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Hiv Risk Perceptions Of Hiv-Infected Adults Ages 30 To 49 Years In Atlanta, Georgia, Esther Nduta Mune-Ashford

Walden Dissertations and Doctoral Studies

More than 49,081 people were diagnosed with HIV in the United States in 2011. Of those 49,081 HIV-infected persons, 1 in 6 was not aware of being HIV positive. In 2011, Georgia had the 5th highest number of HIV diagnoses among the 50 U.S. states. This phenomenological study aimed to understand the lived experiences of HIV-infected adults, ages 30 to 49 years in Atlanta, Georgia, by understanding their perceptions of risk prior to contracting HIV. The health belief model was used to guide this study because it explains and predicts health-related behaviors and it has been used in previous studies …

Public Health Leaders' Perceptions Of And Attitudes Concerning Eating Disorders, Karin L. Lightfoot

Walden Dissertations and Doctoral Studies

Eating disorders are associated with high mortality rates. Most eating disorder prevention research is conducted within the fields of psychology and psychiatry, not in public health. This gap in public health research can lead to insufficient attention to the root causes of eating disorders and minimal upstream prevention efforts. The purpose of this phenomenological study was to identify public health leaders' perceptions of and attitudes concerning eating disorders as a public health issue. Objectification theory was used to describe how societal expectations have created an environment in which people's self-worth is based on their outward physical appearance. Ecological theory was …

Relationship Between Family Income And Obesity Among African American Adults, Charles Dadzie Boison

Walden Dissertations and Doctoral Studies

Obesity is a chronic disease that is caused by a number of factors such as diet, genetics, physical inactivity, and poor dietary habits. This research focused on how income affects obesity among a target population in the African American community in Durham, North Carolina (NC). It has been noted that chronic diseases that are diet-related, for example, obesity, diabetes, hypertension, and high cholesterol, affect African Americans disproportionately, especially those who earn low income. Some studies have also reported that those who make higher income have higher rates of obesity. This inconsistency and gap in the literature prompted research on this …

The Effectiveness Of An Organizational Hospital-Acquired Pressure Ulcer Prevention Workshop On Pressure Ulcer Prevalence Rates, Stacey Johnson

Walden Dissertations and Doctoral Studies

The goal of this project was to evaluate a hospital acquired pressure ulcer (HAPU) prevention program implemented in a New York City hospital in 2012. The program objective was to encourage collaboration of team members to prevent HAPUs in order to reduce prevalence rates to national target benchmarks. The program provided caregivers information about epidemiology, etiology, prevention, and treatment of HAPUs, and presented HAPU prevention as a collaborative process in order to foster greater awareness in each participant's role as an agent of change by emphasizing the importance of communication between members of the health care team. This project evaluated …

Comparison Of Thyroid Disease Mortality Between Urban And Rural Populations In Southwest Georgia, Donyale Bouie Childs

Walden Dissertations and Doctoral Studies

Twenty million people in the United States have some form of thyroid disease. In 2014, there were 62,980 new cases of thyroid cancer and 1,890 deaths. Water source is a known risk factor for thyroid disease. Pollutants that are known to alter thyroid function can find their way into water sources. The effect of various water sources on thyroid- related mortality has not been determined in the state of Georgia. The purpose of this correlational study was to investigate whether invasive thyroid disease mortality differs between urban participants who drank municipal water and rural participants who drank untreated water in …

Initiating Nicotine Cessation In A Community Mental Health Center, Rosalind R. Keith

Walden Dissertations and Doctoral Studies

Individuals suffering from mental illness are often adversely affected by tobacco use. Historically, clinicians are reluctant and inadequately prepared to recognize and treat comorbid nicotine addiction in the chronic mentally ill (CMI) client. As evidenced by a review of the literature, healthcare providers are missing opportunities for nicotine cessation treatment. There is a lack of educational preparation amongst clinicians to treat nicotine addition and a concern that treatment of nicotine addiction can negatively impact existing psychiatric disorders. The purpose of this project was to create an educational plan for nicotine cessation for CMI clients at a community health center. The …

Improving Quality Of Life In Older Adults With Depression And Diabetes Through Medication Compliance Education, Valreen Hinds-Beharrie

Walden Dissertations and Doctoral Studies

Improving Quality-of-Life in Older Adults with Depression and Diabetes through Medication Compliance Education

by

Valreen Hinds-Beharrie

MSN, Adelphi University, 1997

BSN, Adelphi University, 1986

Project Submitted in Partial Fulfillment

of the Requirement for the Degree of

Doctor of Nursing Practice

Walden University

March 2016

Diabetes and depression are prevalent diseases that cause morbidity and mortality. Diabetes is a heterogeneous metabolic disease in which hypoglycemia is a central feature. Depression is associated with increased counter-regulatory, hormone release, and alteration in glucose transport function. Depression occurs in some individuals with diabetes and is associated with poor metabolic control, inadequate control of diet, …

Chronic Disease Self-Management Program, Raquel Marie Biati

Walden Dissertations and Doctoral Studies

The World Health Organization noted that 2 global health problems have reached epidemic proportions: obesity and type 2 diabetes. These conditions affect nearly 170 million people worldwide. The clinical practice problem addressed by this project was the prevalence of adults ages 50 and older in an ambulatory care setting who suffer from obesity and diabetes and may benefit from a tailored weight management and nutrition education intervention. The purpose of this project was to design a program that would decrease body mass index and hemoglobin A1c in older patients through adaption of the Chronic Disease Self-Management Program. The evidence supporting …

Health Literacy Program Proposal For Health Care Workers, Shevon Naomi Howard

Walden Dissertations and Doctoral Studies

Health information literacy influences patient health outcomes, yet almost 90% of adults

struggle to understand health information. This study explored the impact of an education course in health literacy on healthcare professionals' methods of providing information to patients in order to increase effective communication and improve patient outcomes. This study drew from an integrated theoretical framework that suggests development and validation of tools to measure health literacy. Access to and understanding of reliable, high-quality health care information equalizes many other variables that impact health outcomes, including age, economic class, and cultural background. This study analyzed survey data collected from 2 …

Influence Of Patient Engagement Protocol On Health Outcomes And Medication Adherence Of Patients With Metabolic Syndrome, Angela H. Mcconnell

Walden Dissertations and Doctoral Studies

August 2016

Management of metabolic syndrome (MetS) may be enhanced by promoting patient engagement. Training health care providers in the conceptual and practical application of integrative patient centered care tools may promote patient lifestyle behaviors for better management of MetS. The purpose of this quantitative quasi-experimental study was to assess the impact of training providers in integrative patient centered care for patients with MetS. The biopsychosocial construct provided the conceptual framework for the study. Two groups of physicians were included; one received training in an integrative model (IM) while the second received no training and provided usual care (UC). Following …

Stereotype Threat And Work Attitudes Of Older Workers, Cheryl A. Countryman

Walden Dissertations and Doctoral Studies

Abstract

Despite an aging U. S. workforce, age discrimination at work remains an issue. Researchers have found that beliefs about the aging process affect workers' performance and attitudes. There is little research available examining this phenomenon from the perception of older workers. The purpose of this qualitative phenomenological study was to understand the lived experiences of 7 workers aged 55 and older regarding ageism through the theoretical framework of stereotype threat theory. Research questions focused on identifying age-related stereotypes held by the participants, the influence of those stereotypes on perceptions of aging, perception of the impact of aging on job …

The Effect Of Dietary Fruits & Vegetable Consumption And Physical Activity On Obesity In African American Adolescent Females., Tanisha Brooks

Walden Dissertations and Doctoral Studies

Obesity is epidemic among Black adolescent females, and adolescent obesity often leads to adult obesity. Previous research suggests that there may be an interaction between physical activity and dietary fruit and vegetable intake on body mass index (BMI) in obese adolescent females in general, but it was unclear whether the same pattern is evident in Black adolescent females, who, on average, tend to have low levels of physical activity and fruit and vegetable intake. Bandura's social learning theory implies the possibility that adolescent females might model their behaviors on the behavior of others in their high school years, including physical …

Low-Income African American Parents' Perception And Influence On Childhood Obesity, Vickie Sims-Johnson

Walden Dissertations and Doctoral Studies

Childhood obesity affects children from every socioeconomic level, but there is a higher prevalence of obesity among preschool-age children from low-income families. Some obese children are experiencing symptoms (e.g., high cholesterol and diabetes) generally experienced by adults. As a result, healthcare costs have increased. The purpose of this qualitative phenomenological study was to understand how low-income African American parents contribute to the prevalence of obesity in preschoolers. The conceptual framework and constructs from the health belief model (HBM) guided this study. Interview data were gathered from 8 participants who met the inclusion criteria of being a low-income African American parent …

Impact Of Poverty On Undocumented Immigrants In South Florida, Julio Warner Loiseau

Walden Dissertations and Doctoral Studies

Poverty in the United States has been widely explored, but very seldom does research consider the impacts of poverty among undocumented immigrants. As a result, policymakers are unable to account for or accommodate the unique needs of undocumented immigrants. Using Dalton's theory of the psychology of poverty, this case study explored the experiences of undocumented immigrants in Immokalee, Florida to better understand how the current policy landscape impacts their existence and livelihoods. The data were collected through 18 interviews with undocumented immigrants and a review of government data related to poverty among this population from the United States Census Bureau, …

Leadership Skills For Success Of Home Health Care Agencies, Andrina Yankah

Walden Dissertations and Doctoral Studies

Small business managers often lack the leadership skills necessary to sustain their businesses beyond 5 years. The United States Small Business Administration reported that more than 65% of small business owners, including home health care agency managers, fail within the first 5 years of operation. Guided by Burns and Bass's transformational leadership theory, this multiple case study explored leadership skills that managers in home health care agencies need to sustain their new businesses beyond 5 years. The purposeful sample comprised of 3 managers from 3 different home health care agencies within a 75-mile radius of Baltimore, Maryland, that had demonstrated …

Impact Of Simulation On Nurses' Satisfaction, Confidence, And Communication In Neonatal Resuscitation, Kathryn Rudd

Walden Dissertations and Doctoral Studies

Teamwork and communication in clinical practice improves with simulation using the TeamSTEPPS program. However, there is limited research about simulation efficacy for improving neonatal resuscitation through enhanced communication. Based on a needs assessment and literature review specific to quality improvement strategies for neonatal resuscitation, an enhanced neonatal resuscitation provider (NRP) course was infused with TeamSTEPPS communication strategies, and an NRP case was adopted for simulation training. Also, utilizing clinician feedback, the flow of the resuscitation documentation was revised. The purpose of this project was to evaluate the perceived level of confidence, satisfaction, and communication skills in nurses performing neonatal resuscitation …

Predicting Mathematics Teachers' Acceptance Of Reflective Blogging To Improve Instruction, Diana Sue Fesmire

Walden Dissertations and Doctoral Studies

An internal district audit identified that a rural, socioeconomically disadvantaged Southwestern school district has a lack of congruent and consistent implementation of the Common Core State Standards in mathematics. Innovative and cost-saving avenues for professional development (PD), such as reflective blogging, foster teacher learning to reconcile the enacted curriculum with the intended curriculum. This correlational study investigated the predictive power of technology acceptance and motivation constructs on reflective mathematics teachers' social media use intention and participation in informal, virtual Communities of Practice (vCoP). The framework that guided this study is the unified acceptance and use of technology and self-determination theory. …

The Gender-Responsive Approach For The Female Delinquent, Jeanette Alexandria Martin

Walden Dissertations and Doctoral Studies

The number of females arrested for violent crimes has increased. The juvenile justice system continues to be challenged with developing gender-based treatment strategies to accommodate female delinquents. The purpose of this study was to examine probation officers' perceptions of the treatment provided for female delinquents and its ability to rehabilitate, reduce recidivism, and promote successful transition among female delinquents. The framework of this study encompassed the feminist theory from a criminology perspective. Data collection included interviews with 5 probation officers in El Paso County's Juvenile Justice Detention Center. Interviews were reviewed to generate a summary of relevancy. Themes and codes …

Type 2 Diabetes In Offspring Of Diabetic African American Women, Toby Valentino Yak

Walden Dissertations and Doctoral Studies

The prevalence of Type 2 diabetes is greater among African American women and their offspring than it is among Caucasian women and their offspring. In Iowa, there has been a gap in public health knowledge regarding risk factors associated with Type 2 diabetes in African American women and their offspring. The behavioral change wheel model was used to guide this study. This research study was a quantitative, retrospective cohort using primary data to investigate the association between a sample of diabetic African American and the occurrence of diabetes in their offspring. The sample included 105 diabetic African American women between …

Behavioral Modification And Relapse Rates In Opioid-Dependent Pregnant Women Managed With Subutex, Tammy Lynn Minor

Walden Dissertations and Doctoral Studies

Behavioral Modification and Relapse Rates in

Opioid-Dependent Pregnant Women Managed with Subutex

by

Tammy Minor

MSN, Walden University, 2009

BSN, Marshall University, 1986

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

March 2016

Opioid dependency affects not only the individual who is dependent on opioids but negatively impactsalso the family unit, the community, and society as a whole. Opioid use in the prenatal period can have devastating effects on both the mother and the fetus. The purpose of this paper is to perform a secondary analysis of the effectiveness of …

An Obesity Needs Assessment With African American Adults In Central Virginia, Nicole Michelle Brown

Walden Dissertations and Doctoral Studies

The risk for obesity is especially prevalent among African American adults in Central Virginia, who have one of the highest rates of obesity in the nation. Efforts to address obesity in African American adults through diet, weight reduction, and increased physical activity in settings such as schools, worksites, healthcare organizations, churches, and communities, are among the initiatives of Healthy People 2020. The objective of this project, conducted with 91 African American adults (33 females and 58 males) in central Virginia, was to complete a community needs assessment that related to obesity among members of an African American church. The needs …

Diabetes Mellitus Type 2: A Quality Improvement And Patient Safety Initiative, Remeliza Navarrete Tukay

Walden Dissertations and Doctoral Studies

The purpose of the quality improvement (QI) project was to examine the relationship between amended nursing education concerning diabetes mellitus (DM) Type 2 self-care management incorporating Tune in, Explore, Assist, Communicate, and Honor (TEACH) and Motivational Interviewing (MI) strategies and techniques and the Glycosylated hemoglobin (HgbA1C) of veteran patients with uncontrolled diabetes. The target sample included the 2 licensed practical nurses and 2 registered nurses assigned to 2 primary care teams, and the 10 purposively sampled patients with uncontrolled DM Type 2 from each team. The nurses' competencies were measured through descriptive comparison before and after nursing education implementation using …

Influence Of Teacher Participation On Student Fitness And Student Participation In Physical Education, Whitney Morris

Walden Dissertations and Doctoral Studies

Physical activity plays a key role in the health of children. Childhood obesity is increasing in the United States, and children are spending less time being physically active. Active participation by a physical education (PE) teacher in physical activities has been suggested as a means of promoting student fitness. The purpose of this quasi-experimental quantitative study was to determine whether modeling of physical activity by a PE teacher would increase student participation and physical fitness. Bandura's social learning theory provided the theoretical framework for the study. Participants included 311 4th and 5th grade elementary students enrolled in physical education classes. …

Developing A Guideline For Care Of Students With Diabetes, Rita Ozioma Onwenna-Aninyei

Walden Dissertations and Doctoral Studies

Diabetes mellitus (DM) is one of the most common chronic diseases affecting children under the age of 20, and it often leads to serious complications. In recent decades, there has been an increase in incidence of both types of DM among U.S. children. Having this chronic condition not only negatively impacts the health of these children but also their academic achievements. School health nurses struggle to manage these children appropriately and safely. The purpose of this project was to develop an evidence- based guideline for a standardized process in which school nurses coordinate the school and student health care teams …

Exploring An African American Principal's Cultural Leadership Effects On Closing The Achievement Gap, Doristine Cornelius

Walden Dissertations and Doctoral Studies

Closing the achievement gap is a key concern for educational leaders. Research has indicated that principals’ actions directly and indirectly influence student learning. The purpose of this case study was to explore cultural leadership in an urban Mississippi high school from an African American’s racialized perspective. The cultural competency/proficiency theory provided the conceptual framework for this study. Successful leadership practices of this African American principal were examined through the principal and through the perceptions of teachers and the assistant administrator. A researcher-developed questionnaire was content validated and given to a purposeful sample of 17 individuals: the principal, assistant principal, and …

Promoting Diabetes Self-Managment Eduaction And Training In Out-Patient Clinics, Inemesit Godwin Udo

Walden Dissertations and Doctoral Studies

Abstract

Type 2 diabetes mellitus (T2DM) is a long term metabolic disorder characterized by high blood sugar, insulin resistance, and relative lack of insulin. T2DM is a leading cause of cardiovascular disease, blindness, kidney failure, lower-limb amputation, and other complications that are costly to patients and the U.S. health care system. Lack of knowledge and underdeveloped skills for self-management of diabetes continues to be the biggest problem for patients with T2DM. Using a team approach and Rosswurm and Larrabee's (1999) conceptual model as a framework, the purpose of this doctorate of nursing practice quality improvement project was to develop an …

Impact Of Medicare And Medicaid Beneficiaries With Selected Conditions On Emergency Department Utilization, John K. Amoh

Walden Dissertations and Doctoral Studies

Chronic Obstructive Pulmonary Disease (COPD) and Congestive Heart Failure (CHF) are conditions that represent significant and ongoing medical costs, including frequent emergency department (ED) visits, hospitalizations, work absences, and disability. This retrospective cross-sectional study, examined the effects of the frequent ED visits due to COPD and CHF on the beneficiaries of Medicare and Medicaid in Maryland. The goal was to identify the factors that led these patients to visit the ED, the impact of these visits on Medicare utilization and costs across Maryland, and preventative intervention strategies to control this population's costs of care. Secondary data were analyzed from 2010-2012 …

Effect Of Reduced-Fee Dental Hygiene Treatment And Oral Health Perceptions Among Socioeconomically Deprived Persons, Janeime Necole Asbury

Walden Dissertations and Doctoral Studies

Access to oral health care remains problematic for millions of Americans. Factors such as socioeconomic status, age, race, and lack of dental insurance benefits inhibit the ability of many to obtain preventative oral health care. The aim of this study was to explore the effect of preventive oral health treatment and education at reduced-fee dental hygiene facilities on the oral health behaviors and perceptions of socioeconomically deprived persons within the state of Georgia. This study was based on the health belief model constructs. A convenience sample of 102 participants was recruited from the individuals who visited two dental hygiene colleges …

Gestational Age, Birth Weight, And Incidence Of Adult Type 2 Diabetes Among Southeast Alaska Natives, Renee Elaine Crawford

Walden Dissertations and Doctoral Studies

American Indian and Alaska Native adults are 2.6 times more likely to have adult onset diabetes resulting from higher weight at birth. Pregnant women, providers, and Indian Health Service administrators may benefit from timely information during pregnancy to intervene and prevent Type 2 diabetes. The purpose of this study was to examine the role of birth weight in the development of Type 2 diabetes among Southeast Alaska (SEA) Natives. Guided by the socioecological model, this study examined the extent to which birth weight and gestational age predict the incidence of Type 2 diabetes. The study used a quantitative research design …

Influences Of Nutritional Food Label Understanding In African-American Women With Obesity, Cynthia Jean Hickman

Walden Dissertations and Doctoral Studies

Nutritional food label understanding (NFLU) in African American Women (AAW) is a philosophy that addresses obesity. Public health efforts have implemented nutritional and caloric information to packaged and restaurant foods to improve nutrient and calorie literacy. Research suggest NFLU might have a minimal effect on reducing obesity. However, it is not known how obese AAW born during the baby-boom era (51 to 64 years of age) perceive NFLU in relation to their dietary behaviors. The purpose of this phenomenological study was to understand the lived experience of obese AAW regarding NFLU from a cognitive and behavioral perspective. Twelve, AAW answered …