Digital Commons Network^™

Influence Of Low Rate Of Reporting Of Adverse Events Following Immunization On Immunization Dropout, Samuel Errie Yenyi

Walden Dissertations and Doctoral Studies

Immunization protects millions of children. Yet, many children drop out of immunization in Jigawa State of north Nigeria. This cross-sectional quantitative correlational study based on the Health Belief Model was designed to determine whether the dropout from routine immunization (RI) was influenced by low rate of reporting of adverse events following immunization (AEFI) to health facilities by caregivers. Primary data was collected from 307 caregivers with dropout children using structured interviewer-administered questionnaire. The data were analyzed using logistic regression and descriptive statistics. The results showed that 61.3% of the children had AEFI and dropped out. Rate of reporting of AEFI …

Social And Cultural Factors Influencing The Management Of Type 2 Diabetes Among African American Men, Lavetta W. Lopez

Walden Dissertations and Doctoral Studies

African American men are more likely to have diagnosed or undiagnosed diabetes than non-Hispanic White Americans and are less likely to adhere to treatment. Culture in the African American community plays a key role in how this community copes with illness and the health care system. The purpose of this study was to examine the lived experiences of social and cultural determinants of Type 2 diabetes self-management among African American men. Bandura's social cognitive theory provided the theoretical framework for the study. The research question sought to identify cultural and social factors that contribute or protect how African American men …

Antenatal Care And Maternal Sociocultural Determinants Of Childhood Immunization In Northern Nigeria, Amaka Tonia Okafor

Walden Dissertations and Doctoral Studies

Immunization has been recognized globally as a cost-effective public health intervention. However, despite its benefits, children in northern Nigeria are still adversely affected by the negative consequences of inadequate uptake of immunization. The purpose of this study was to assess antenatal care and maternal sociocultural determinants that influence childhood immunization within 2 months of birth in northern Nigeria. Constructs of social cognitive theory were applied to this retrospective correlational cross-sectional inquiry involving women 15-49 years old in northern Nigeria. Secondary data (the 2013 Nigeria Demographic and Health Survey) were analyzed using univariate, bivariate and multivariate logistic regression. Statistically significant (p < 0.05) predictors of uptake of childhood immunization within 2 months of birth were the person who delivered antenatal care, the number of antenatal care visits, the number of tetanus injections, maternal educational level, religion, wealth index, husband/partner educational level, and the person who decides on health care. Educated Christian women from middle-class or rich homes, whose husbands/partners were also educated and who jointly decided on health care, made numerous contacts with health care professionals, and received at least one tetanus injection during antenatal care, had a higher likelihood of immunizing their children within 2 months of birth. The positive social change implications for this study include providing evidence of deterrents to childhood immunization that could lead to relevant policies and interventions leading to healthier children, communities, and society.

Women's Empowerment As A Policy For Poverty Reduction In Haiti, Flore Saint.Louis Weinstein

Walden Dissertations and Doctoral Studies

Women represent more than 50% of the population of Haiti and embody the poorest group due to their lack of socioeconomic development. Numerous nongovernmental organizations (NGOs) including diaspora NGOs (DINGOs) have engaged in the fight to reduce poverty in Haiti by enabling empowerment programs to help women become self-reliant. The programs appear to be ineffective because the level of poverty remains high and there has been little research on the relative effectiveness and sustainability of the programs implemented by the DINGOs. Using the feminist theories of DeBeauvoir and Friedan in conjunction with the empowerment theory of AlMaseb and Julia as …

Health System Access To Maternal And Child Health Services In Sierra Leone, Alhassan Fouard Kanu

Walden Dissertations and Doctoral Studies

The robustness and responsiveness of a country's health system predict access to a range of health services, including maternal and child health (MCH) services. The purpose of this cross-sectional study was to examine the influence of 5 health system characteristics on access to MCH services in Sierra Leone. This study was guided by Bryce, Victora, Boerma, Peters, and Black's framework for evaluating the scaleup to millennium development goals for maternal and child survival. The study was a secondary analysis of the Sierra Leone 2017 Service Availability and Readiness Assessment dataset, which comprised 100% (1, 284) of the country's health facilities. …

Association Of Health Facility Delivery And Risk Of Infant Mortality In Nigeria, Susan Adaku Ukwu

Walden Dissertations and Doctoral Studies

Infant mortality (IM) incidence in health facility systems during or after infant delivery is

substantially high in Nigeria. In this quantitative, cross-sectional study, the effects of skill

birth attendants (SBAs), prenatal care, and providers of prenatal care on IM in health

facility delivery centers were examined. The Mosley and Chen theoretical framework

informed this study and was used to explain the relationship between SBAs, prenatal

care, and providers of prenatal care and IM. One hundred and sixty infant deaths were

examined among mothers who used an SBA versus those who did not, mothers who had

prenatal care versus those without, …

Feeding Practices And Nutritional Status Of Infants In Northwest Nigeria, Michael Enyi Enwere

Walden Dissertations and Doctoral Studies

Infants and young children in the Northwest province of Nigeria are susceptible to malnutrition. Inappropriate and inadequate breastfeeding and complementary feeding result in stunting, underweight, and wasting. The purpose of this cross-sectional study was to examine current feeding practices of infants not older than 2 years and their nutritional status in Northwest Nigeria. The theory of planned behavior was adopted in this research. With a total sample size of 3,861, multiple linear regression was adopted as a predictive analysis to delineate the correlation between two or more independent variables and one continuous dependent variable. Also, adopted was an independent t …

Strategies For Catalyzing Business Innovation In Small-Scale Agribusinesses In Southern Africa, Golden Mahove

Walden Dissertations and Doctoral Studies

Agribusiness leaders in emerging economies require effective business model innovation strategies to succeed in closing innovation gaps and increasing market share in the growing smallholder farmers' market. Small agribusiness seed companies in Malawi, Zambia, and Zimbabwe in southern Africa often face the challenge of closing the innovation gap in the smallholders' market, resulting in small-scale seed companies missing 90% of the smallholder farmers' seed market segment. The purpose of this multiple case study was to explore strategies that small agribusiness seed company leaders used to close innovation gaps in smallholders' markets. The conceptual framework was based on the business model …

Public Education/Public Health Perspectives On Collaboration-Influence On High School Completion, Claudette Virginia Campbell

Walden Dissertations and Doctoral Studies

The research problem focused on the use of collaboration by managers, supervisors, consultants, and professional staff in a department of public education and health to address disparities in on-time high school completion rates. The purpose of the study was to examine the perspectives of individuals in these public sectors on the use of collaboration as a means to improve on-time high school completion rates for African American and Hispanic students. The theoretical foundation and conceptual framework for the study were John Rawls's theory of justice and Amartya Sen's capability approach. The key research question involved how individuals in the public …

Correlating Personality Types And Educational Attainment, Nicole Marie Orcutt

Walden Dissertations and Doctoral Studies

There was a gap in the current literature examining degree attainment, in that there was no research found on personality type and the highest degree level someone attains. The goal of this study was to understand if there was a correlation to an individual's personality classification as determined by their Myers Briggs Personality Inventory (MBTI) and the highest education level they achieve for the 225 people in the entire sample and 95 in the subsample (participants raised in poverty). The MBTI's theoretical foundation is based upon Dr. Carl Jung's personality typology and was later expounded upon by the tool's creators. …

Funding Strategies For Smallholder Rice Farmers In Afadzato South District, Ghana, Faith S. Ababio-Twi

Walden Dissertations and Doctoral Studies

Agriculture revenue contributions to Ghana's gross domestic product have declined because of limited farm funding, which has constrained some smallholder rice farmers access credit to acquire necessary inputs, and to secure a stable market for their harvests. The purpose of this qualitative multiple case study was to explore successful strategies some smallholder rice farmers in the Afadzato South District of Ghana used in obtaining farm funding. Data collection included semistructured, face-to-face interviews with 9 smallholder rice farmers who successfully obtained farm funding. Previous research, reports, and policies of the Ghana Ministry of Food and Agriculture served as additional data collection …

Manufacturing Companies' Strategies To Mitigate Supply Chain Disruptions, Vanessa Kaye Benton

Walden Dissertations and Doctoral Studies

Supply chains have become increasingly unstable due to unanticipated disruptive events, which undermines a firm's capacity to achieve a competitive market advantage and increase profitability. The disruption of a supply chain is essential to supply chain managers, as the interruption can be expensive, and the goods and services lost can negatively affect the entire supply chain. The purpose of this qualitative multiple case study was to explore strategies that manufacturing firm managers use to mitigate supply chain disruptions to remain profitable. The population consisted of 4 supply chain managers from 2 manufacturing firms located in the southern region of eastern …

Pregnant African American Women Breastfeeding Intentions, Beliefs, Attitudes And Perspectives, Janelle S. Mcclain, Phd

Walden Dissertations and Doctoral Studies

Breastfeeding is the best infant feeding source of nutrition for infants in their early stages of development. However, there is a fundamental gap in the number of African American women that initiate breastfeeding compared to White, Asian, and Hispanic mothers. Social cognitive theory was used to explore the breastfeeding intentions, beliefs, perceived barriers, and perceptions on breastfeeding through a basic qualitative research method. To capture the essence of the lived experiences of African American pregnant women, a purposeful sample of 13 African American pregnant women were invited to participate in the study. Two focus groups discussions pertaining to breastfeeding intentions …

Life Chaos As A Predictor Of Diet Quality In U.S. Adults, Heidi Barbara Buchert Egan

Walden Dissertations and Doctoral Studies

Poor diet quality is a source of morbidity and mortality within the United States. Previous researchers have examined psychosocial influences on diet; however, the relationship between life chaos, a psychosocial measure, and diet quality was not known. The purpose of this cross-sectional survey study was to use the Life Chaos Scale and the Healthy Eating Index-2010 to collect data on life chaos and diet quality, consistent with the biopsychosocial model of health, from a sample of 103 U.S. adults. Regression analysis was used to construct a predictive model. According to the study results, life chaos was not a significant predictor …

Nursing Pain Management In An Emergency Room With Hallway Overflow, Zaida Ruiz

Walden Dissertations and Doctoral Studies

Overcrowded emergency rooms (ERs) decrease the flow of nursing care creating a delay in nurse-administered pain management leaving patients in pain. The project-focused question asked if ER nurses felt that overcrowding in the ER led to inadequate pain management and if a clinical practice guideline (CPG) could be developed to promote effective pain management in the setting. Callista Roy's theory of human adaptation was used to guide the project. To prepare for CPG development, data from a simple random selection of 10 nurses who had worked in the ER for a minimum of 6 months was obtained from the practice …

Patient Satisfaction Management In Office Visits And Telehealth In Health Care Technology, Todd Price

Walden Dissertations and Doctoral Studies

Telehealth and remote medical treatments have begun to be more commonly used in healthcare systems. Researchers have theorized that providers' abilities to treat patients are not directly tied to the proximity of the patient to the doctor, but by the identification and treatment of the patient's symptoms. Although the treatment and cure rates are being established within individual health systems and professional medical associations, empirical research is lacking regarding patient satisfaction with this remote treatment situation. The purpose of this quantitative study was to address this gap by examining satisfaction ratings of patients between virtual provider visits and face-to-face provider …

Perceptions Of Obese African American Women Regarding Altering Traditional Soul Food Preparation, Patricia A. Young

Walden Dissertations and Doctoral Studies

The obesity epidemic continues to be a major concern in the United States. The World Health Organization reported that 1.4 billion adults were either obese or overweight. African American (AA) women have the highest incidence of obesity worldwide. The obesity rate among AAs has continued to rise over the past 2 decades. The problem is that AA women prepare and consume high caloric foods that contribute to obesity. This qualitative descriptive study explored the perceptions that obese AA women have about altering how they prepare soul food to make it a healthier soul food. The empowerment model and the health …

Early Interventionists' Perspectives Of Self-Efficacy With Neonatal Abstinence Syndrome, Adrienne Anderson

Walden Dissertations and Doctoral Studies

An increasing number of infants are diagnosed with neonatal abstinence syndrome (NAS) as a result of prenatal opioid exposure. Early intervention services are recommended for this population of children and families to mitigate developmental delays associated with NAS. The effectiveness of early intervention is dependent on the ability of interventionists who deliver these services. The purpose of this qualitative case study was to explore early interventionists' perspectives of self-efficacy when working with infants diagnosed with NAS and their families. Bandura's self-efficacy theory and Rotter's concept of locus of control provided the conceptual framework for this study. The study's guiding research …

Quantifying The Spectrum Of Depression, Octavious Bishop

Walden Dissertations and Doctoral Studies

Walden University

College of Social and Behavioral Sciences

This is to certify that the doctoral dissertation by

Octavious Bishop

has been found to be complete and satisfactory in all respects,

and that any and all revisions required by

the review committee have been made.

Review Committee

Dr. Thomas Edman, Committee Chairperson, Psychology Faculty

Dr. Ricardo Thomas, Committee Member, Psychology Faculty

Dr. Joanna Bissell-Havran, University Reviewer, Psychology Faculty

Chief Academic Officer

Eric Riedel, Ph.D.

Quantifying the Spectrum of Depression

by

Octavious Bishop

MA, University of Texas at Austin, 2008

BS, University of Texas at Austin, 2001

Dissertation Submitted in Partial Fulfillment …

Changes In Attitudes Towards Substance Use Among High School Students, Laura Sue Catherine Elias

Walden Dissertations and Doctoral Studies

Use of alcohol and illicit drugs during adolescent development can have negative effects on cognitive functioning and mental health. The purpose of this cross sectional study was to examine grade level, sex, athletic affiliation, and ethnicity as they relate to substance-using attitudes to isolate the period in which shifts in attitudes toward substance use in adolescents occur. The social learning theory provided the framework for the study. Participants included 276 high school students from a midsized Midwestern city. Students in the ninth, 10th, 11th, and 12th grades who participated in the study were asked to complete a brief electronic survey …

Second Grade Teachers' Perspectives On Differentiated Instruction, Alyssa Simmons

Walden Dissertations and Doctoral Studies

Despite various instructional efforts, the second grade students in a mid-sized Southwestern school district failed to progress in reading. Although differentiated instruction has been shown to improve literacy skills for young readers, many teachers at the study site did not differentiate instruction for all students. Grounded in theories of social constructivism and differentiated instruction, the purpose of this study was to investigate second grade teachers' perspectives about using differentiated literacy instruction and the effect of their teaching experience and participation in professional development on those perspectives. Data for this nonexperimental, causal-comparative study were collected from 93 second grade teachers via …

Minimizing Home Health Care-Acquired Pressure Injuries Through Effective Nursing Teamwork, Juliana Baah

Walden Dissertations and Doctoral Studies

Pressure injuries (PIs) affect an estimated 2.5 million people in America and cost the nation approximately $11.6 billion each year. The goal of this DNP project was to minimize the rate of PIs at a home health care agency through effective teamwork. Prevention of PIs is very important because PIs damage patients' skin integrity, cause significant amount of pain, are costly to treat, and cause life-threatening infections. The purpose of this DNP project was to evaluate nursing compliance with PI prevention measures and the level of nursing teamwork at the project agency. The Braden-Bergstrom conceptual framework was used to explain …

Meeting The Nutritional Needs Of Very Low Income Diabetic Patients, Mary Hossley

Walden Dissertations and Doctoral Studies

Adult Type II diabetes is an increasing public health problem, particularly among very low-income minority populations. The purpose of this study was to create a nutritional guide for a diabetic specific meal plan with an accompanying food pantry nutrition packet for very low-income Type II diabetic patients at a rural Mississippi Free Clinic. The practice-focused question is: Will a nurse-prepared nutritional guide with supplemental food packets improve the glucose control in low income diabetic patients? The gap in practice is that there has been no structured nutrition education guide and no food pantry support plan for Type II adult diabetics. …

Perceptions Among African American Women Welfare Recipients In Advocating For Welfare Reform, Linda Denise Scope

Walden Dissertations and Doctoral Studies

The 1996 Personal Responsibility and Work Opportunity Act (PRWORA) significantly affected many families by changing public assistance from an entitlement program to a work program for recipients and imposing a 60 month maximum period for receiving assistance. Unanticipated outcomes created deleterious results for many single parents. This multiple case study explored the experiences of four African American single mothers in the mid-Atlantic region of the United States receiving assistance regarding welfare reform, the welfare system and their perceptions of welfare advocacy. Black feminist and empowerment theories framed the study to examine how welfare policy changes affected African American women's families …

What Matters Most To Mayors Making Interlocal Agreement Decisions, Douglas C. Haney

Walden Dissertations and Doctoral Studies

Local governmental units in the United States are struggling to cope with dwindling public resources and surging public demands. They often turn to interlocal agreements (ILAs) as a collaborative means by which to more effectively serve their constituents. Unfortunately, many ILAs never materialize or fail prematurely. The purpose of this qualitative, phenomenological study was to explore the experiences of 13 purposefully selected mayors in the State of Indiana to discover what factors they considered important when making their ILA entry and continuation decisions. It utilized a conceptual framework based on the transaction costs theory, as informed by the utility maximization, …

Self-Disclosure Of Human Immunodeficiency Virus Status In Personal Relationships: Perceptions Of South Africans Living With Human Immunodeficiency Virus, Delile Gertrude Langeni

Walden Dissertations and Doctoral Studies

Despite enormous research on the experience of living with HIV, many questions remain regarding self-disclosure of HIV status to sexual partners by people living with HIV (PLWHIV), which is essential to reducing further infection. In this study, a phenomenological approach captured the experience of self-disclosure among South Africans living with HIV in Louwsburg, South Africa. The health belief model served as a theoretical framework, and in-depth interviews were conducted with 12 PLWHIV (8 women, 4 men) who self-disclosed their HIV status to their sexual partners. Their experiences were explored, discovering their illness, motives for self-disclosure, feelings regarding disclosing, responses of …

Complementary Infant Feeding Practices In Afghanistan, Hasibullah Na Niayesh

Walden Dissertations and Doctoral Studies

Children are at greater risk of malnutrition in Afghanistan than they are in many other countries. Malnutrition impairs the mental and physical growth of more than 50% of children in Afghanistan. It also exacerbates the risks of mortality by 45% in infants and children in Afghanistan. The purpose of this study was to determine the association between mothers' knowledge, attitudes, and practices regarding complementary feeding and malnutrition in children in Afghanistan. The precaution adoption process model served as a theoretical framework in this quantitative cross-sectional research study. Data analyzed were collected from 306 mothers and children at 6 randomly selected …

Socioeconomic Status And Cancer Risks In Employer-Insured Cancer Survivors, Christine Clinton

Walden Dissertations and Doctoral Studies

Chronic illnesses such as cancer continue to be among the costliest for employers who provide health insurance to their employees. Despite efforts to incorporate health improvement programs in the workplace, there are concerns about the effectiveness of these programs that do not always deliver a positive return on investment. Little is known about the specific socioeconomic status of employees for whom these workplace health improvement programs are designed for. Guided by the social-ecological model, this study sought to understand the relationship between cancer health risks about socioeconomic factors among cancer survivors in the employer-insured population. Data were extracted from the …

Breastfeeding Perceptions, Rates Of Initiation, And Duration Among Urban And Rural Women, Shaunta N. Rutherford

Walden Dissertations and Doctoral Studies

Breastfeeding is the optimal feeding method for infants up to the age of 2. Breast milk is suited to fulfill the nutritional needs of infants while providing immunological and neurological benefits. Breastfeeding rates of initiation and duration are low in the United States, especially in the state of Georgia. The purpose of this cross-sectional study was to investigate how breastfeeding initiation and duration, self-efficacy, perceptions, and community breastfeeding resources differ based on geographical location. The social ecological model was used as the theoretical framework for this study. An online and in-person survey that combined the Iowa Feeding Attitude Scale, Breastfeeding …

Clinical Practice Guideline For Differentiating Risk Factors For Avoidable And Unavoidable Pressure Ulcers., Vivian Suarez-Irizarry

Walden Dissertations and Doctoral Studies

Pressure ulcers (PUs) present intrinsic risk factors that are not consistently identified by clinical assessments. The objective of this project was to develop a clinical practice guideline (CPG) to provide nurses with guidance in identifying and differentiating how intrinsic and extrinsic risk factors are associated with populations at risk for developing avoidable and unavoidable PUs. CPG development followed a systematic method to search the literature, organize findings, and assess the strength of the resulting evidence and its applicability to the CPG. Quality of the CPG was assessed by a panel of 8 health care professionals using the Appraisal of Guidelines …