Digital Commons Network^™

Facilitators And Barriers To Physical Activity Among People With Spinal Cord Injury, Laura Nicole Richardson-Smith

Walden Dissertations and Doctoral Studies

Research has shown that people with physical disabilities are at risk for developing secondary health conditions. Many of these secondary health conditions may be reduced by engaging in physical activity, yet people with physical disabilities are less likely to participate in physical activity. Information gaps remain regarding facilitators and barriers to physical activity. The purpose of this phenomenological study was to understand the experiences with physical activity among adults with a spinal cord injury (SCI). Research questions asked were about exercise experiences, barriers and facilitators, and the role of the natural and social environment. The theoretical framework used was the …

The Effects Of Maturational Variation On The Performance Of Young Australian Footballers And Their Selection Into The Australian Football League's Talent Pathway, Ashley Cripps

Theses

Traditional player development pathways share a common goal, to identify and accelerate the development of talented adolescent players for senior competition. Players who gain selection into development programs gain greater access to experienced coaches, training facilities, support staff and competition. However, despite such advantages, research has shown that few players who gain initial selection into development pathways progress into professional senior competition. A major factor which potentially contributes to poor player retention in development pathways is the initial misidentification of talented athletes due to variations in biological maturity.

Earlier maturing individuals have been shown to be at a physical advantage …

Evaluating The Role Of Nurses In Educating Women During The Preconception Period, Oluwatoyin Ottun

Walden Dissertations and Doctoral Studies

Nurses play a crucial role in promoting educational programs aimed at informing women about their reproductive health. However, the role of nurses in providing the health related information is not well defined. Guided by the continuum model, this project evaluated nurses' perceived role in promoting the reproductive health of women during the preconception period. Twenty nurses from 2 outpatient offices wrote responses to an open-ended questionnaire. A summary of the responses indicated that 70% of the participants refer women to community-based programs to enhance awareness for preconception care. Twenty percent of the nurses indicated that they have an educational program …

Comparative Memory/Behavioral Symptoms Of Alzheimer's Disease: Eoad Vs. Load, Marcia Gale Roberson

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is a fatal disorder with no apparent cure. Early-onset AD (EOAD) occurs in individuals before the age of 65, and late-onset AD (LOAD) occurs in individuals age 65 and older. Past studies have proven that AD is fatal among Americans age 65 and older. The disease is characterized by impairments in memory and executive function as well as other cognitive and behavioral problems. The research questions addressed by this sequential, mixed-method study compared EOAD and LOAD by exploring common behavioral/cognitive symptoms and stage levels of AD. Research participants were recruited from the Alzheimer's Association who were members …

Using Nutrition And Fitness Awareness To Reduce Overweight And Obesity In Adolescents, Allissa.Johnson Johnson

Walden Dissertations and Doctoral Studies

In the United States, adolescent obesity rates continue to increase unabated, yet there is a paucity of programs to address these conditions for this population. The current study evaluated an after-school program in California high schools that uses a mentoring model with youth to promote regular exercise and healthy food choices. It is grounded in Social Cognitive Theory which focuses on both the impact of the environment on shaping behaviors and the ability of an individual to construct his or her own suitable environment. A quantitative single-group pretest-posttest design using archived participant responses was utilized in order to determine whether …

Characteristics Of Adult Icu Patients With Device Associated Nosocomial Infections, Doramarie Arocha

Walden Dissertations and Doctoral Studies

Nosocomial infections are a cause of concern for hospital patients and the incidence rates of these infections are greater in intensive care units (ICUs) due to the invasive nature of treatments, additional risk factors and comorbidities, and therapies used. Invasive devices, such as vascular central lines, Foley catheters, and mechanical ventilators pose a risk for critically ill patients in the ICUs to develop device-related, healthcare-associated infections (HAI). The purpose of this study was to describe the epidemiological characteristics of patients who developed device-related HAIs within 3 ICU units (medical-surgical, cardiovascular, and neurosurgical) of an academic medical facility. The ecosocial theory …

A Comparative Analysis Of Meals Offered At Child Care Centers By Participation In A Child And Adult Care Food Program, Melissa Lynn Williams

Walden Dissertations and Doctoral Studies

Nearly 70% of preschool children in the United States are enrolled in child care facilities. This means that they eat many meals away from their homes. Despite government support for childhood nutrition through the Child and Adult Care Food Program (CACFP), research that measures the nutritional value of meals served in child care facilities has been lacking. The purpose of this quantitative study was to determine if there are differences in the calories and nutritional value of lunch meals offered to preschool children in facilities that participate in CACFP and in facilities that do not participate in CACFP. Ajzen's theory …

Adventist Affiliation And Type 2 Diabetes Pre- And Post-Complete Health Improvement Program (Chip), Janie Unruh

Walden Dissertations and Doctoral Studies

Adventists following a plant-based diet have half the prevalence and incidence of type 2 diabetes than nonvegetarian Adventists. This study used a quantitative, correlational study design to assess if there was a significant difference in type 2 diabetes prevalence rate between Adventists and non-Adventists preprogram, and if there were significant differences in biometrics between Adventists and non-Adventists with diabetes pre- and post-Complete Health Improvement Program (CHIP). This study incorporated the social ecological model for its conceptual framework and examined pre- and postprogram changes among Adventists (n=210; 20.1%) and non-Adventists (n=836; 79.9%) with type 2 diabetes. It used secondary data from …

Absenteeism In An International Custom Software Engineering Company, Jennifer M. Mudek

Walden Dissertations and Doctoral Studies

Absenteeism has a negative impact on organizational output in the form of lost productivity and profit reduction for software engineering companies. The purpose of this qualitative descriptive case study was to explore the strategies that software engineering managers utilize for reducing absenteeism. The theory of planned behavior formed the conceptual framework for this study. Data were collected through semistructured interviews from a purposeful sample of 11 managers at an international custom software engineering company. Data collection also included organizational data on employee absences for the past 5 years (2011-2015), e-mail memos, newsletters, employee handbook, and employee performance reviews. Based on …

Young Adults Adherence To Cancer Treatment As Compared To Older Adults, Laurie Ann Cox

Walden Dissertations and Doctoral Studies

As compared to pediatric and older adult cancer patients, young adults are the only oncology group that has not demonstrated an increase in survival rates. Low treatment adherence rates have been one explanation for this discrepancy, although this hypothesis has not been explored specifically. Guided by the biopsychosocial model of health and wellness, this study compared the treatment adherence rates of 46 young adult cancer patients (ages 18-39 years) to 46 older adult cancer patients (ages 40 years and older). Adherence was measured by a dichotomized variable, as yes/no, adhering to radiation treatment and follow-up appointments recommended by the physician, …

Diabetes Management Regimens And Cardiovascular Disease Risk In African American Men, Joseph Garilus

Walden Dissertations and Doctoral Studies

One of the most common health complications related to diabetes is the development of cardiovascular disease (CVD). Studies addressing the association between adherence to diabetes management regimens and the risk of CVD among minority populations are limited. This cross-sectional study was conducted to examine the association between diabetes management regimens and risk of CVD among African American men. The health belief model was used to frame the study. Data were collected from the Behavioral Risk Factor Surveillance System database for the states of Missouri and Ohio. Multiple logistic regression analysis was used to assess the association between adherence to diabetes …

Experiences Managing Type 1 Diabetes Mellitus Among Parents Of African-American Youth, Sonya T. Strider

Walden Dissertations and Doctoral Studies

Type 1 diabetes mellitus (T1DM) is one of the most frequently diagnosed endocrine and metabolic conditions that occur during childhood. This research study utilized a phenomenological study design to examine how the lived experiences of 20 African American (AA) parents of children with T1DM recruited using social media affects their management and control of the disease among AA youth age 5-17 years old. The interview questions were outlined in categories that tested key constructs of the health belief model (HBM) to determine the perceived barriers, seriousness, and susceptibility to maintaining good glycemic control for their children. Data from each interview …

Socioeconomic Status Mobility And Lifetime Exposure To Discrimination On Cardiovascular Disease Events, Nkenge H. Jones-Jack

Walden Dissertations and Doctoral Studies

Blacks in the United States have the highest rates of hypertension in the world, and their cardiovascular disease mortality rates are higher than for any other population group as a result of traditional risk factors such as obesity and stronger family history. However, additional underlying factors, such as social determinants of health (e.g., socioeconomic status [SES]) and macrosocial factors (e.g., racism), also correlate with adverse health outcomes. This study investigated whether the interaction between SES mobility over the lifecourse and lifetime racial discrimination influenced the extent to which hypertension contributed to the cardiovascular disease health disparities observed among Blacks in …

Communicating Periodontal Disease Risk To American Indian Patients With Diabetes, Jennifer Jordan

Walden Dissertations and Doctoral Studies

Type 2 diabetes is epidemic in the American Indian population. One problem health care providers face when working with the American Indian population is communicating about secondary complications, such as periodontal disease. From a public health standpoint, periodontal disease prevention is important not only to prevent unnecessary oral pain and tooth loss, but also to prevent other more serious systemic problems from occurring such as cardiovascular disease, strokes, and bacterial pneumonia. The purpose of this qualitative study was to examine the communication efforts of health care providers and understand if and how they discuss periodontal disease with their American Indian …

Gender And Self-Care Behaviors In The Burnout Of Mental Health Professionals, Kafy-Ann Martin-Johnson

Walden Dissertations and Doctoral Studies

Difficulties experienced at work can cause feelings of burnout that become prolonged and intensified without acts of self-care. The intense nature of mental health workers' jobs may make them, more vulnerable to burnout than other professionals. Because mental health professionals' mental and emotional wellness can significantly affect their work, adequate self-care is critical to both their well-being and that of their clients. Previous researchers have investigated the self-care behaviors of mental health professionals, but little was known about how gender affected the use of these behaviors in burnout prevention among mental health professionals. The purpose of this quantitative study was …

Doctor Of Nursing Practice, Sharon Jean Scott

Walden Dissertations and Doctoral Studies

Evidence demonstrates the health benefits of early breastfeeding for mothers as well as infants. The World Health Organization states, "Breast milk should be given within the first hour of life." This purpose of this project was to develop a breastfeeding educational toolkit to promote breastfeeding in the hospital environment. The question that guided this project was, "Will the development of a breastfeeding education toolkit, designed to serve as a learning tool to support the breastfeeding mothers, be found to be useful and valid by professional staff and lay end-users?" The goals of the project were to provide an educational toolkit …

The Effect Of Higher Education Classroom Management Behavior Strategies On Learning, Kalebra Henderson Henderson

Walden Dissertations and Doctoral Studies

Higher education instructors experience many uncivil behavior challenges among students in the classroom that affect learning. The purpose of this qualitative study was to investigate the effect of higher education classroom management behavior strategies on learning. Guided by Bandura's social learning theory and Piaget's cognitive theory, the research questions were designed to explore the perceptions of instructors and students about classroom management behavior strategies used in college settings and how student classroom incivility affects learning. The study included a panel of experts to aid in determining the feasibility of the project study protocol, testing the adequacy of research instruments, and …

The Relationship Between Physical Fitness And Academic Achievement In Sixth Grade Students, Shannon Usco Shook

Walden Dissertations and Doctoral Studies

Researchers have reported on the relationship between academic achievement and physical fitness levels. At one rural middle school, 25% of the students enrolled were either overweight or obese and failing at least one course. Educators at the local site were seeking methods to improve the academic achievement of their students. The purpose of this quantitative study was to examine the relationship between academic achievement and physical fitness of middle school students at the study site. Framed by the theoretical connection between improved physical fitness levels and academic achievement, the research questions examined the relationship between physical fitness levels of 6th …

Healthy Weight Maintenance: Narrative Analysis Of Weight Cycling In The Formerly Obese, Cheri Renee Lewis

Walden Dissertations and Doctoral Studies

Medical and economic costs for obesity are estimated at $147 billion per year, yet less than 1/3 of overweight individuals successfully maintain weight loss. The literature is replete with descriptions of the problem and research on treatments, yet demonstrations of effective loss and maintenance are lacking. Missing is an understanding of the experiences of individuals who successfully maintained healthy weight loss, which could provide insights regarding effective psycho-social interventions. The purpose of this qualitative narrative study was to explore key events and experiences in the lives of former weight cyclers. The primary phenomena of interest included weight cycling and sustained …

Infant-Driven Feeding Vs. Scheduled Feeding: The Effect On Hospital Length Of Stay, Lori L. Messer

Walden Dissertations and Doctoral Studies

Developmental delays related to feeding dysfunction in premature infants can lead to lengthy hospitalizations and increased healthcare costs initially and throughout the first year of the child's life. The purpose of this project was to use readiness-to-feed assessments to evaluate the impact of an infant-driven feeding protocol on length of stay. The project compared the length of stay of 2 groups of infants: a demand fed according to a readiness-to-feed protocol (protocol group, n = 14) and a traditionally fed according to scheduled, volume-driven feedings (traditional group, n = 15). The logic model served as the change management framework and …

Comparison Of Neovascular Age-Related Macular Degeneration Populations In The United States, Susan Lynette Coultas

Walden Dissertations and Doctoral Studies

Age-related macular degeneration (AMD) is one of the leading causes of blindness in the United States in people who are 50 and older. The safety and efficacy of aflibercept for the treatment of late stage neovascular AMD (NAMD) has been demonstrated by clinical trials among several populations; however, it is unclear whether all NAMD patients respond in the same manner as was studied in the clinical trials. The purpose of this study was to examine if populations of patients treated with aflibercept for the treatment of NAMD were significantly different from one another in terms of health characteristics, treatment regimens, …

Police Officer Perception Of Wellness Programs, Ellen M. Chism

Walden Dissertations and Doctoral Studies

Police officer applicants need to be in top physical condition and must pass a physical

ability test in order to be accepted into the police academy. However, many police

departments do not require incumbent police officers to take such tests after passing the

academy, even though the job requirements may not change. Research has documented

the importance of police officer fitness and its applicability to their work. Separate

studies have also shown the benefit of organizational wellness programs to employees.

There is a gap in the literature, however, regarding police officer perceptions of physical

fitness as it relates to police …

Evaluation Of Serum Vitamin D Levels In Older Adults Who Fall And Sustain A Fracture: A Retrospective Chart Review, Suzanne L. Pilon

DNP Projects

Purpose: This practice inquiry project was designed to (i) evaluate serum vitamin D levels in individuals aged 65 years and older who had fallen and sustained a fracture and (ii) identify if the serum vitamin D levels were within therapeutic range.

Background: Older adults are at increased risk of falling and sustaining a fracture as a result of falls. Vitamin D has been shown to be effective in fall prevention yet vitamin D is deficient in the older population worldwide. Evaluating current serum vitamin D levels in older adults who fall and sustain a fracture may provide additional insight in …

Outcomes Experienced By Patients Presenting With Ventral Hernias And Morbid Obesity In A Surgical Clinic, Margaret A. Plymale

DNP Projects

Surgeons generally agree that morbid obesity is a contraindication to ventral hernia repair surgery due to risk of adverse outcomes. The purpose of this study was to describe the experience of patients with ventral hernia complicated by morbid obesity by reviewing a population of patients that were seen by a surgical service to determine the characteristics of those patients that had favorable and unfavorable outcomes. A retrospective medical record review was conducted of new patients with ventral hernias and morbid obesity (body mass index (BMI ) ≥ 40 kg/m²) seen by one surgical service over a two and …

A Study Of Provider Practices In The Screening, Diagnosis, And Treatment Of Childhood Overweight And Obesity In A Rural Eastern Kentucky Clinic, Ashley R. Healy

DNP Projects

Objectives: The purpose of this study is to assess the current practices of providers for overweight and obese children at well visits, and how the demographics of age, sex, race, ethnicity, primary language spoken, insurance type, and provider type influence the care provided to overweight and obese children at the study site, which is a rural primary care clinic in eastern Kentucky.

Methods: This study is a retrospective design auditing well child charts (n = 571) from the study site over a two year period. Charts were audited for the data points of age, sex, race, ethnicity, primary spoken language, …

Management Of Hypertension In Student Patients In A University Student Clinic, Kathleen E. Solter

DNP Projects

Purpose: To evaluate provider adherence to a clinical guideline for management of hypertension, and to assess improvement in quality of management of student patients with hypertension in a university student clinic.

Methods: A retrospective chart review was conducted to identify student patients with hypertension. Data collected included the demographics of the sample patients, blood pressures, LDL results, weights, and evidence of provider compliance with guidelines.

Results: Of the 13 patient charts audited, providers recommended exercise to 46.15% of patients, weight loss or maintenance to 53.85% of patients, no-added salt diets to 53.85% of patients, low fat to 23.08% of patients, …

Use Of Simulation Involving Standardized Patients As An Education Program To Increase Nurse Confidence In Caring For Patients With Drug And Alcohol Problems, Brandy G. Mathews

DNP Projects

Purpose: The purpose of this pilot project was to test the effectiveness of a simulation exercise using standardized patients on nurses’ perceived confidence in caring for patients with drug and alcohol problems.

Method: The project was a mixed methods pre-test and posttest design to assess whether simulation using standardized patients was effective in improving nurses’ confidence in caring for patients with problematic drug and alcohol use issues. Qualitative data was obtained by interviewing participants using a semi structured interview.

Results: All nurses reported a positive experience as a result of participating in the simulation exercises. Use of simulation as …

Assessment Of Depression Screening In Women’S Primary Care Clinic, Susanna Gorton

DNP Projects

Purpose: The purpose of this practice inquiry project was to evaluate provider adherence to depression screening documentation in the ambulatory electronic health record (AEHR) before and after changing locations of the depression screening questions within the AEHR. Provider knowledge about depression screening and barriers related to depression screening were also examined.

Methods: A retrospective chart review was completed for patients seen for an annual exam by a physician provider in a women’s primary care clinic. Data collected included demographic data, co-morbid conditions, depression screen documentation (PHQ-2 & PHQ-9), and interventions documented. A questionnaire was sent to providers in the primary …

Retrospective Analysis Of Body Mass Index Screening And Obesity Counseling In A Primary Care Setting: Comparative Analysis Of Demographic Variables And Co-Morbidities, Christina Fisher Higdon

DNP Projects

Study Purpose: To assess obesity screening and counseling in patients at annual wellness exams in an urban primary care clinic. Specific aims of the study: determine percentage of patients with documented body mass index (BMI), ICD-9/ICD-10 diagnosis of overweight or obesity, documentation of education or a follow-up plan for weight management, follow-up visit for weight loss and documentation by provider, and comparative analysis of co-morbidities and demographic variables during well-exam visits.

Target Population and Measures: Adults over the age of 18 in an urban primary care clinic with a BMI greater than 25 kilograms (kg)/meters squared (m2). BMI screening and …

Community Level Assessment For Breastfeeding In The Gateway District, Vanessa Flannery

DNP Projects

Purpose: To assess community level support for breastfeeding in the Gateway District of eastern Kentucky.

Methods: A descriptive study was conducted to identify institutional support of breastfeeding women. Data collected during interviews included community level support based on the framework of the Ten Step program from the Baby-Friendly Hospital Initiative (BFHI) (WHO & UNICEF, 2009) and the Mother-Friendly Worksite Initiative (Texas Department of State Health Services, 2012). Respondents answered questions to determine breastfeeding support from the healthcare, education and business communities.

Results: Of the ten organizations whose representatives were interviewed, 100% perceived health benefits for mothers and infants from breastfeeding. …