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A Policy Feedback Theory Approach To Food Assistance Program Distribution Mechanisms, Ahmad Sabbagh

Walden Dissertations and Doctoral Studies

Many families that experience hunger in the United States rely on Food Assistance Programs to meet their daily nutrition needs. However, these programs do not always meet the needs of these individuals, as has been the case for individuals living under higher than expected levels of poverty in the Great Lakes region of the United States. Using policy feedback theory (PFT), the purpose of this case study was to explore the experiences of individuals from a county in the Great Lakes region of the United States, who depend on the federal Food Assistance Program, with particular attention given to evaluate …

Predictors Of Nutritional Counseling Among Adolescents By Physicians In California, Jean Kigozi

Walden Dissertations and Doctoral Studies

The prevalence of obesity in the United States was stable at 17% from 2011-2014 among approximately 13 million children and adolescents 12-19 years of age, according to the Centers for Disease Control and Prevention. Nutritional counseling has been recommended, and while most physicians agree that it is necessary, it is not happening consistently. The purpose of this study was to examine the association between dietary intake, physical activity, and body mass index (BMI) characteristics of youth 12-17 years old in California and the receipt of nutritional counseling. Social cognitive theory guided this quantitative cross-sectional analysis of archived data from 814 …

A Structured Weight Loss Program To Combat Obesity In Women, Tara English

Walden Dissertations and Doctoral Studies

Rates of obesity and the associated comorbidities continue to increase for women in the United States. Despite information available, efforts at weight loss are often unsuccessful because women lack integral knowledge of how to approach the various components essential for weight loss. This doctoral project was created to address the practice question of whether obesity can be reduced through a step-wise weight loss program that identifies essential elements to reduce weight in menopausal age women. Guided by the information-motivation-behavioral skills model, this project led 17 volunteer participants from a Northwest, Florida primary care clinic through 6 weeks of protocols supplemented …

Reading Achievement Of Middle School Boys In Single-Gender And Coeducational School, Jean Hunter-Batty

Walden Dissertations and Doctoral Studies

The problem addressed in the study was the lack of evidence on the efficacy of the single-gender educational model as compared to the coeducational model in increasing reading achievement for middle school boys in the local school district. Leaders in the district implemented the single-gender model to address the problem of an ongoing reading achievement gap among middle school boys and girls. The gap has also been noted nationally and leads to limited reading-dependent opportunities for boys. The purpose of this quantitative study was to compare the two educational models to determine whether the single-gender model offered advantages over the …

The Relationship Of Location And Educational Achievements To Vision Impairment In Asians, Sonali Trivedi

Walden Dissertations and Doctoral Studies

Introduction: Increasing incidence of vision impairment in the United States reinforces the urgent need for research and public health awareness. Eye diseases are of common concern in Asian and other ethnic groups globally. Glaucoma, cataracts, macular degeneration, myopia, and retinitis are types of eye diseases and common causes of vision impairment in Asians. This study addressed the current gap in knowledge regarding vision impairment prevalence among Asian-Americans by geographical location and level of education. Socio-ecological theory was used as the theoretical foundation.

Method: A cross-sectional secondary dataset from U.S. Census Bureau included 3,916,947 participants' survey responses from 2011 through 2015 …

Stakeholder Perceptions Of Gun Violence Perpetrated By Young Men, Birda Garrett

Walden Dissertations and Doctoral Studies

In three low socioeconomic urban communities of Greenwood (pseudonym), young men's lack of education provides dim prospects of employment, possibly causing the young men to turn to gun violence. The purpose of this study was to understand the perceptions of concerned clergy, law officials, and members of a Neighborhood Watch organization regarding the factors that contribute to gun violence in the southern communities in the United States. The conceptual framework for this study was Bandura's modeling theory. The central research question addressed how the community stakeholder groups described their perceptions regarding gun violence among young male adults. For this qualitative …

The Influence Of School Discipline Approaches On Suspension Rates, Donna Christy

Walden Dissertations and Doctoral Studies

A free and appropriate public education is promised to every child in the United States. However, zero tolerance school discipline policies have broken that promise, pushing students out of the classroom and into the school-to-prison pipeline. Despite the growing body of research demonstrating negative social and economic impacts of exclusionary discipline, public school administrators have been slow to adopt innovative policies that provide rehabilitative alternatives. The purpose of this study was to compare, using the consequences of innovations application of Rogers's diffusion of innovations theory, the impact of various school district approaches to school discipline on suspension rates while controlling …

Association Between Body Mass Index And Depression On Hbaic Control Among Veterans, Opokua Osei-Yeboah

Walden Dissertations and Doctoral Studies

The study investigated the association between body mass index (BMI) and depression based upon glycated hemoglobin levels (HBA1C) among United States veterans. Based on Bandura's social cognitive theory, a cross-sectional analysis examined the association between BMI and depression on HBA1C regulation, and if the interaction between BMI and depression affects HBAIC regulation among veterans. Multiple regression analysis was used to test the multivariate associations between depression and BMI on the outcome variable of HBA1C. Linearity, normality, and homoscedasticity were assessed using normal probability plots and residual analysis. Durbin-Watson statistics were used to test for autocorrelations, and variance inflation factor was …

Educating Primary Care Nurses On Phosphorus Management In Chronic Kidney Disease Patients, Lilian Somuah

Walden Dissertations and Doctoral Studies

Fifteen percent of adults in the United States have been diagnosed with chronic kidney disease (CKD). CKD is the slow, progressive, and irreversible loss of kidney function. The most effective means of controlling CKD is by managing dietary phosphorus intake. It is important that staff nurses be educated about effective patient education tools to improve dietary phosphorus management. The purpose of this project was to educate primary care nurses about phosphorus management in CKD patients through the introduction of the phosphorus pyramid as a visual tool. The project sought to understand if an educational intervention regarding phosphorus management in CKD …

Predictors Of Blood Pressure And Lipids Levels Among African Americans, Frank Lanor

Walden Dissertations and Doctoral Studies

African Americans disproportionately develop cardiovascular disease risk factors including high blood pressure and high cholesterol levels in comparison to European Americans. The purpose of this study was to examine the associations of diet quality and physical activity with blood pressure levels and cholesterol levels among African Americans. The social ecological model was the theoretical foundation for the study. Research questions were designed to examine the extent to which diet quality and physical activity predict blood pressure levels and cholesterol levels. The research design was quantitative cross-sectional secondary analysis of 959 participants. After controlling for demographic factors, body mass index, and …

A Patient-Centered Approach To Diabetes Education In A Rural Clinic, Paul Okpuzor

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus (T2DM) is a heterogeneous metabolic disease impacting more than 8.3% of adults in the United States. Diabetes-related care accounts for more than 11% of all patient care expenditures. The purpose of this project was to identify the primary concerns of members of the T2DM patient population in an underserved clinic in rural southcentral United States and to make recommendations for a staff diabetes education program to address these concerns. Orem's theory of self care outlined the importance of educating and supporting patients in their efforts to manage their own healthcare. Knowles's assumptions of how adult's learn …

A Community Oriented Solution To Access To Care, Margaret Louise Thornell

Walden Dissertations and Doctoral Studies

Access to primary health care services is a significant issue for many communities seeking to improve the health of their populations. This single case study describes the 12-year journey of 2 adjoining rural counties in 2 states towards meeting the primary and specialty care needs of the uninsured and underinsured population. Data were triangulated using historical documents, first-person interviews, and health utilization data. The community leadership moved through various models including a free clinic and a university-sponsored health center before finally establishing a federally qualified health center, which now serves 40,000 citizens in these counties. The site is now hosting …

Fast Food Business Survivability Beyond 5 Years In Nigeria, Victor Ukorebi

Walden Dissertations and Doctoral Studies

The lack of manager's effective business strategies contributes to the failure of fast food businesses in Nigeria. The size of the fast food industry in Nigeria grows at the rate of 4% annually with rapid rate of return on investment. The annual value of the fast food business in Nigeria was N250 billion in 2015, which is approximately US$700 million. However, approximately 80% of fast food restaurants launched in Nigeria in 2014 failed to persist for longer than 5 years because of lack of survival strategies. Using the human capital theory, the purpose of this multiple case study was to …

Young Female College Millennials' Intent For Behavior Change With Wearable Fitness Technology, Andrea Christine Haney

Walden Dissertations and Doctoral Studies

Among young college-aged females, overweight and obesity, type 2 diabetes, uncontrolled hypertension, and high stress levels have increased, causing overall worse health conditions than previous generations. The use of wearable fitness technology (WFT) by young adults assists in fitness and nutrition monitoring, provides feedback in health statistics, and has shown improvements in reducing health-related issues in young college females. A wide body of literature related to physical activity, nutrition, and health issues in young college females exists; however, the experiences and intent of WFT use for behavior change by young college female millennials has not been well researched. The purpose …

Increasing Medication Adherence In Hypertensive Patients With Million Hearts® Health Literacy Program, Tammy Ross

Walden Dissertations and Doctoral Studies

Healthy People 2020 identified hypertension (HTN) as a controllable risk factor to prevent cardiovascular disease and stroke. Adhering to regular antihypertensive (AHT) medications improves outcomes in patients diagnosed with HTN by controlling blood pressure, reducing hospital visits, and promoting patient wellness. Medication adherence occurs when prescribed medicine regimens are utilized by the patient as directed to manage illness or disease, as evidenced by patients receiving medications at their pharmacy. The practice-focused question for this quality improvement project asked whether implementation of health literacy tools from Million Hearts® HTN Control: Action Steps for Clinicians, increased medication adherence as evidenced by regular …

County Health Leadership And Readiness For Noncommunicable Disease Services, Paul Wekesa Agunga

Walden Dissertations and Doctoral Studies

Premature mortality resulting from the growing global burden of noncommunicable diseases (NCDs) is a contemporary development challenge. Low-income and lower-middle-income countries are disproportionately affected, with the poorest in society considered the most vulnerable. A paucity of literature exists on how leadership practices at the implementation level relate to ensuring readiness for NCD services. The purpose of this study was to investigate whether any relationship exists between leadership practices at the county level and readiness for NCD services in Kenya. Path-goal and adaptive leadership theories were used to guide this quantitative correlational study, using secondary data from a 2013 Service Availability …

Diabetes Management Protocol In The Rehabilitation Setting, Hannah Mottel

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a growing healthcare problem in the United States. Diabetes affects 1.4 million Americans yearly, impacting the lives of individuals of all ages. One of the most challenging aspects about diabetes is that many individuals are not aware of the impact of the disease on multiple organs until the progression of the disease has reached latter stages. Prevention and early detection of diabetes is a key component of lifesaving interventions including proper nutrition counseling, exercise regimens, management, and patient compliance with a treatment plan. The purpose of this doctoral project was to create a standardized diabetes management protocol …

Domestic Violence And Demographic Variables As Predictors Of Resiliency Among Young Adults, Sylvanus O. Abraham

Walden Dissertations and Doctoral Studies

An increased understanding of resilience may determine how human psychological development can result in positive outcomes despite adversarial situations. However, current studies have not provided a relevant predictive model that can adequately predict resilience, particularly among young adults exposed to domestic violence. Based on Bronfenbrenner's ecological systems theory, the purpose of this quantitative noncomparative study was to examine whether domestic violence, age, gender, ethnicity, individual emotional and physical abilities, types of domestic violence exposure, and frequency of domestic violence exposure could adequately predict resilience among young adults. Quantitative data were collected from 118 young adults in the Midsouth region of …

A Chronic Obstructive Pulmonary Disease Self-Management Packet To Reduce 30-Day Readmissions, Josette Askratni

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) signifies a significant public health challenge that is both avoidable and treatable. There was no standardized education offered to the COPD population at the practice location. The scope of the project encompassed standardizing education by developing a self-management packet for the COPD patients. The goal of this project was to examine how the development of a standardized COPD self-management packet enhances the quality of care and strategizes reducing 30-day readmissions compared to nonstandardized delivery of education. Orem's self-care theory and Bandura's self-efficacy concept were used to explain the principle of self-management, while Rosswurm and Larrabee's …

A Nurse-Led Evidence-Based Quality Improvement Program On Childhood Obesity Prevention, Ana Flor Rasonabe Ciocson

Walden Dissertations and Doctoral Studies

The increased prevalence rate of childhood obesity in Saudi Arabia is a nationwide health issue. The doctoral project was instituted in the pediatric out-patient clinic (POPC) of a tertiary university hospital in Riyadh, Saudi Arabia. Child obesity clinic and clinical practice guideline (CPG) for primary prevention were not available in the pediatric outpatient clinic with a high incidence of newly diagnose obese children. The focus of this doctoral project was to improve the clinical nursing practice of POPC nurses through the adoption of CPG on primary prevention of childhood obesity. The knowledge translation into action framework provided a summary of …

Cultural And Environmental Determinants Of Dental Discoloration Among School-Aged Children In Nigeria, Ogbudu Gabriel Ada

Walden Dissertations and Doctoral Studies

Dental discoloration from fluorosis is a global public health problem. In Nigeria, 11.4% of the population is impacted by this disorder. Dental discoloration is caused by successive exposures to high fluoride concentrations during tooth development in utero and it is linked to the development of a variety of psychological and physiological problems, from dental aesthetics to a reduction in intelligence and skeletal changes. The purpose of this quantitative, cross-sectional study was to examine the cultural and environmental determinants of dental fluorosis in children in a rural community in Nigeria. A multilevel theoretical model was used to develop possible fluoride exposure …

Perceptions Of Preconception Health And Prenatal Care By Young Adult Women And Men At Risk For Unintended Pregnancies, Broderick Crawford

Walden Dissertations and Doctoral Studies

Among young adults at risk for unintended pregnancies, preconception health and prenatal care programs aimed at positive birth outcomes remain unaddressed. The purpose of this phenomenological study was to explore the lived experiences of young adults in terms of their willingness to use preconception health and prenatal care as a means for increasing both positive birth outcomes and overall health. All study participants met the following criteria: (a) young adult man or woman, (b) age 18 to 25, (c) at risk for unintended pregnancies, (d) sexually active, (e) single or in cohabiting partnerships, and (f) living in the greater Los …

Program To Prevent Subsequent Fragility Fractures, Kathleen Jean Forti-Gallant

Walden Dissertations and Doctoral Studies

One out of 2 women and 1 out of 5 men over age 50 will sustain a fragility fracture (FF) in their lifetime. The risk of a 2nd FF increases dramatically after the 1st fracture and can lead to pain, disability, and mortality. Despite the evidence that secondary prevention programs are effective, the local facility did not have a formal mechanism to address this need. The purpose of this project was to design a program for secondary prevention of FFs and to address the need for a program for secondary FF prevention that was sustainable locally. The program was designed …

Neighborhood-Level Predictors And Obesity Among African-American Children, Uche Onyeka

Walden Dissertations and Doctoral Studies

The steady raise in childhood obesity is a major public health problem nationally and globally. Childhood obesity is primarily caused by an imbalance between caloric intake and caloric expenditure. The increase in childhood obesity rates over the past 3 decades suggested involvement of environmental and behavioral factors in the obesity epidemic. While childhood obesity is considered a public health crisis in the United States, only limited research is available about the potential impact of neighborhood-level factors such as access to healthy food, neighborhood safety, and risk-free outdoor playgrounds. The purpose of this study was to examine if any relationships existed …

Regression Analysis Of Young Elderly Americans' Needs To Alleviate Poverty, Barbara Ann Parker

Walden Dissertations and Doctoral Studies

Demographics are changing for the young elderly population in America, and poverty is a growing concern among this population. The purpose of this correlational study was to examine the relationship between young elderly demographics and income level, and between government programs and economic status. Rawls's theory of justice was useful to examine the relationship between predictor variables and the outcome variable. Secondary data came from the U.S. Census Bureau's Current Population Survey from March 2016. The results of multiple and logistic regressions indicated no statistically significant linear correlation. There was no statistical linear correlation between income level and region, race, …

Relationships Among Vitamin D Deficiency, Metabolic Syndrome, Smoking Behavior, And Physical Activity, Ethan Pham

Walden Dissertations and Doctoral Studies

Aging increases the risk of both vitamin D deficiency and metabolic syndrome. Vitamin D deficiency and metabolic syndrome may be related, although there are mixed findings. Furthermore, literature suggests other factors such as physical fitness activity and smoking behavior are associated with Vitamin D deficiency and the development of metabolic syndrome. A number of studies have documented associations between Vitamin D levels and physical fitness activities, while other studies found correlations between Vitamin D levels, metabolic syndrome, and smoking behavior. However, no previous study has examined the links between physical fitness activity, smoking behavior, Vitamin D levels, and the risks …

A Practice Change In Adult Obesity Primary Care, Jasmine Tinsley

Walden Dissertations and Doctoral Studies

The rate of obesity in American adults has increased dramatically over the last decade. Obesity has reached epidemic proportions and demands attention to reverse the current trend. This project was developed to evaluate a quality improvement initiative implemented in 2016 to address the problem of obesity in a rural southeastern primary care clinic setting where underserved populations are treated. The quality improvement (QI) initiative was developed using the plan-do-act-check model and the evaluation of the initiative was the focus of the current project. The project question asked if a quality improvement initiative for weight loss monitoring and counseling could improve …

Health Promoting Behaviors Of Young Adults With Chronic Lyme Disease, Patricia D. Bolivar

Walden Dissertations and Doctoral Studies

Lyme disease is the most prevalent arthropod-borne (tick) disease in North America. The disease is more prevalent in some Eastern and Central states than in Western states. The general problem is that, in southern California especially in Los Angeles County, both patients and practitioners fail to recognize the disease, resulting in misdiagnosis and delayed treatment. Consequently, the patient may develop the long-term, chronic Lyme disease (CLD). The purpose of this phenomenological study was to explore the impact of CLD on the health-promoting behaviors of ethnically diverse young adults from similar educational and socioeconomic backgrounds based on their lived experiences. The …

Hand Expression With Lactation Support: Effect On Self-Efficacy And Breastfeeding Duration, Florence Omekara

Walden Dissertations and Doctoral Studies

Breastfeeding is the best infant feeding method, and breastmilk has many immunological and anti-inflammatory properties that protect babies against illnesses and diseases. It protects the health of the mother and saves society substantial economic costs, as demonstrated in many studies. Studies show that if 90% of U.S mothers breastfed for 6 months, up to $13 billion in healthcare costs could be saved. Despite the health and economic benefits of breastfeeding, most women stop breastfeeding before 6 months postpartum, which falls short of the recommendations of the World Health Organization, U.S. Surgeon General, and American Academy of Pediatrics. This study explored …

Variables That Impact Incidence Of Diarrhea Amongst Under-Five In Uganda, Anne Ngonde Muli

Walden Dissertations and Doctoral Studies

Diarrhea in children remains a major public health problem in Uganda and other countries in the region and acts as one of the leading contributors to child mortality. Most of the risk factors for diarrhea in children are preventable. This study, guided by the socioecological model, was conducted to investigate the association between the occurrence of diarrhea in children and length of breastfeeding, coinfection with acute respiratory infection (ARI), and vaccination status of the child. These variables were identified in the literature as risk factors for diarrhea that had not been investigated in Uganda. The source of the data for …