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Community And Individual Risk Factors Associated With Tuberculosis Treatment Outcomes: Ca, Md, And Oh, [2017-2021]., Kadiatu Banjoko
Community And Individual Risk Factors Associated With Tuberculosis Treatment Outcomes: Ca, Md, And Oh, [2017-2021]., Kadiatu Banjoko
Walden Dissertations and Doctoral Studies
There are unsuccessful treatment outcomes with Tuberculosis (TB) disease, although effective therapies exist. This study aimed to identify predictors of unsuccessful treatment using the socioecological model. A quantitative cross-sectional study and multinomial logistic regression analysis were used to measure the associations between long-term care (LTC), homelessness, correctional facility, Human Immunodeficiency Virus (HIV), diabetes, excess alcohol, illicit drug use, and TB treatment outcomes of death, lost to follow-up, and treatment refusal. The sample consisted of 7,589 individuals aged 15 and older with pulmonary TB between 2017 and 2021, residing in California, Ohio, and Maryland. Findings indicated a correlation between community factors …
Teaching Staff About Pressure Ulcers, Ann Maria Stewart
Teaching Staff About Pressure Ulcers, Ann Maria Stewart
Walden Dissertations and Doctoral Studies
Pressure ulcers are local injuries to the skin and underlying tissue primarily caused by prolonged pressure, friction, or shear forces. These preventable complications are prevalent among immobile patients and can lead to poor patient outcomes and increased healthcare costs. Despite the availability of evidence-based prevention strategies, significant gaps in practice continue due to limited staff knowledge, ineffective communication systems, and inconsistent implementation of established guidelines. This Doctor of Nursing Practice (DNP) project focused on enhancing nursing staff knowledge through an evidence-based educational strategy designed to educate staff on strategies for preventing pressure ulcers. The education program included a PowerPoint presentation …
Early Atopic Dermatitis And Risk Of Later Autism Spectrum Disorders, Annissa Courtney Heslope-Mathieu
Early Atopic Dermatitis And Risk Of Later Autism Spectrum Disorders, Annissa Courtney Heslope-Mathieu
Walden Dissertations and Doctoral Studies
Early-onset atopic dermatitis (AD) affects approximately 10-20% of children in the United States, and emerging evidence suggests potential links between early immune dysregulation and neurodevelopmental outcomes. Limited research has examined whether early AD serves as a specific risk factor for later ASD diagnosis. Guided by life course theory, the purpose of this study was to examine whether AD diagnosed within the first two years of life predicts later diagnosis of ASD among U.S. children younger than five years. A secondary analysis of the Fragile Families and Child Wellbeing Study was conducted using a retrospective cohort design. The sample included 2,949 …
Staff Education To Improve Diabetes Management Knowledge For Primary Healthcare Providers, Helen Njoku
Staff Education To Improve Diabetes Management Knowledge For Primary Healthcare Providers, Helen Njoku
Walden Dissertations and Doctoral Studies
I developed this Doctor of Nursing Practice staff education project to improve primary healthcare providers’ knowledge of diabetes management. Given the vital role nurses, advanced practice providers, and physicians play in patient education, chronic illness management, and care coordination, this issue must be addressed within nursing practice. The practice-focused question guiding this project was: Among primary healthcare providers, does implementing a structured diabetes education training program, compared to the current standard practice, improve provider knowledge in diabetes management? The purpose of this project was to develop, implement, and evaluate a targeted education intervention session. As analytical strategies, I employed expert …
Need For A Psychiatric Facility To Develop A Clinical Practice Guideline On Self-Care To Give To Patients Upon Discharge, Judith Agwu
Walden Dissertations and Doctoral Studies
The project is a Doctor of Nursing Practice (DNP) clinical practice guideline (CPG) on the need for a psychiatric facility to develop a CPG on self-care to give to patients upon discharge. The practice problem was a healthcare facility did not have guidelines to educate patients on self-care upon discharge. Addressing the problem within nursing practice can promote self-care practices and improve overall health outcomes for patients with mental illnesses. The practice-focused question that guided this project was: will a CPG potentially increase self-care among discharged patients? The purpose of the study was to develop a CPG on self-care for …
Postdischarge Pediatric Mortality In Nigeria For Children Under 5 Years Of Age, Philomina Nwaugo Chukwudike
Postdischarge Pediatric Mortality In Nigeria For Children Under 5 Years Of Age, Philomina Nwaugo Chukwudike
Walden Dissertations and Doctoral Studies
Child mortality has remained a public health issue that is prevalent among families living in Nigeria and low- and middle-income countries. Factors associated with post-discharge pediatric mortality among children under 5 have not been explored. The study involved examining associations between timely individual follow-up visits, availability of healthcare facilities for follow-up care, and likelihood of post-discharge mortality among children under 5 while adjusting for household income, geographical location, mothers’ age, and mothers’ education. The theoretical framework was the social ecological model. Data were generated from the 2018 Demographic and Health Survey. A sample size of N=21,671 was used to determine …
Best Practices To Reduce Patient Falls In Skilled Nursing Facilities In Virginia, Kianna J. Tinsley
Best Practices To Reduce Patient Falls In Skilled Nursing Facilities In Virginia, Kianna J. Tinsley
Walden Dissertations and Doctoral Studies
Patient falls in skilled nursing homes highlight the need for effective, evidence-based strategies to reduce falls and improve residents' quality of life. The purpose of this integrative review was to identify administrative strategies for reducing patient falls within skilled nursing facilities. The review question centered on the most effective strategies and best practices that healthcare administrators can use to reduce patient falls and injuries and increase patient satisfaction. The Donabedian model served as the theoretical framework, providing a strong foundation for evaluating health services and quality of care to reduce patient falls. A comprehensive literature review identified 50 relevant articles, …
Respiratory Health And Environmental Risks Among California Children: The Role Of Socioeconomic Status, Wen Chieh Chia
Respiratory Health And Environmental Risks Among California Children: The Role Of Socioeconomic Status, Wen Chieh Chia
Walden Dissertations and Doctoral Studies
Abstract Air pollution has been cited as a factor in the development of respiratory illness in children. Socioeconomic differences can intensify the effects of air pollution exposure on low-income children compared to higher-income children. This correlational study examined the relationship between air pollution exposure and respiratory health outcomes among California children, as well as the moderating role of socioeconomic status. The study was guided by the environmental health disparities framework and used secondary data from the California Environmental Health Tracking Program, analyzing data from 49 California counties (n = 49). Independent variables were PM2.5 concentrations and the number of ozone …
Development Of An Educational Intervention To Enhance Nurses’ Knowledge And Intent To Implement Evidence-Based Diabetes Self-Management In Clinical Practice, Anne Marie Sieyou Ngouane
Development Of An Educational Intervention To Enhance Nurses’ Knowledge And Intent To Implement Evidence-Based Diabetes Self-Management In Clinical Practice, Anne Marie Sieyou Ngouane
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project was purposed with closing critical gaps in staff knowledge and adherence to diabetes self-management protocols in a busy primary care clinic. Rising readmission rates and uneven use of American Diabetes Association (ADA) standards signaled an urgent need for a structured approach to staff education. To address this, a one-hour interactive training session was created that blended teaching, evidence-based handouts, and a practical diabetes care checklist. Staff learning was measured through pretest and posttest, confidence and adherence used a 5-point Likert-scale survey, and 21day readmission data tracked patient outcomes. The project question asked if …
Evaluation Of Unmet Needs Of Vulnerable Populations And At-Risk Communities Through Disaster Management Planning, Ryan Austin Crowe
Evaluation Of Unmet Needs Of Vulnerable Populations And At-Risk Communities Through Disaster Management Planning, Ryan Austin Crowe
Walden Dissertations and Doctoral Studies
This community-based non-profit organization aimed to aid those most in need by providing critical social services. The client organization has been selected numerous times as a recipient of federal disaster case management programs, often not until a year after the disaster, resulting in distrust of the federal government and organizations contracted to perform recovery services. Providing services to areas impacted has been difficult due to contract delays. The practice research question addressed in this study was: How can a client organization address the one-year service gap frequently associated with federal contracts through a disaster management planning system? The purpose of …
National Survey Of Physical Therapists’ Participation As Health Educators In Physical Activity Promotion Among Older Adults, Casey Nicole Mokres
National Survey Of Physical Therapists’ Participation As Health Educators In Physical Activity Promotion Among Older Adults, Casey Nicole Mokres
Walden Dissertations and Doctoral Studies
Physical inactivity among older adults remains a major national and global public health concern linked to preventable morbidity, mortality, and rising healthcare costs. Physical therapists are uniquely positioned to promote physical activity (PA) through health education, yet their engagement in this role is not well defined. This quantitative cross-sectional study examined associations between clinical practice factors—years of experience, board certification status, and practice setting—and three domains of the theoretical domains framework (knowledge, skills, and behavioral regulation) related to PA promotion among older adults. The framework guided identification of behavioral and contextual factors influencing therapists’ delivery of PA promotion interventions. Data …
The Association Between E-Cigarette Use And Community Mattering Among Adolescents In Maine, April Hughes
The Association Between E-Cigarette Use And Community Mattering Among Adolescents In Maine, April Hughes
Walden Dissertations and Doctoral Studies
E-cigarette use among U.S. high school students is a significant public health issue. Factors such as mattering, sexual orientation, and gender identity (SOGI) influence e-cigarette use among adolescents, yet few studies have explored the relationship between mattering and e-cigarette use when considering SOGI. This quantitative study explored the association between past 30-day e-cigarette use and mattering among Maine high schoolers while controlling for SOGI and grade level. This correlational cross-sectional study used the 2023 Maine Integrated Youth Health Survey data, and the socioecological model served as the theoretical foundation. A multivariate binary logistic regression analysis indicated a significant association between …
Strategies To Mitigate Supply Chain Disruptions In Small Restaurant Business, Aminu Hassan
Strategies To Mitigate Supply Chain Disruptions In Small Restaurant Business, Aminu Hassan
Walden Dissertations and Doctoral Studies
Supply chain disruptions can impact the operational capability of small restaurant businesses, thereby affecting their financial health. Some small restaurant supply chain managers lack effective strategies to manage supply chain disruptions. Grounded in Oliver and Webber’s supply chain management theory, the purpose of this qualitative pragmatic inquiry was to explore strategies small restaurant supply chain managers use to manage supply chain disruptions. The participants were 10 small restaurant supply chain managers located in Baltimore who effectively mitigated the effects of at least one significant supply chain disruption. Data were collected using semistructured interviews and publicly available documents and reports. Through …
Staff Education On Evidence-Based Practice On External Factors That Impact Management Of Chronic Hypertension In African American Patients, Stella Ngozi Paul
Staff Education On Evidence-Based Practice On External Factors That Impact Management Of Chronic Hypertension In African American Patients, Stella Ngozi Paul
Walden Dissertations and Doctoral Studies
This doctoral staff education project was developed to address a significant gap in nursing practice, specifically the limited knowledge of outpatient clinical staff regarding cultural, social, and health literacy factors that influence the management of chronic hypertension in African American (AA) patients. Through this project, I aimed to equip clinical staff with evidence-based, culturally competent strategies to promote equitable, patient-centered care. This project was guided by the following practice-focused question: Can an evidence-based practice educational session on how external factors impact the management of chronic hypertension in the AA population enhance staff knowledge and understanding? Using the analysis, design, development, …
Effect Of Stages Of Prehospital Hypertensive Crisis And Length-Of-Stay On Acute Stroke Readmission, Thomas Bob Ross Phd
Effect Of Stages Of Prehospital Hypertensive Crisis And Length-Of-Stay On Acute Stroke Readmission, Thomas Bob Ross Phd
Walden Dissertations and Doctoral Studies
Stroke is the second leading cause of mortality and the third leading cause of disability, affecting over 800,000 Americans annually. Traditional stroke research has focused on in-hospital settings, but not on prehospital stroke admissions, despite evidence that over 75% of acute stroke cases managed by emergency medical services involve prehospital hypertensive crises (HTN-C). HTN-C is classified into three systolic blood pressure (SBP) stages: Stage 1 (140–159 mm Hg), Stage 2 (160–179 mm Hg), and Stage 3 (≥180 mm Hg), the latter associated with organ damage. Hypertension correlates with longer hospital stays and more intensive interventions in hospitalized patients, but HTN-C …
Perceptions Of Lumbee Tribe Members On Participating In Diabetes Type Ii Prevention Practices, Jeremy Wesley Lowery
Perceptions Of Lumbee Tribe Members On Participating In Diabetes Type Ii Prevention Practices, Jeremy Wesley Lowery
Walden Dissertations and Doctoral Studies
Type II diabetes (DB2) is one of the leading causes of death in the United States, whether directly or as a comorbidity. This is especially alarming for Native Americans, who have the highest DB2 prevalence and death rates when compared to their non-Native American peers. This qualitative phenomenological study explored the lived experiences of Lumbee Tribe members in Robeson County regarding DB2. The health belief model was used as a lens through which to understand and interpret findings. In-person semi-structured audio-recorded interviews were conducted with 12 participants recruited through social media. Data were coded and analyzed using deductive thematic analysis. …
Lived Oral Health Experiences Of Syrian Refugees In The United States, Taniya Michael Henry-Sangar
Lived Oral Health Experiences Of Syrian Refugees In The United States, Taniya Michael Henry-Sangar
Walden Dissertations and Doctoral Studies
The oral health status of Syrian refugees has been impacted by war and displacement since the 2011 civil war. To date, limited in-depth knowledge is available on oral health experiences of resettled Syrian refugees in the United States. The purpose of this qualitative study was to explore lived oral health experiences of resettled Syrian refugees before, during, and after the 2011 Syrian civil war. The health belief model (HBM) and theory of planned behavior (TPB) were theoretical frameworks for this phenomenological inquiry. The study was guided by semi-structured phone interviews with a purposeful sample of 11 Syrian refugees over the …
Adapter Changes Of Central Line Patients On Total Parenteral Nutrition, Courtney Erin Schappell
Adapter Changes Of Central Line Patients On Total Parenteral Nutrition, Courtney Erin Schappell
Walden Dissertations and Doctoral Studies
Central line-associated bloodstream infections (CLABSIs) remain a significant and preventable patient safety issue, especially among hospitalized patients receiving total parenteral nutrition (TPN). Patients on TPN face a higher risk of infection due to the high glucose content of the solution and the frequent access required for central line therapy. The Centers for Disease Control and Prevention and the Agency for Healthcare Research and Quality have recognized CLABSI prevention as a national priority. In addition, there is emphasis on high-risk groups like patients receiving TPN. The Infusion Therapy Standards of Practice, an evidence-based guideline, recommends catheter care, including timely adapter (i.e., …
Implementing Sbar-Based Staff Education And A Diabetes-Specific Discharge Checklist To Reduce Patient Identification Errors During Handoffs, Maragarate Nesoa
Implementing Sbar-Based Staff Education And A Diabetes-Specific Discharge Checklist To Reduce Patient Identification Errors During Handoffs, Maragarate Nesoa
Walden Dissertations and Doctoral Studies
This doctoral project was an organization change initiative using staff education to reduce patient identification errors during handoffs among older adults with Type 2 Diabetes (T2DM). Misidentification during transitions of care contributes to medication errors, unnecessary readmissions, and preventable adverse events
Correlational Study Of Health Checkups And Patient Wellness: Epidemiological Evaluation On Prophylaxis Pathways, Samantha H. Beaubrun
Correlational Study Of Health Checkups And Patient Wellness: Epidemiological Evaluation On Prophylaxis Pathways, Samantha H. Beaubrun
Walden Dissertations and Doctoral Studies
Health checkups and wellness visits are a vital pathway to early detection and diagnosis of disease. It is not known whether young adults, insured or not, are opting into preventive care services to optimize health status via health checkups/wellness visits at primary care academic health centers. The purpose of this quantitative study was to examine the relation of wellness visits to healthcare insurance and health status while adjusting for gender among young adults ages 18–35 years in the United States. A descriptive correlational design was used with the 2023 National Health Interview Survey data set (N = 6,544). The results …
Self-Connection As A Mediator Between Exercise And Well-Being, Lauren Esmay
Self-Connection As A Mediator Between Exercise And Well-Being, Lauren Esmay
Walden Dissertations and Doctoral Studies
Scientists and health professionals have established the connection among physical activity and overall wellbeing. In more recent years, scholars have also researched the correlation among increased self-connection with increased overall well-being. Nevertheless, insignificant data has been gathered to investigate the impact of predictor variables upon the connection between exercise and wellbeing. This research study examined the mediating effect of self-connection among the relationship between exercise and wellbeing. The current study’s purpose was to gain better insights on how self-connection predicts a person’s physical activity, contributing to comprehensive insights how exercise habits may predict a person’s wellbeing by using a cross-sectional …
Factors Affecting School Readiness And Level Of Distraction Among Black Children During Virtual Learning In The United States, Imani Barnes
Factors Affecting School Readiness And Level Of Distraction Among Black Children During Virtual Learning In The United States, Imani Barnes
Walden Dissertations and Doctoral Studies
The COVID-19 pandemic necessitated an shift to mandatory virtual learning (VL) for kindergarten through grade 12 students, disrupting educational systems globally and exposing systemic inequities. Although researchers had explored health and education disparities separately, they had not adequately examined the intersection of child health, specifically body mass index (BMI) and health-affected ability, with school readiness and level of distraction in VL environments. The purpose of this quantitative, cross-sectional study was to examine associations between BMI, health affected ability, school readiness, and distraction levels among U.S. Black children engaged in VL in the 2020 school year, controlling for gender, age, and …
Healthcare Access, Economic Stability, And Food Security And Inflammatory Bowel Disease In Hispanic Adults Living In The United States, Jennifer Rodriguez
Healthcare Access, Economic Stability, And Food Security And Inflammatory Bowel Disease In Hispanic Adults Living In The United States, Jennifer Rodriguez
Walden Dissertations and Doctoral Studies
Hispanic adults in the United States experience disparities in chronic disease detection and outcomes, including inflammatory bowel disease (IBD). Social determinants of health (SDoH), including economic stability, healthcare access, and food security, play a crucial role in shaping health risks and diagnostic opportunities in this population. The purpose of this quantitative cross-sectional study was to examine the relationship between selected SDoH factors and self-reported IBD diagnosis among U.S. Hispanic adults. This study utilized survey data from the 2023 National Health Interview Survey (n = 29,457). Weighted descriptive statistics and logistic regression were used to analyze the relationships between variables while …
Assessing Health Literacy In Somali Women Living In The United States With Hypertension, Tawanna Morris
Assessing Health Literacy In Somali Women Living In The United States With Hypertension, Tawanna Morris
Walden Dissertations and Doctoral Studies
Health literacy (HL) remains a critical public health concern, particularly among immigrant populations. This qualitative study explored how low health literacy relates to hypertension (HTN) management among Somali immigrant women. Low HL and chronic conditions such as HTN continue to affect this group disproportionately, emphasizing the need for targeted interventions. Guided by the Health Belief Model, this research examined Somali immigrant women’s perceptions of HL, how literacy levels influence hypertension management, and the barriers they encounter when managing their condition. Five Somali immigrant women who met the criteria participated in semi-structured interviews. All spoke English, were at least 18 years …
Social And Contextual Factors Influencing Hypertension Among Latino Men Living In California, Leslie Ivett Ortega
Social And Contextual Factors Influencing Hypertension Among Latino Men Living In California, Leslie Ivett Ortega
Walden Dissertations and Doctoral Studies
Hypertension remains a critical and often silent public health issue that disproportionately affects Latino men in California. This quantitative, retrospective cross-sectional study explored the social and contextual factors influencing hypertension among this vulnerable population. Using the 2019 Behavioral Risk Factor Surveillance System dataset, which included a sample size of 2,060 participants, the study examined the relationship between hypertension and key variables including primary care utilization, health insurance, smoking, physical activity, mental health, and marital status, while controlling for age, education, and income. Guided by the health belief model, binary logistic regression analyses found health insurance and primary care utilization significantly …
Examining The Association Between User Fee Exemptions And Maternal Healthcare Utilization In Northern Ghana, Martina Hilton-Ansah
Examining The Association Between User Fee Exemptions And Maternal Healthcare Utilization In Northern Ghana, Martina Hilton-Ansah
Walden Dissertations and Doctoral Studies
Abstract In Ghana, the user fee exemption policy, implemented in 2008, provides free maternal health services, which are a key component of the National Health Insurance Scheme (NHIS). Grounded in the Health Access Livelihood Framework, the purpose of this study was to determine the association between the user fee exemption policy and the utilization of antenatal care, facility-based delivery, and postnatal care in Northern Ghana, while controlling for sociodemographic factors. A quantitative approach was employed using secondary data from the Ghana Demographic and Health Surveys, encompassing women of reproductive age (15–49 years; N = 6,948). Logistic regression was used to …
Pet Ownership And Health-Related Quality Of Life Among Middle-Aged Adults, Kristi Martin
Pet Ownership And Health-Related Quality Of Life Among Middle-Aged Adults, Kristi Martin
Walden Dissertations and Doctoral Studies
Pet ownership continues to be part of modern society in the United States. Researchers have explored pet ownership’s impact on chronic diseases and aging populations, but research on health-related quality of life is limited. Grounded in the socioecological model, this quantitative study analyzed data from the 2005-2006 National Health and Nutrition Examination Survey (N = 10,348) to investigate the impact of pet ownership on health-related quality of life among low-income adults aged 30-50 years. Chi-square tests were performed to analyze the associations between age, income, gender, and race with three health-related quality of life metrics. Results showed no statistically significant …
Experiences Of First-Generation College Students Engaging In Online Learning Amid A Global Pandemic, Anthony Capers Jr
Experiences Of First-Generation College Students Engaging In Online Learning Amid A Global Pandemic, Anthony Capers Jr
Walden Dissertations and Doctoral Studies
The global pandemic, COVID-19, had an impact on the academic experiences of all college students. First-generation college students who often experience special challenges in adjusting to academia may have faced additional challenges given the transition to online learning. However, there has been little research focused on the impact of COVID on their adjustment to college. The purpose of this study was to explore the experiences of an unanticipated learning transition among first-generation college students pursuing higher education at a 4-year school, during a global pandemic. The theoretical framework for this study was based on an interactionalist theory focused on the …
Differential Substance Use Screening Approaches Among Medical Providers Based On Pregnancy Status, Ericka L. Suarez-Vella
Differential Substance Use Screening Approaches Among Medical Providers Based On Pregnancy Status, Ericka L. Suarez-Vella
Walden Dissertations and Doctoral Studies
Exploring medical providers’ role in relation to pregnant individuals who use substances is critical. Understanding how screening practices and provider biases influence addiction treatment referrals based on pregnancy status can help address several key issues, including potential disparities resulting from provider bias. It can ensure fair referral practices, promote equitable access to treatment, and ensure timely intervention resulting in better health outcomes. It can influence changes to policy and procedure among healthcare and judicial establishments, ultimately improving the relationship between providers and patients. The purpose of this study was to explore how medical providers’ screening practices of substance use in …
Staff Education Workshop Focusing On Enhancing Nurse Knowledge And Adherence To The Time (Tissue, Infection/Inflammation, Moisture, Edge) Framework To Improve The Quality Of Wound Assessment And Care, Ijeoma G. Onyejiji
Walden Dissertations and Doctoral Studies
This staff educational project focused on implementing training on the tissue, infection/inflammation, moisture, edge (TIME) framework to address gaps in nurses’ knowledge and improve adherence to the TIME framework during wound assessment. Current evidence shows inconsistent use of standardized wound assessment among nurses, which can lead to inappropriate treatment, delayed wound healing, increased infection risk, and higher healthcare utilization. This project’s question sought to assess whether implementing a staff education workshop focusing on the TIME framework would enhance nurse knowledge and adherence to the TIME framework. Six nurses participated in the training. Pre/post questionnaires were used to evaluate knowledge before …