Digital Commons Network^™

Influence Of Maternal Psychosocial Health On Infant Feeding Practices, Tessy Linda Aguzie

Walden Dissertations and Doctoral Studies

Choice of nutrition has a great effect on the early development of human growth. Despite increased knowledge on the benefit of breastfeeding to both mother and child, some mothers still choose to formula feed. The purpose of this study is to explain how maternal health contributes to choices. The theory of maternal role attainment and the social cognitive theory are used to evaluate these feeding choices. This study tests for the association between maternal weight status and choice of infant feeding practices, the association between postpartum depression and choice of feeding and finally, if depression mediates the relationship between maternal …

Evaluating The Impact Of An Evidence- Based Weight Reduction Program Among The Obese At A Medical Facility In North Central United States, Petronilla Eke

Walden Dissertations and Doctoral Studies

In September 2016, the Centers for Disease Control and Prevention (CDC) determined that more than one-third (36.5%) of U.S. adults have an obesity problem. According to the CDC, this issue results in other medical conditions such as type 11 diabetes, hypertension, cancer, heart disease, and stroke. This project was designed to evaluate the effectiveness of an evidence-based weight reduction program for obese individuals at a medical facility in the North Central United States. The methodology used consisted of a retrospective chart review of pre- and post-data for 45 people who participated in the medical facility's weight-reduction program over a 6 …

Possible Risk Factors For Multidrug-Resistant Tuberculosis Infection In The Philippines, Molovon Jr Pasagui Azores

Walden Dissertations and Doctoral Studies

Multidrug-resistant Mycobacterium tuberculosis (MDR-TB) is a leading cause of morbidity and mortality in the Philippines. The purpose of this study was to gain knowledge about the relationship between potential risk factors and MDR-TB. Risk factors (the independent variables) for MDR-TB (the dependent variable) include previous TB treatment, infection with HIV, exposure to patients with drug-susceptible TB/MDR-TB, delays in diagnosis and treatment, employment status, smoking, imprisonment, alcohol abuse, and poor compliance with TB treatment regimens. The study was based on the epidemiological approach to causal inference work. A case-control study design was used wherein a quantitative method was applied in data …

Academic Achievement In Schoolwide Title 1 Elementary Schools, Kelli K. Cronin

Walden Dissertations and Doctoral Studies

Title I federal funds are provided to schools with high percentages of children from low-income families to help ensure that all students meet academic standards. Despite this and other efforts by the federal government to assist low-income families with the problems associated with poverty, the minimum proficiency levels required by the No Child Left Behind Act have not been met by all students. Little research has been conducted to assess performance of South Dakota schools receiving federal funding under Title 1 to alleviate these deficits in academic achievement. The purpose of this study was to determine whether Title 1 had …

Biosociocultural Factors And Motivation To Lose Weight Among Obese African American Women, Odette Marie Russell

Walden Dissertations and Doctoral Studies

Obesity is a pandemic that has a substantial impact among African American women. Biological, social, and cultural acceptance of obesity, collectively referred to as biosociocultural factors, represents an obstacle to efforts to address this health risk among this group. The purpose of this study was to develop a better understanding of the relationship between biosociocultural factors and motivation to lose weight. Self-determination theory, objectification theory, and social learning theory formed the study's theoretical framework. The key research question concerned the extent to which the investigated constructs (BMI, internalized body image, and social networks) helped to explain motivation for weight loss …

Adherence Barriers To Healthcare For African Americans With Hiv/Aids On Antiretroviral Medications, Angela Bumphus Corbin

Walden Dissertations and Doctoral Studies

The purpose of this mixed methods research study was to examine the role of adherence barriers to healthcare and the impact that such barriers have on highly active antiretroviral therapy (HAART) compliance for African Americans living with HIV/AIDS. HAART helps reduce HIV/AIDS morbidity and mortality. Of the 49% of study participants who had been out of medical care for more than 12 months, financial concerns were listed as the most common barrier (22.8%). Not having the support from family and friends (17.5%), being tired of going to doctor appointments (15.8%), health challenges (12.3%), lack of transportation (12.3%), and incarceration (12.3%) …

Health Disparity In Preventive Care Among Nigerian Immigrants In The United States, Loveday E. Nwobilor

Walden Dissertations and Doctoral Studies

The roles of immigration status in preventive health care services among Nigerian immigrants in the United States were investigated in this quantitative, cross-sectional survey study. About 260,724 Nigerian immigrants reside in the Unites States, but many do not complete lifesaving preventive health services such as immunization and screening, a major factor contributing to the rise in the cost of healthcare resultant from their use of emergency room services. This study investigated the extent to which immigration status independently explains the relationship between health disparities and risks in non-completion of preventive health care among Nigerian immigrants in the United States by …

Discovering Opportunities To Improve Profitability At A Federally Qualified Health Center, Robert Jackson Jackson

Walden Dissertations and Doctoral Studies

Federally Qualified Health Center (FQHC) organizations, which provide health care services to low-income, underserved patients, are underfunded. From 2000 to 2007, the cost of treating an FQHC patient increased by $146, while federal compensation to FQHCs increased by only $44 per patient. One FQHC organization in rural Alabama experienced financial losses from the fiscal year 2011 through 2014, jeopardizing services to approximately 6,000 low-income patients. The purpose of this qualitative case study was to analyze the subject organization and discover opportunities to improve financial performance. The research question pertained to the opportunities for improving profitability at the subject organization. The …

Impact Of Osteoarthritis Self-Efficacy Toolkit On Adults With Osteoarthritis, Connie Hutley Kiser

Walden Dissertations and Doctoral Studies

Over 26 million U.S. citizens have a form of arthritis; osteoarthritis (OA) is the most common form. Self-efficacy (SE) is defined as a psychological construct which identifies an individual's confidence when performing a behavior. SE is deemed a vital judge of self-management (SM) in those with OA. The purpose of this evidence-based practice, quality improvement project was to improve SE in OA patients. The identified gap in nursing practice was the lack of SE in OA patients. The project question asked whether a toolkit with information regarding SE in OA can improve SE of management of disease-associated symptoms in adults …

Health Promotion Behavior Among Hypertensive And Normotensive Armenian Americans, Zoya Minasyan

Walden Dissertations and Doctoral Studies

Hypertension presents a significant health risk to both developed and developing countries, affecting approximately 78 million Americans of various ethnic backgrounds. Though a great deal of research about hypertension and minority groups has been published, few studies have examined hypertension in the Armenian American population in the Los Angeles area, one of the most concentrated Armenian American communities in the United States. The purpose of this study was to examine the differences in health promotion behavior between hypertensive and normotensive Armenian Americans. The theoretical basis for this study was Pender's health promotion model and the health promoting lifestyle profile (HPLP-II), …

Perceived Job Stress And Life Style Behaviors' Effects On The Quality Of Life Of Registered Nurses, Jennifer Rose Limongiello

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to examine to what extent work demands as measured by perceived job stress affected the health-related quality of life (HRQOL) as determined by the number of unhealthy days of registered nurses in the United States. This study was also an investigation of the extent to which other variables such as body-mass index (BMI) and certain lifestyle behaviors affected the HRQOL (number of unhealthy days). The independent variables were perceived job stress, weight (BMI), and lifestyle factors such as tobacco and alcohol use, physical inactivity, and the mindful eating score, and the dependent variable …

Generational Communications In The New York City Public Sector Workplace, Nathasha Anita Brooks-Harris

Walden Dissertations and Doctoral Studies

Walden University

College of Social and Behavioral Sciences

This is to certify that the doctoral dissertation by

Nathasha Brooks-Harris

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. Mark Gordon, Committee Chairperson,

Public Policy and Administration Faculty

Dr. Michael Knight, Committee Member,

Public Policy and Administration Faculty

Dr. Michael Brewer, University Reviewer,

Public Policy and Administration Faculty

Chief Academic Officer

Eric Riedel, Ph.D.

Walden University

2017

There is a digital divide between Baby Boomers and Millennials in the way they communicate …

Spiritual Leadership: Achieving Positive Health Outcomes In African-American Christian Churches, Cynthia Bracey

Walden Dissertations and Doctoral Studies

In the United States, African-American residents are an underserved population with evidence of higher health disparities than those associated with any other race, contributing to escalating health care costs. Despite the absence of health promotion and wellness training, pastors in predominately Black churches accept the responsibility for addressing more than the spiritual needs of their church members. The purpose of this qualitative grounded theory research study was to explore the perspectives of African-American Christian pastors on giving health guidance and their lived experiences as health promotion advocates. A total of 10 African-American Christian pastors were voluntarily recruited from 3 southern …

A Minority Perspective On The Public Health Response To The Obesity Epidemic, Rickey L. Ford

Walden Dissertations and Doctoral Studies

Obesity is currently viewed as one of the most important health concerns in the United States. Researchers have minimally investigated perspectives surrounding obesity within the African-American female population. This lack of research presented a gap in knowledge concerning the perceived social, environmental, and cultural influences of obesity within this population. The research questions asked African-American females about their views toward these influences. This research was guided by tenets of the social cognitive theory and the transtheoretical model for behavioral change. Thirteen African-American females participated in the interviews. The data collected were reviewed and coded using word frequencies and themes. Findings …

Association Between Age-Related Macular Degeneration And Sleep-Disordered Breathing, Jeffrey A. Nau

Walden Dissertations and Doctoral Studies

Age-related macular degeneration (AMD) is a chronic, irreversible disease that robs individuals of vision, quality of life, and independence. It is the leading cause of blindness in industrialized countries. Sleep-disordered breathing (SDB) is a condition characterized by repeated episodes of apnea and/or hypopnea, insomnia, short sleep duration, and/or sleep disturbances (snoring, gasping, etc.). Because SDB has been shown to cause chronic hypoxia resulting in oxidative stress on the retina, it has been proposed that SDB may be associated with AMD. Based on the life course theory of chronic disease, this quantitative, cross-sectional study used data from the 2005-2008 National Health …

Perceptions Of Childhood Obesity Among African Americans In A Low-Income Community, Cotella Wilkes Wilkes

Walden Dissertations and Doctoral Studies

Childhood obesity is a prevalent chronic condition affecting millions of children and adolescents in the United States and is rising in record-breaking numbers among African Americans in low-income communities. Guided by the social cognitive theory, the purpose of this evidence-based project was to understand the impact of an educational intervention on parents' perceptions of childhood obesity risk factors, weight status, and prevention strategies in a rural South Carolina community. A convenience sample of parents who attended a church-based community health promotion service in a low-income area (n = 10), aged 28 to 54, completed The Childhood Obesity Perceptions survey before …

The Association Between Dietary Flavonoid Intake And Chronic Obstructive Pulmonary Disease, Systemic Inflammation, And Comorbidity Burden, Tennador Sanderson

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality in the United States. Dietary habits may have an impact on COPD through anti-inflammatory mechanisms. For this cross-sectional secondary data analysis study, the advanced model of the epidemiology triangle was used as a guide to assess the association between total daily flavonoid intake and COPD diagnosis, COPD severity, systemic inflammation, and comorbidity burden. Data from over 5,100 male and female participants aged 30 and older were obtained from the 2007-2010 National Health and Nutrition Examination Survey. The prevalence of COPD was 5.2% according to spirometry data. Multiple …

Autonomy Supportive Teaching Strategies And Student Motivation In Middle School Physical Education, Amanda Lynn Savage-Speegle

Walden Dissertations and Doctoral Studies

Many U.S. adolescents struggle with obesity and a lack of motivation to be healthy and physically active, which affects individual as well as public health. The purpose of this mixed-method study was to evaluate students' motivation to participate in physical education class and better understand the teaching strategies currently used by physical education teachers who participated in an interview and 2 observations. Self-determination theory framed the research questions, which focused on students' intrinsic motivation to participate in physical education class and physical education teachers' use of autonomy supportive teaching strategies. Learning Climate and Basic Need surveys were administered to 6th-8th …

Parents' And Teachers' Perspectives Regarding Parental Involvement And Student Achievement, Christi Nelson Walker

Walden Dissertations and Doctoral Studies

The U.S. government has stated in federal guidelines that parents must be involved in their children's education in order for student achievement to increase. For more than 5 years, a small rural middle school in Mississippi was designated a low-performing school due to its failure to achieve the required standards for quality distribution index and adequate yearly progress on the Mississippi Curriculum Test, 2nd Edition. The purpose of this study was to examine whether parents' and teachers' perspectives regarding parental involvement and student achievement differed at the school. Epstein's theoretical framework was used as the basis for this quantitative study. …

The Use Of A Patient Mobility Sensor To Decrease Hospital-Acquired Pressure Ulcers, Monica Vassallo Shallow

Walden Dissertations and Doctoral Studies

Pressure ulcers are a serious health condition that have negative consequences for patients and organizations. The primary cause of pressure ulcers is intense and/or prolonged pressure or pressure in combination with shear that results in damage to the skin and underlying soft tissue. Early identification of patients at risk for pressure ulcers and 2-hour repositioning to off-load pressure are key components in reducing pressure ulcer development. Despite ongoing efforts to prevent pressure ulcers, the incidence and prevalence of hospital-acquired pressure ulcers (HAPUs) at the practicum site exceeded the benchmark for Magnet hospitals and the health system's goal of 1%. Patient …

Nonresidential Fathers Parenting Their Children Residing In Shelters: A Phenomenological Study, Karen Denise Hudson

Walden Dissertations and Doctoral Studies

This phenomenological qualitative study explored the parenting role of nonresidential fathers of children living in shelters. Special attention was paid to the perceived contributions of these fathers to the overall health and general well-being of their children residing in shelters. Often separations of nonresidential fathers from their children in shelters decreased their contributions to their children's health and well-being. Increased knowledge of these parental roles and contributions can enhance programs and policies to support these fathers in improving the health and well-being of their children. In-depth semistructured interviews were conducted with 6 demographically diverse nonresidential fathers living in Philadelphia. The …

A Clinical Practice Guideline To Reduce Behavioral Outbursts In Veterans With Posttraumatic Stress Disorder, Mary Adejumoke Badru

Walden Dissertations and Doctoral Studies

In a Department of Veterans Affairs hospital on the East Coast of the United States, behavioral outbursts result in 2 out of 10 veterans dismissed from a posttraumatic stress disorder (PTSD) unit prior to completing the 6-week program. The purpose of this evidence-based quality improvement project was to create a clinical practice guideline (CPG) based on social cognitive theory (SCT) to provide new strategies for managing veterans with PTSD and to improve the confidence of the nurses in managing outbursts. The Star Model guided the project development with the Delphi method to achieve participant consensus, the AGREE II to assess …

Nurse Practitioners' Guide On Consumption Of Hundred Percent Fruit Juice By Children, Monisola Adeyemo

Walden Dissertations and Doctoral Studies

Childhood obesity has reached an epidemic level in the United States, growing exponentially and posing a great risk to the current and future health of the American people. The trend of increasing incidence of overweight and obesity in children has been occurring for decades; there is a need for multimodal preventative solutions to control the rate of growth. Sufficient evidence has shown a correlation between the feeding of 100% fruit juice to infants as dietary supplements and childhood obesity. Therefore, the purpose of this project was development of a guideline for 100% fruit juice feeding in children that is adaptable …

Diabetes Self-Management Problems Of Older, Low-Income African American Women, Pearlean Day Day

Walden Dissertations and Doctoral Studies

Type 2 diabetes disproportionately affects low-income African American women, age 50 years and older: 30% to 40% of this population has this chronic disease. Two significant factors affecting poor diabetes practice adherence are food insecurity and depression; another is obesity. The purpose of this quantitative correlational study was to determine if either food insecurity or depression significantly affect Type 2 diabetes self-management practices; and/or if food insecurity significantly influences practice adherence indirectly, through the mediator of depression, while controlling for obesity. The research questions were aligned with the theoretical pathways posited in Matthews's reserve capacity model (RCM) and used the …

How Parenting Behaviors Influence Weight And Health Status Of African American Adolescents, Natasha T. Hourel

Walden Dissertations and Doctoral Studies

There has been an upward trend in obesity among African American (AA) adolescents over the last 2 decades. While parenting characteristics (e.g., styles and practices) are linked to adolescent eating habits and weight status, related research has focused on European American children from 2-parent middle-class households or economically disadvantaged AA children from single mother households. The purpose of this quantitative secondary data analysis was to investigate the relationship between parenting characteristics on the weight status of adolescents aged 12 to 17 years (n = 325) among a broader population of AA mothers and fathers residing both inside and outside of …

Experiences Of Middle-Aged, African American Women With Excessive Weight, Tina Ann Mcclaire

Walden Dissertations and Doctoral Studies

Obesity and overweight issues are nationally recognized crises for African American women. A noteworthy gap remains in the literature regarding this population's experiences with excessive weight, specifically, the role of culture and social support networks on their experience with being overweight. Without an understanding of the experience and meaning of being overweight for African American women, physicians and clinicians will not be able to fully support African American women in their weight loss journeys. Using the social learning theory as a framework, the purpose of this phenomenological research study was to explore experiences of obese or overweight middle-aged African American …

Quality Improvement Initiative To Reduce Fall Risk In The Snf, Ramona C. Lancaster

Walden Dissertations and Doctoral Studies

Residents who fall in SNF either sustain significant decline to quality of life or die from their injuries. The average fall costs about $34,000 per incident. On average, 19.8% of residents fall at least once per month. The purpose of this project was to assess, identify, and advance nursing practice to decrease falls by evaluating current facility standard of practice, fall policy, procedures, and protocol. The objective was to create actions that would close the communication gap between clinicians and residents. This project encourages clinicians to intertwine resident feedback and strategies into the plan of care to help reduce fall …

Relationship Between Project Managers’ Age, Years Of Project Experience, And Project Success, Luli Hoxha

Walden Dissertations and Doctoral Studies

Project failures are costly to businesses and are increasingly present in the news. In many industries, projects have a 40% failure rate, and 90% of venture capital projects fail even to start. Project managers play a key role in delivering successful projects. The purpose of this correlational study was to examine the relationship between project manager’s age and years of project experience and project success. The population of this study consisted of 108 active or former project managers working in Albania or Kosovo who were LinkedIn members. The study was not grounded in a named theory; rather, based on the …

Examining Binge Eating Rates Between Caucasian-American And African-American Men, Elizabeth Anne Raky

Walden Dissertations and Doctoral Studies

Eating disorders (ED) are maladaptive eating patterns that can have social, biological, health, and occupational consequences. The purpose of this study was to explore and compare binge eating episodes, locus of control, and body dissatisfaction between African-American men (n = 66; 53.70%) and Caucasian-American men (n = 57; 46.30%). There is a current gap in the existing literature regarding the study of men who BE and a sampling bias with regard to ethnic minorities. Based on Bandura's social learning theory model and Rotter's locus of control, the purpose of this research was to determine and compare the relationship between BE, …

Development And Validation Of An Adult Diet And Physical Activity Program In Primary Care Setting, Christiana Chinyere Keke-Ekekwe

Walden Dissertations and Doctoral Studies

Obesity is a national health problem with serious medical, psychological, and economic outcomes. Nurses and nurse practitioners (NPs) are frequently the first point of patient contact and play an essential role in the management of obesity. The current literature noted that practitioners working in primary care settings demonstrate inadequate knowledge related to evidence based practice (EBP) strategies to treat obesity, including diet modification and physical activity. The purpose of this DNP project was to develop and validate an EBP provider educational module related to diet modification and physical activity education for adult patients diagnosed with obesity in a primary care …