Digital Commons Network^™

The Effect Of Maternity Care Practices On The Duration Of Breastfeeding, Lisette Rodriguez

Walden Dissertations and Doctoral Studies

The natural practice of breastfeeding has been strongly noted as one of the most cost-effective, health promoting, disease-prevention strategies of the 21st century. Although primary health organizations recommend exclusive breastfeeding for the first 6 months of life with added complementary foods and continued breastfeeding up to 2 years of age or longer, many mothers do not breastfeed their infants for the recommendation length of time. Applied policies and health practices, such as those described under the 10 Steps to Successful Breastfeeding and The International Code of Marketing of Breast Milk Substitutes, have been noted as contributing factors that can considerably …

Increasing Uninsured Patients' Compliance With Return Primary Care Visits, Dorothy Clare Carleton

Walden Dissertations and Doctoral Studies

Patients who are unable to comply with their health care regimen are almost 3 times more likely to have an adverse health outcome and are more likely to suffer irreversible progression of a chronic disease process. Increasing patient return clinic visits is essential, not only to curtail rapidly rising costs of health care but also to improve patient outcomes. This project focused on an uninsured patient population of a clinic in a rural community in the southeastern United States. The purpose of the project was to conduct a systematic review of the literature and identify the barriers and motivating factors …

Effect Of The Breakthrough Student Assistance Program On Grades, Behavior, And Attendance, Regina Shoppe

Walden Dissertations and Doctoral Studies

It is estimated that 9-14% of children from birth to age 5 experience social and emotional problems that may significantly affect their ability to learn later in life and students of any age may experience an array of problems resulting in difficulty learning. Although interventions are available to address these issues within the school context, government funding for programs is often limited to those that are evidence based. Student Assistance Programs (SAPs) address a variety of barriers to learning but many are not supported by empirical evidence. The purpose of the study was to determine if Breakthrough, a specific SAP, …

Leptin Level Variance In Adults With And Without Cancer, Vilisa Chatman-Terry

Walden Dissertations and Doctoral Studies

Abstract

In 2018, health statistics revealed that, despite the many preventive measures established,

cancer was the second leading cause of death in the United States and the leading cause

of death in 22 states, exceeded only by heart disease. With obesity/leptin levels reaching

pandemic levels worldwide, and cancer having a well-known association with obesity,

both chronic diseases represent a large proportion of public health challenges. Guided by

the social ecological model, the purpose of this cross-sectional, quantitative study was to

examine if a significant difference exists in leptin levels among adults with different

types of obesity-associated and common cancers and …

Poverty, Demographics, And Hepatitis C Infection In The National Health And Nutrition Examination Survey, Wilson J. Washington Jr

Walden Dissertations and Doctoral Studies

Hepatitis (HCV) is a communicable disease that impacts many Americans. The scholarly literature lacked the knowledge pertaining to the relationships between poverty and HCV diagnosis and prescription for HCV medication. The purpose of the study was to measure the magnitude and statistical significance of these relationships, as modeled by the health belief model and public health surveillance and action framework. Specifically, the study was designed to determine whether there is a statistically significant relationship between living below the poverty line and being diagnosed with HCV, as well as living being below the poverty line and being prescribed HCV medication. A …

Adolescent Obesity Intervention In An Outpatient Primary Care Setting, Chinyere Susanna Awamba-Agu

Walden Dissertations and Doctoral Studies

Lack of education in the outpatient setting related to causes, complications, and prevention of obesity is associated with high rates of obesity in adolescents 12 to 19 years of age. The gap in the adolescents' and family members' knowledge of obesity contributes to the adolescents' high calorie consumption and the development of obesity. The purpose of this project was to develop a staff education guideline for use by clinicians to educate adolescents and their families on how to develop nutritious food plans and decrease obesity. The project practice question asked whether educating the primary care providers in the primary care …

Increasing Daily Exercise Adherence In Women By Examining Motivational Factors, Victoria Wozniak

Walden Dissertations and Doctoral Studies

Women ages 20–39 years old have seen the most dramatic increase in obesity levels in the United States over the last 2 decades. Researchers have indicated the need for studies to increase motivation in women to promote daily exercise. There is a gap in the literature about what motivational factors are most effective with increasing exercise in daily life. Using the transtheoretical model of change (TM) as the grounding theory, this study measured daily exercise adherence. A selective sampling of women ages 20–39 years old in the United States were recruited to complete an online survey. The online survey included …

African American, Postrelease, Opioid, Female Offenders' Experiences In Job Interviews, Wanda Dunmore

Walden Dissertations and Doctoral Studies

The increasing recidivism rate for African American female offenders is exacerbated by postrelease job candidates' difficulties with interviewing for employment. The purpose of this hermeneutical, phenomenological study was to examine experiences from postrelease, African American, female, opioid offenders when interviewing with potential employers. Critical race Black feminist theory was used as the ontological lens for this research. Criterion sampling was used to recruit 12 female African American opioid female research participants. Data collection occurred via 12 semistructured, face-to-face interviewees. Thematic analysis was used to develop common emergent themes from the lived experiences of postrelease, African American, female, opioid offenders. Results …

Leadership Practices Principals Believe Reduce Reading Achievement Gaps For Economically Disadvantaged Students, Andrew Richard Buchheit

Walden Dissertations and Doctoral Studies

Evidence suggests that principals' practices influence student achievement. The purpose of this qualitative study was to examine the beliefs elementary school principals in the mid-Atlantic United States had about which leadership practices have been instrumental in reducing the achievement gap between economically-disadvantaged students and all other students at their schools. The leadership model that Kouzes and Posner developed, which identified 5 practices of exemplary leaders, served as the conceptual framework for this study. Eleven principals who were leaders at schools where the achievement gap in reading had been reduced compared with the state average were interviewed. A combination of a …

Positive Deviance Behaviors And Definition In Nursing, Stacy L. January

Walden Dissertations and Doctoral Studies

The concept of positive deviance (PD) has not been studied in the context of nursing. Grounded in narrative inquiry and combined with vocabularies of motive and symbolic interactionism, the purpose of this study was to explore whether PD behaviors existed in nursing, and if so, to develop an operational definition of PD for nursing. The research question addressed what PD behaviors, if any, were present in nurses’ workplace stories. Using posted flyers, eight participants either self-selected or were selected by snowball method to participate. Interviews were conducted in locations decided on by each participant. Interview data were obtained, transcribed, then …

A Lifestyle Modification Toolkit To Increase Physical Activity Among Young Adults, Anthonia Ninikanwa Nwanna

Walden Dissertations and Doctoral Studies

Substantial decreases in physical activity have been observed between early to late adolescence in males and females, with decreases in levels of activity into adulthood. Physical inactivity among young adults leads to medical conditions such as Type 2 diabetes, stroke, ischemic heart disease, falls resulting in hip fractures, and depression later in life. Advanced Nurse Practitioners have a significant impact on the problem of physical inactivity among young adults through education to improve knowledge regarding physical activity participation. The focus of this project was to develop a toolkit on lifestyle modification as a resource for physical education teachers and nurses …

Staff Education: Hypertension Management For Adults In Primary Care Settings, Doris Adediwura Obaze

Walden Dissertations and Doctoral Studies

Management of hypertension and its complications requires health care providers to

understand the reason for developing the disease. Complications of hypertension (HTN)

are more prevalent when patient interventions are not consistently performed by staff. A

gap in staff knowledge regarding the management of patients with HTN was noted at an

outpatient clinic in the southwestern United States. A staff education project based on

the Eighth Joint National Committee (JNC-8) guidelines for HTN management was

developed to address the gap in knowledge. This DNP project sought to understand the

impact of an evidence-based staff education program in improving the knowledge of …

Utilizing Food Safety Knowledge In Comprehensive Patient Care Among Harlem Hospital Physicians, Sean Alexander Shivers

Walden Dissertations and Doctoral Studies

According to the World Health Organization (WHO), people throughout the world become sick every year from consuming contaminated foods, which impacts countries’ socioeconomic development, straining their healthcare system, travel and tourism, and foreign trade markets. To help alleviate the impact foodborne illness (FBI) has on society, scholars suggest physicians incorporate food safety in their standard work practice. The purpose of this study was to determine if Harlem Hospital physicians utilized food safety knowledge in comprehensive patient care with a diagnosis of FBI, in addition to how physicians passed this food safety information onto the patient. A qualitative methodology using an …

The Impact Of Campus Health Services On The Attitudes, Perceptions, Beliefs, And Behaviors Of Historically Black College And University Students, Micah Mccray Griffin

Walden Dissertations and Doctoral Studies

African Americans suffer worse health outcomes related to chronic disease than any other racial or ethnic group. The negative effects associated with poor dietary habits and a low propensity to exercise impact young adult African Americans who attend Historically Black Colleges/Universities (HBCUs) and can lead to higher mortality rates. It is important for HBCU campus health centers to address the perceptions and beliefs of students to positively impact health behaviors associated with diet and exercise. At the time of this study, there was limited research on-campus health centers and their impact on HBCU student health beliefs and behaviors. Therefore, this …

Factors That Influence Physical Activity Among African American Mothers At Recreation Centers, Nichole Leigh Glover

Walden Dissertations and Doctoral Studies

Physical activity is a critical factor in preventing obesity and other chronic illnesses. African American women experience higher rates of physical inactivity than the general population. As a key figure in the family, African American mothers should model healthy behaviors to the family, especially their children. This qualitative study explored the physical activity attitudes of African American mothers who frequently visit a recreation center in the Columbus, Ohio, area. The research questions focused on the possible barriers and motivators for physical activity engagement. The theory of planned behavior, which emphasizes behaviors, intentions, and attitudes when exploring health behaviors, guided the …

Nutritional Education Program Using The Dash Diet For African Americans, Angela B. Williams

Walden Dissertations and Doctoral Studies

Hypertension (HTN) is a serious yet common condition that can be prevented or

controlled. Complications of uncontrolled HTN can lead to cardiac failure, renal disease,

and stroke. In the United States, HTN is greater among African Americans than any other

ethnic group and is prevalent in the community in which this project was conducted. To

address the problem of HTN and its effect on members of the African American (AA)

population in the site community, a program of HTN self-management emphasizing

patient education and healthy behaviors for the AA community was developed. The

purpose of this project was to search …

Failure To Launch, Wellness, And Mentorship, Adriano Roberto Marcoccia

Walden Dissertations and Doctoral Studies

As of 2015, over 34% of emerging adults in the United States between 18 and 34-years-old were still living with their parents or guardians, and prior research has suggested this trend was steadily growing. The current study examined contextual factors, such as an individual's state of well-being during this transitional phase, to determine what, if any, variables may also be contributing to this issue. Both Adlerian theory and social exchange theory were used as the theoretical foundation to better understand how to mitigate this phenomenon. Amazon MTURK was used to recruit 336 participants who completed the survey. A series of …

Social-Emotional Support As A Mediator Of Household Structure And Mental Distress In Women, Trisha Jeanine Walker

Walden Dissertations and Doctoral Studies

Mental illness affects more women than men in the United States. Poor mental health in reproductive-age women has negative implications on population health. The purpose of this quantitative, correlational study was to examine the relationship between household structure and frequency of mental distress, with consideration of the mediation social-emotional support provides for reproductive-age women. The social ecological model was the theoretical framework for this research, in which frequency of mental distress related to the individual-level of the human-environment interaction construct. Household structure and social-emotional support were examined at the relationship-level. Pearson's correlation coefficient and linear regression were used to conduct …

Natural Environment Associations With Mental Health And Obesity Status, Adam Edwin London

Walden Dissertations and Doctoral Studies

Mental health and obesity were ranked among the health priorities of the 2014 and 2017 Community Health Needs Assessments in Kent County, Michigan. Exposure to nature is correlated to improved health outcomes across a variety of morbidities including poor mental health and obesity. This cross-sectional study set within the frameworks of attention restoration theory, environmental health, and pathways to health benefits from nature assessed county survey data including self-reported nature exposures/interactions separated into 3 domain areas: access to nature, attitudes about nature, and physical activity in nature or in nature-based activities. Binary logistic regression analyses of the 653 respondents found …

Middle School Mathematics Teachers' Perception Of Socioeconomic Status And Effects On Instruction, Kristen A. Jones

Walden Dissertations and Doctoral Studies

In a small but diverse suburban school district, the gap in mathematics performance between economically disadvantaged and economically nondisadvantaged students was slowly widening as evidenced by state test scores. The purpose and key research questions of this instrumental case study were designed to (a) identify what Grades 6, 7 and 8 mathematics teachers perceive the role socioeconomic status plays in ability to learn mathematics and to (b) understand what teachers believe affects their perceptions of students' ability to learn mathematics. The conceptual framework guiding this study was social reproduction theory. The nine participants were middle school (i.e., Grades 6, 7 …

Physical Activity And Dietary Interventions For Adolescent African Americans In Mississippi, Tanga Deson Hart Robinson

Walden Dissertations and Doctoral Studies

African American (AA) adolescents have higher rates of obesity than many other ethnic groups, which increases their risk for obesity-related diseases. Culturally sensitive obesity preventive interventions have been unsuccessful, resulting in a steady increase of obesity among AA adolescents. AA adolescents in the southern region of the United States are at a higher risk for obesity and physical inactivity; knowledge and understanding of causative factors remains limited. To identify the impact of programs, a systematic review of the literature focused on structured physical activity and/or dietary education interventions in Mississippi. The ecological framework was used to guide this study. The …

Nursing Knowledge On Pressure Injury Prevention In The Intensive Care Unit, Yanick Jacob

Walden Dissertations and Doctoral Studies

Over 60,000 hospital patients die each year from complications associated with hospital-acquired pressure injuries (HAPIs). Pressure-injury rates have increased by 2% within the past decade as life expectancy has also increased due to high cost in Medicare. Evidence shows that the incidence of pressure injuries (PIs) in healthcare facilities is increasing, with high rates of occurrence in intensive care units (ICUs). At the clinical site for which this project was developed, multiple in-services had been provided to staff regarding PIs, but uncertainty persisted about how knowledgeable the nurses were. This project, using the Academic Center for Evidence Star Model of …

Physical Activity, Healthcare Use, And Medication Use In Diabetes Patients, Julie Kwon Evans

Walden Dissertations and Doctoral Studies

Physical Activity, Healthcare Use, and Medication Use in Diabetes Patients

by

Julie Kwon Evans

MS, The Chicago School of Professional Psychology, 2013

Dissertation Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Psychology

Walden University

November 2019

Associations Between Healthcare Utilization Factors And Diabetic Retinopathy Among Adult African Americans, Olusina Adesanya

Walden Dissertations and Doctoral Studies

African Americans are disproportionately affected by diabetes mellitus (DM) and complications that include diabetic retinopathy and its disease and socioeconomic burdens. This study examined the relationships between diabetic retinopathy and health care utilization factors, such as gender, DM comorbidities of hypertension and hyperlipidemia, and health care access, among sampled African Americans with DM in the United States. The Andersen health care utilization model was the framework for the study. In this correlational cross-sectional study, data from the 2011-2016 National Health and Nutrition Examination Survey datasets were analyzed. Results of complex samples logistic regression showed that there were no significant associations …

Influence Of Educational Equity Policies On High School Graduation Rates For Black Students, Vincent Kiriza Chirimwami

Walden Dissertations and Doctoral Studies

The achievement gaps between White and Black students remain prevalent in American public schools. To resolve the problem, many school districts have developed equity-centered practices to improve high school graduation rates. The purpose of this quantitative study was to determine whether the (a) duration of exposure to educational equity policies, (b) percentage of economically disadvantaged students, (c) percentage of students with disabilities, and (d) percentage of limited-English-proficient (LEP) students are predictive of high school graduation rates for Black students in large school districts. This study was grounded in Schneider and Ingram’s social construction of target populations theory. Archival data of …

Effects Of Increasing Education For Clinicians On Stress While Treating Pressure Injuries, Roscelyn Garner

Walden Dissertations and Doctoral Studies

Previous healthcare professionals researched the effects of treating and healing pressure

injuries within long-term care facilities. This study was conducted to explore the stress clinicians face when treating pressure injuries in the long-term care setting. This qualitative study provides information for the need to educate nurses about treating and healing pressure injury. It was derived from a phenomenological study that incorporated real life perspectives of individuals responsible for treating and healing pressure injury. This study was guided by Castles and Ferguson’s conceptual framework related to employee perceptions on pressure injuries, employee level of education and knowledge about improving quality initiatives …

Mental Health Counselors’ Experiences In Personal Counseling, Torrie Gilden

Walden Dissertations and Doctoral Studies

In various aspects of the counseling profession, instructors, supervisors, and colleagues often recommended that their fellow counselors engage in personal counseling for professional development and personal wellness. However, the existing literature has yet to explore the lived experiences of mental health counselors in personal counseling. The purpose of this transcendental phenomenological study was to explore the lived experiences of mental health counselors in personal counseling. Purposeful sampling was used to select 7 licensed mental health counselors in a Northwestern state. Data collection methods included semistructured interviews in person and via Zoom, an online video conferencing format. Interpretive phenomenological analysis was …

Effects Of Maternal Obesity On Preterm Birth And Birthweight, La Tosha Headley

Walden Dissertations and Doctoral Studies

Obesity is one of the major risk factors for neonate low birthweight among reproductive women. The purpose of this quantitative study was to examine the association between 3 categories of obese status (moderate, severe, and very severe) and low neonate birthweight and preterm birth among women ages 18 to 39 years at all socioeconomic levels. Secondary data were obtained from 141,859 women ages 18-39 years living in the United States who had participated in the 2012-2015 Pregnancy Risk Assessment Monitoring System. Social-ecological theory was used to guide the study, and binary logistic regression was used for the analyses adjusting for …

Effects Of Teach-Back On Children’S Treatment In Parents With Low Health Literacy, Marion Ines Kopulos

Walden Dissertations and Doctoral Studies

Health literacy (HL) skills are necessary to understand the context of medical information provided to patients in all settings including the emergency room. People with low health literacy (LHL) have difficulty comprehending and implementing basic tasks such as understanding medication administration. The purpose of this quasi-experimental study guided by Orem’s self-care theory was to determine the effect of using the teach-back method for discharge instructions compared to standard written instructions based on parents’ learning style and HL skills assessed during their visit to the emergency room. The Newest Vital Sign (NVS) tool was reworded to assess the parents’ HL. A …

Development Of A Tele-Healthcare Clinical Practice Guideline For Diabetic Patients, Kathy J. Montgomery

Walden Dissertations and Doctoral Studies

Lack of access to healthcare in rural communities has resulted in increased morbidity and mortality rates among diabetic patients. The problem identified in this project was the lack of access to healthcare among diabetic patients living in rural southeast Ohio. Tele-healthcare is a strategy that provides healthcare remotely and has been introduced into the rural setting and offers an appropriate healthcare delivery mode for the rural community. The purpose of the project was to develop a tele-healthcare clinical practice guideline, including smart phone applications, for the management of diabetic patients. An expert panel consisting of 2 advanced practice nurses in …