Digital Commons Network^™

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 Data were triangulated using historical documents, first-person interviews, and health utilization data.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 …

Service Speaks 2018, Service Speaks Committee, Depaul University

Service Speaks

Service Speaks is an annual conference that demonstrates the multitude of ways DePaul students work with community partners to advance social justice causes in Chicago communities. Each academic year, over 200 courses and programs send students into the community to lift up the assets of our community partners through community-based service learning (CbSL) and project-based classes, community internships and community-based research. These connections result in mutually beneficial outcomes for the community organization and provide transformational experiences for our students.

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 …

Development Of A Scholarly Educational Intervention To Improve Inpatient Diabetes Care, Sharon.Hasfal Hasfal

Walden Dissertations and Doctoral Studies

Advanced practice providers (APPs), consisting of nurse practitioners and physician assistants, face many challenges in the provision of evidence-based practice in their management of hospitalized adult patients with diabetes. Some of the barriers faced by APPs at a Northeast acute care facility are poor communication between disciplines, lack of confidence in initiating insulin, limited understanding of the management of insulin and the insulin pump, and insufficient treatment of the hospitalized patient with diabetes that aligns with current clinical guidelines for the management of inpatient hyperglycemia. This quality improvement project focused on the development of an evidence-based theory supported educational intervention …

A Diabetic Child's Impact On An African American Family, Silvanus Okeke

Walden Dissertations and Doctoral Studies

Diabetes, a chronic disease with devastating but preventable consequences, is common in the United States, especially within African American communities. Earlier research has indicated that 21.7% of African American parents have children diagnosed with Type 1 diabetes in the Mississippi Delta Region. Researchers have examined coping, stress, and behaviors of African American parents of children diagnosed with Type 1 diabetes; however, there is a gap in literature regarding how African American parents can cope with stress and how changes in health behavior due to Type 1 diabetes impact African American families. The purpose of this qualitative phenomenological study was to …

The Relationship Of Factors Contributing To Burnout And Grit Among Division I Collegiate Athletes, Mckenzie Cavanaugh Cavanaugh

Honors Theses

Within the sports field, one popular interest is burnout among athletes. The objective of this study was to determine the association of risk factors to burnout and grit among Division I collegiate athletes. Seventeen males and twenty-five females (age= 19.88 ± 1.02) participated in this study (football, n = 8; cross country/track n = 1; soccer, n = 1; basketball, n = 2; golf, n = 1; volleyball, n = 13; baseball, n = 5; and rifle, n = 11). A survey and the athlete burnout questionnaire (ABQ) was used to evaluate risk factors of burnout and to assess burnout …

Cardiolipin Profiling In Metastatic Breast Cancer Cells, Meghan Houston Mcneely

Honors Theses

Six human breast cancer cell lines (MDA-MB-231, LM, BoM, T47D, MCF7, and MCF7-BoM) were treated with three differentially targeted phospholipase inhibitors (bromoenol lactone, tricyclodecan-9-yl-xanthogenate, and halopemide) as well as various dietary oils (canola oil, avocado oil, coconut oil, olive oil, sesame oil, and soybean oil). Cell viability assays were performed to examine the effects of each inhibitor and oil in varying concentrations on the proliferation of each breast cancer cell line. The goal was to detect changes in cardiolipin concentration within each cell line after exposure to a series of various phospholipase inhibitors and oils. Liquid chromatography-mass spectrometry (LC-MS) was …

Effects Of Emotion And Construal Level On Obesity Stigma, Peyton D. Curtis

Honors Theses

We conducted the present study to determine how emotion and construal level contribute to obesity bias. Specifically, we examined if different emotions, such as disgust, sadness, and happiness, played a role in several different judgments of an obese versus thin individual: 1) general impressions, 2) supporting a friend, and 3) endorsing personal versus biological/environmental causes for weight. We also investigated whether a self me construal or collective we construal influenced these judgments. We additionally considered whether emotion and these construal levels would interact to influence such judgments. The current work found that emotion and construal level did not interact to …

Characterization Of Kndy Neuronal Activity In Gilts: Distribution And Effect Of A Progestin, Ashley Nicollette Lindo

Graduate Theses, Dissertations, and Problem Reports (ETD)

Puberty is a process that incorporates a large array of both external factors and internal signals. The endocrinology of puberty has been studied in a number of mammalian species and typically depends upon an increase in hypothalamic secretion of gonadotropin releasing hormone (GnRH). Neural inputs regulating GnRH secretion during the pubertal process are not completely understood. In the past decade, attention has focused on the role for a particular set of neurons located in the arcuate nucleus (ARC) of the hypothalamus. They have been named KNDy neurons because they coexpress kisspeptin, neurokinin B (NKB) and dynorphin and have been shown …

Analysis Of Membrane Transporter Systems Expressed During Symbiotic Nitrogen Fixation In The Model Legume Medicago Truncatula, Christina Laureen Wyman

Graduate Theses, Dissertations, and Problem Reports (ETD)

No abstract provided.

An Evaluation Of Preliminary Outcomes And Characteristics Of Peer Support Within A Community Based Weight Management Program, John Spencer Ingels

Graduate Theses, Dissertations, and Problem Reports (ETD)

No abstract provided.

Improving The Lifestyle Of Andrews Korean Seventh-Day Adventist Church Members, Myung Do Park

Doctor of Ministry Projects

Problem

The Andrews Korean Seventh-day Adventist church in Berrien Springs, Michigan has holistic lifestyle problems that are on the rise. Church members are experiencing health issues such as cancer, high blood pressure, diabetes, osteoporosis, and insomnia. In observing dietary patterns, it was noticed that some of our members do not bother to ascertain the content of the food being eaten. Other members have express the desire to learn about a healthy lifestyle. Purposeful attention to this need of the church is necessary. As a church community comprised of mostly pastors, university students and their families it is time to advocate …