modifications can be used as applied tools in the field of nursing in the prevention and management of hypertension among African American patients. This doctoral project was conducted to address the gap in nursing practice that currently exists for the African American population with regards to hypertension. The project focused on a nursing staff education program with 10 participants to promote the implementation of …

The Association Between Teen Pregnancy And Academic Performance Among Schoolgirls In The Ivory Coast, Moussokoura Ouattara Epse Assoumou

Walden Dissertations and Doctoral Studies

AbstractTeen pregnancy (TP) is a social and public health problem around the world. In developed nations, approximately 16 million girls from aged 15 to 19 years become pregnant each year, presenting health problems for the mother and fetus in addition to economic and social consequences for the communities in which they live. The purpose of this quantitative causal-comparative study, based on the theory of planned behavior, was to explore the association of academic performance and self-efficacy with TP. The research questions examined the association between the TP and the academic performance and self-efficacy while controlling for two covariates (socioeconomic status …

Analysis Of Malaria-Induced Anemia And Gender Differences Among Children In Nigeria, Temitope Bamgbose

Walden Dissertations and Doctoral Studies

Malaria is one of the leading causes of death among children under 5 years old in sub-Saharan Africa (SSA). Also, public health efforts on malaria prevention have been successful in many regions but remains an issue in SSA. Malaria-induced anemia (MA) is associated with health complications among children. The impact of several sociodemographic factors (age, gender, residential type, and parent’s educational level) and malaria preventive/intervention measures such as mosquito net use and malaria medication use among children under 5 years old in Nigeria were assessed to inform malaria best practices and strategies, prioritize resource allocation, and support existing literature on …

The Impact Of Self-Esteem And Body Dissatisfaction On Internalized Stigma In Obese, Hispanic Women, Dorothy M. Burns

Walden Dissertations and Doctoral Studies

AbstractThe current literature on self-esteem (SE), body dissatisfaction (BD) and internalized weight stigma (IWS) was limited, albeit evolving. The variables were well established across multiple domains of study: IWS was consistently noted to be a contributing factor for the development of obesity, but no studies explored the relationship between SE and BD on IWS. Therefore, the purpose of this correlational study was to explore the relationship between SE and BD and their effect on IWS in 30–44-year-old, obese, Hispanic women who are 20% more likely to be overweight or obese than non-Hispanic women. The study was guided by symbolic interactionism …

Parent Practices In Homeschooling Children With Autism Spectrum Disorder Who Demonstrate Problem Behaviors, Cymantha Jewel Channey-White

Walden Dissertations and Doctoral Studies

AbstractThere is a gap in literature regarding parent practices in homeschooling children with autism spectrum disorder (ASD) who demonstrate problem behaviors during instructional sessions. Research literature showed that children with ASD demonstrate problem behaviors during instructional sessions in educational environments. The problem is a gap in the literature regarding how parents who homeschool their students with ASD address the same behaviors. The conceptual framework—social learning theory. The research questions were focused on parent practices of managing problem behavior during homeschool instructional sessions and the support they received. Qualitative research was used to explore the experiences of homeschool parent practices in …

Perspectives On The Study Circles Program For Increasing Parental Involvement, Eugenia Sophia Dawson

Walden Dissertations and Doctoral Studies

Administrators were concerned over a lack of minority parental involvement and challenges in meeting the needs of a rapidly growing minority student population in a local school district. To enhance minority parental involvement, one local middle school implemented the Study Circles program that involved a series of interactive small group sessions in which parents and educators collaborate to build a culturally sensitive, inclusive community. The problem addressed in this study was grounded in the fact that the adequacy of this program’s implementation to address the low minority parental involvement at the school was not fully understood. Guided by Epstein’s model …

Antenatal And Postnatal Care Services And Maternal Mortality In Nigeria, Lucy Evans

Walden Dissertations and Doctoral Studies

Nigeria has had a high maternal mortality rate per 100,000 live births since the 1990s. A possible contributing factor is that many Nigerian women are not aware of prenatal and postpartum pregnancy care-related services. The purpose of this study was to investigate the association between pregnancy-related care (access to antenatal services, maternal health education, and knowledge of prenatal and postpartum care) and maternal mortality in Nigeria. The theory of planned behavior forms the basis of this study. A cross-sectional quantitative study design was used to determine whether maternal mortality is influenced by pregnancy-related care. Secondary data collected by the Demographic …

The Role Of The Public During The Decision-Making Process In Preparation For And In Response To A Pandemic, Ludmila M. Flores

Walden Dissertations and Doctoral Studies

AbstractMany advances have been made in technology and medicine; however, humanity remains vulnerable to existing, emerging, and re-emerging infectious diseases that have a profound negative impact on our society. This study investigated how individuals balance socioeconomics, demographics, and religious views with their actual behavior in response to public health guidelines during an epidemic/pandemic. The participants' perceptions and experiences of a practical problem, how the public was asked to respond, and how the public ultimately responded to public health guidelines were explored. The theoretical model for the study, the polarity of democracy model, has been explored as a possible decision-making tool …

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 …

Clinical Practice Guideline On Childhood Obesity, Catherine Nanyongo Manga

Walden Dissertations and Doctoral Studies

AbstractFamily care practitioners (FCPs) are important players in the treatment of childhood obesity. However, the evidence-based literature shows that practitioners lack both knowledge of how to diagnose the condition as well as the confidence and education to care for patients with obesity. The primary care setting for this project has a 77% obesity rate among the clinic pediatric population compared to a national average of 19%; the FCPs at the target clinic lacked sufficient knowledge on the diagnosis and treatment of obesity, limiting their ability and confidence to counsel families on weight control measures. Following the Walden University Clinical Practice …

Association Of Surgical Site Infections With Hospital Size And Urban And Rural Locations In California, Jim Edjerore Omaraye

Walden Dissertations and Doctoral Studies

Approximately 20% of health care-associated infections (HAIs) result from surgical site infections (SSIs), increasing health costs, morbidity, and mortality. The mandates of public reporting of HAIs through the Centers of Medicare and Medicaid Services can have consequential effects on hospitals’ reimbursement, a significant concern to health care administrators. The primary purpose of this quantitative study was to determine if urban and rural locations and the size of hospitals affect the rate of SSIs in California. The two research questions addressed whether there is an association between the rate of SSIs in urban and rural locations and the size of hospitals …

Lived Experiences Of Reintegration Of Malaysian Nonviolent Ex-Offenders In Singapore, Hendrika Wilhelmina Vosselman

Walden Dissertations and Doctoral Studies

AbstractNonviolent ex-offenders in Singapore of Malaysian descent face many challenges with reintegration into the community following incarceration. The Malaysian ethnic group comprises a small part, only 14%, of the Singaporean population, but they are overrepresented in the criminal justice system, which creates challenges for the Singapore government. The Malaysians face challenges such as the lack of support, academic underachievement, and economic and socioeconomic disparities. There is a literature gap regarding the Malaysian nonviolent ex-offenders who are experiencing problems with reintegration into society and have more limitations than other ethnic groups in Singapore. There are currently no studies focusing on clarifying …

Impact Of Case Management On Childhood Lead Exposure In Marion County, Indiana, Maliki Yacouba

Walden Dissertations and Doctoral Studies

The Centers for Disease Control and Prevention recently declared that no amount of childhood blood lead level (BLL) is safe. The purpose of this quantitative study with a retrospective cohort design was to evaluate the effectiveness of case management intervention on children diagnosed with elevated BLL (EBLL; ≥ 5 μg/dL) in Marion, County, Indiana. The health belief model was used as the theoretical foundation for the study. A data set of 160 lead exposure case management records was analyzed to find whether: (a) BLL at post-case-management time significantly differ from BLL at baseline (b) BLL at post-case-management time is affected …

Exploring 4-Year Business School Curriculum’S Relation To Graduates’ Hiring And Earnings, Richard A. Gayle

Walden Dissertations and Doctoral Studies

In 2013, roughly 7% of college graduates under 25 could not find employment, and about 37% were underemployed. Public university tuition costs increased by 42% between 1999 and 2012, and 71% of college graduates have an average of $29,400 in outstanding student debt. Employers for several decades have complained about how higher educational institutions have failed to deliver graduates with developed nontechnical skills comprising (a) work ethic, (b) communication, (c) organization, (d) problem solving, and (e) teamwork. The purpose of this qualitative archival study was to assess and explore integrating the nontechnical skills that businesses require to hire graduates immediately …

Use Of Evidence-Based Clinical Practice Guidelines In Obesity Management In Women, Chizimako Margaret Eze

Walden Dissertations and Doctoral Studies

Obesity is one of the Healthy People 2020 high-priority public health issue. Obesity is of importance due to the troubling higher prevalence in women because of the close link that exists between body weight and reproductive health in females from menarche to menopause and beyond. The identification of guidelines to improve or manage the care of female patients can alleviate the burden and complications from being overweight or obese. This project guided by the ADDIE (analyze, design, develop, implement, and evaluate) model was conducted in a family primary care clinic to address a gap in practice, the lack of knowledge …

Medication Beliefs And Behaviors Of Hypertensive Caribbean Immigrants Living In New York City, Nadia Williams

Walden Dissertations and Doctoral Studies

Hypertension remains a worldwide health phenomenon with serious health consequences including heart attack, stroke, aneurysm, and heart failure. Beliefs about medicines have been shown to influence hypertension outcomes. Medication adherence has emerged as a vital component of hypertension control and management. However, there has been limited research which addresses beliefs about medicines and medication adherence in Blacks of Caribbean origin. The purpose of this quantitative cross-sectional study was to identify the beliefs about medications held among hypertensive Caribbean immigrants living in New York City using the Beliefs about Medicines Questionnaire to identify what factors/barriers were related to these specific medication …

Contaminated Raw Produce As A Major Source Of Foodborne Salmonellosis, Barisua C. Ikpe

Walden Dissertations and Doctoral Studies

Foodborne pathogens continue to threaten the food supply chain. Salmonellosis is a persistent foodborne pathogen responsible for gastroenteritis, leading to severe illness in children below 5 years of age, adults 65 and older, and people with weakened immune systems. Maryland has rising cases of salmonellosis linked to outbreaks due to consumption of raw or fresh fruits and produce. The purpose of this quantitative study was to determine the association between the development of salmonellosis and the consumption of raw (fresh) produce, demographic and geographic characteristics, type of produce, and seasonal variation in Maryland. The study is based on the theory …

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 …

Urban School District Principals’ Perceptions Of Job Satisfaction, Darcy Lynn Woodcock

Walden Dissertations and Doctoral Studies

Principals in urban school districts directly and indirectly affect school communitiesthrough student achievement, teacher retention, and school climate. When a high-quality school principal leaves a school, it can negatively affect these areas due to the interruption of progress toward school improvement goals to increase student achievement. Seeking to address this issue, the purpose of this qualitative case study was to investigate the perceptions of job satisfaction among urban school district principals. The conceptual framework was Herzberg’s motivation-hygiene theory. The key research question concerned investigating the perceptions of job satisfaction among urban school district principals. Qualitative data were collected via virtual, …

Pulmonary Rehabilitation And Hospital Readmissions Among Individuals With Chronic Obstructive Pulmonary Disease, Nicholas Prush

Walden Dissertations and Doctoral Studies

Due to policies that penalize hospitals for chronic obstructive pulmonary disease (COPD) readmissions and the health problems faced by individuals who are readmitted due to COPD, it is critical to identify treatments and strategies that can help reduce the likelihood of readmission. The purpose of this study was to assess the association of pulmonary rehabilitation and demographic variables (age, gender, and BMI) on 30-day hospital readmissions for patients with COPD. Shearer’s health empowerment theory was the theoretical framework for this quantitative study. Secondary data were obtained from a hospital and the sample was comprised of 253 COPD patients admitted between …

Decreasing Pressure Injuries With Early Mitigation Strategies For The Elderly In The Intensive Care Unit, Janet L. Wilson

Walden Dissertations and Doctoral Studies

Healthcare acquired pressure injuries (HAPIs) are a serious and debilitating condition in the elderly, and it is therefore critical to reduce the incidence of HAPIs. Mitigation strategies are often implemented for patients who score in the highest risk categories on the Braden Scale for Predicting Pressure Sore Risk©. Yet, the evidence suggests vulnerable older adults who score in the midrange of the Braden Scale, and specifically, the mobility subscale, develop HAPI more frequently. The review question centered on the evaluation of the current evidence for early mitigation strategies in response to Braden Scale midrange mobility subscale scores. The gap addressed …

Internet Use, Perceived Social Support, And Obesity Among African American Young Adults, Cynthia Adams

Walden Dissertations and Doctoral Studies

African Americans are disproportionately affected by obesity. Public health practitioners have an incomplete understanding of the social-environmental risk factors and how they affect obesity. The purpose of this quantitative, cross-sectional study was to explore whether internet use and perceived social support predicted obesity among African American young adults. The social cognitive theory guided this study. Secondary data were analyzed from the 2017 Behavioral Risk Factor Surveillance Survey. The sample consisted of 6,765 African American young adults age 18 to 34 and represented the U.S. population using weighted estimates. A Bonferroni correction was performed to reduce Type I error due to …

Perspectives Of Physicians Mandated To Complete Cultural Competence Education, Wayne Mccarthy Boatwright

Walden Dissertations and Doctoral Studies

Perspectives of Physicians Mandated to Complete Cultural Competence Educationby Wayne M. Boatwright

Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in Health Services

Walden University May 2021 Abstract Studies show that ethnic and racial disparities continue to exist in health care delivery. The economics of today’s multicultural world along with changing demographics and persistence of inequality in healthcare have challenged healthcare professionals to consider cultural competency (CC) training to assist in eliminating health disparities. The purpose of this study was to identify the perspectives of physicians who were mandated to complete CC education. …

Type Ii Diabetes Mellitus Risk Factors Among African Immigrants 20 – 45 Years Old Residing In The United States, Abu Bakar Sidique Fofanah

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus is highly prevalent among African Americans. Africans born abroad are a subset of the African American population in the U.S., but few studies have been conducted on this population, a gap this study aims to close. The incidence and prevalence of type 2 diabetes continue to rise among this population. This study explored type 2 diabetes risk factors among Africans born abroad who were 20-45 years old in the U.S. This was a retrospective and quantitative cross-sectional study involving National Health and Nutrition Examination Survey (NHANES) 2013-2014 type 2 diabetes data. The total sample size was …

Association Between Bisphenols, Acrylamide, Glycidamide, Fast Food, And Obesity: An Obesogenic Perspective, Morgan Murphy

Walden Dissertations and Doctoral Studies

Endocrine disrupting chemicals (EDCs) are exogenous man-made substances that have the ability to interfere with hormone action and are believed to be a contributing factor to chronic illnesses, including but not limited to obesity. Recent studies have suggested that environmental agents (environmental obesogens), such as food additives, plasticizers, and personal care products are contributors that aid in the altering of hormone receptors and hormone mimicry. Such environmental obesogens have the potential to promote adipogenesis and fat accumulation. In this study, the social-ecological model was used to determine the factors that can influence the increased exposure to obesogenic chemicals at the …

Prevention And Self-Care Education For Osteoporosis In A Rural Orthopedic Clinic, Jean Sanford

Walden Dissertations and Doctoral Studies

Abstract Osteoporosis affects 25 million people in the United States causing over 1.5 million fractures every year. The gap in practice at a rural southeast orthopedic clinic was a lack of patient education on prevention and self-care management of osteoporosis and osteopenia. The purpose of the project was to develop a program to educate clinic providers on prevention and self-care management for osteoporosis and osteopenia. The Knowles theory of adult learning framed the project components. A 10-question pretest/posttest assessing knowledge was administered to 10 registered nurse participants. For the presurvey, five participants demonstrated a lack of knowledge of medication administration …

Substance Use, Mental Health Problems And Missed Appointments By Race, Gender, And Sexual Orientation Among Hiv-Infected Individuals, Abraham Adonis Anderson

Walden Dissertations and Doctoral Studies

Human Immunodeficiency Virus (HIV) disproportionately affects African American men who have sex with men. According to the Centers for Disease Control and Prevention, in 2020 African American adult and adolescent African American men accounted for 42% (16,002) of all HIV diagnoses (37,968). Furthermore, while substance use is common among this population, in previous studies very few individuals with HIV have reported receiving substance abuse treatment or discussing substance use with HIV medical providers. The purpose of this study was to examine the differences in substance use/mental health problems by race, gender, and sexual orientation among HIV-infected individuals. This study also …

Healthcare Access For Elderly African American Type 2 Diabetics On Medicare, William Alexander Floyd

Walden Dissertations and Doctoral Studies

AbstractPrior research has shown that African Americans have less access to healthcare than do White Americans. The study’s purpose was to determine the association between race/ethnicity and quality care measures in a population of Medicare recipients with Type 2 diabetes, aged 65 75 years and over. Covariates predicted satisfaction with doctor care, compassionate doctor care, and indifferent doctor care using Andersen’s health behavior theory. The Medicare Current Beneficiary Survey (MCBS) sample consisted of 1,716 people with Type 2 diabetes, with most (76.6%) being non-Hispanic Whites, and the remainder non-Hispanic Blacks (10.8%) and Hispanics (12.6%). Race/ethnicity were associated with quality-of-care measures …