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Health Department Prevention/Education Plans And Perceived Risks Of Zika Infection, Lacey Jacques Jan 2022

Health Department Prevention/Education Plans And Perceived Risks Of Zika Infection, Lacey Jacques

Walden Dissertations and Doctoral Studies

AbstractZika virus is an infectious disease caused by the bite of an infected mosquito that has been linked to increased rates of microcephaly and other devastating birth defects. The existing body of knowledge has focused on the individual-level factors that influence a person’s decisions about prevention activities and risk perceptions related to Zika virus. The purpose of this study was to determine the relationship between state-level plans for prevention and education and individual-level risk perceptions. Rosenstock’s health belief model lays a foundation for why individuals make the health decisions they do and helps explain how these can be influenced for …


Health-Related Quality Of Life For Veterans Transitioned Into Civilian Life, Vicki Ann Guerra Jan 2022

Health-Related Quality Of Life For Veterans Transitioned Into Civilian Life, Vicki Ann Guerra

Walden Dissertations and Doctoral Studies

Texas veterans transitioning to civilian life have experienced health issues after discharge. There are processes to follow before seeking treatment or diagnosis for any health issue prior to military discharge. Given the gaps in the literature on veteran health, quality of life and transition to civilian life, scholars lack understanding of the transitional events that take place. Veteran health issues are impacted by medical appointment wait-times, day to day life events, and this can lead to decreased quality of life. The purpose of this mixed-methods study (N=36) was to evaluate veterans’ health related quality of life who had transitioned from …


Weight Change And Hyponatremia As Predictors Of Polydipsia Among Persons With Schizophrenia, Kingsley Okechukwu Nwachukwu Jan 2022

Weight Change And Hyponatremia As Predictors Of Polydipsia Among Persons With Schizophrenia, Kingsley Okechukwu Nwachukwu

Walden Dissertations and Doctoral Studies

AbstractPolydipsia is found in 20% of inpatients with chronic severe mental disorders. Of this, 80% are diagnosed with chronic schizophrenia, hence polydipsia is strongly associated with chronic schizophrenia. Despite the prevalence and serious health complications of coexisting polydipsia in this population, its current method of detection is flawed. The purpose of this quantitative study was to accurately identify comorbid polydipsia in schizophrenia using periodic weight change and hyponatremia. The Wilson’s complexity theory and primary data were used to attempt to explain the relationship between weight change and hyponatremia and polydipsia, in a cross-sectional study design. The dependent variable was polydipsia, …


Suicidal Ideation Among American Indian And Alaska Natives In The United States, Lacie Lashawn Tillman Jan 2022

Suicidal Ideation Among American Indian And Alaska Natives In The United States, Lacie Lashawn Tillman

Walden Dissertations and Doctoral Studies

Suicidal ideation is a silent public health issue across the United States. Evidence suggests that suicidal ideation is a predictor of suicide attempt and completion. Suicide is a leading cause of death among American Indians and Alaska Natives (AIs/ANs) in the United States, especially among younger people. Alcohol and illicit drug use, coupled with poor social conditions, can lead to suicidal ideations—and sometimes suicide completion. Using social cognitive theory, this quantitative cross-sectional study compared variables within the 2017, 2018, and 2019 National Survey on Drug Use and Health to determine the effect that alcohol and/or illicit drug use has on …


Predictors Of Glycemic Control Among Type 2 Diabetes Mellitus Patients In Owerri, Nigeria, Jideuma Ikenna Egwim Jan 2022

Predictors Of Glycemic Control Among Type 2 Diabetes Mellitus Patients In Owerri, Nigeria, Jideuma Ikenna Egwim

Walden Dissertations and Doctoral Studies

Diabetes mellitus (DM) is a significant public health concern globally and in Owerri, Nigeria. The deleterious effects of diabetes have been linked to poor glycemic control. According to the International Diabetes Federation, poor glycemic control is reflected in glycosylated hemoglobin (HbA1c) levels greater than 7.0%, which are associated with substantial morbidity and mortality. Studies have shown a dramatic rise in diabetic complications in Nigeria, particularly in Owerri. However, evidence is lacking on specific risk factors associated with poor glycemic control among DM patients in Owerri. With health insurance assuming a significant position in healthcare service delivery in Nigeria, addressing this …


Opioid Types And Adolescent Prescription Opioid Misuse, Orchid George Jan 2022

Opioid Types And Adolescent Prescription Opioid Misuse, Orchid George

Walden Dissertations and Doctoral Studies

AbstractAdolescent prescription opioid misuse (POM) in the United States is a significant public health issue, and there is a lack of studies investigating the association between opioid types and adolescent POM. The purpose of this quantitative cross-sectional study was to explore possible associations between a set of independent variables: opioid types, gender, religiosity, and education, and the outcome variable, POM among adolescents ages 12 to 17 in the United States. The socio-ecological model was the theoretical framework that guided the study. A sample size of 13,722 from the 2017 Substance Abuse & Mental Health Data Archive was analyzed using descriptive …


Bullying, Participation In Violence, Suicidal Ideation, And Behavior Among African American Youth, Kierystan Lorquoyea Johnson Jan 2022

Bullying, Participation In Violence, Suicidal Ideation, And Behavior Among African American Youth, Kierystan Lorquoyea Johnson

Walden Dissertations and Doctoral Studies

Suicide is the second leading cause of death among adolescent, teens, and young adults. Suicidal ideation is a predictor of suicide attempts. Guided by the integrated motivational-volitional model and social cognitive theory, Youth Risk Behavior Surveillance Survey data were used to investigate whether traditional bullying, cyberbullying, and participation in physically violent behavior (independent variables) were associated with suicidal ideation and behavior (dependent variables) among African American high school aged youth controlling for age, gender, physical, and sexual abuse. It was found that experiencing traditional bullying increased suicidal ideation significantly, as there is an 82% increase in likelihood. There was also …


Stigma And Discrimination’S Effect On Hiv Testing Of Pregnant Women In Nigeria, Charles Echezona Nzelu Jan 2022

Stigma And Discrimination’S Effect On Hiv Testing Of Pregnant Women In Nigeria, Charles Echezona Nzelu

Walden Dissertations and Doctoral Studies

The utilization of HIV testing services among pregnant women in Nigeria has not been optimal. Although much is known about the determinants of HIV testing among pregnant women, there is a gap in knowledge on determinants for pregnant women infected with the virus, specifically whether stigma and discrimination are barriers. The purpose of this study was to examine the effect of stigmatizing attitudes and personal knowledge of discriminatory practices towards persons living with HIV/AIDS on the decision by pregnant Nigerian women aged 15-49 years to test for HIV during antenatal visits or childbirth. The health belief model served as the …


Vitamin K Deficiency And Ischemic Stroke In Atrial Fibrillation Patients On Warfarin, Kimberly Therese Thompson Jan 2022

Vitamin K Deficiency And Ischemic Stroke In Atrial Fibrillation Patients On Warfarin, Kimberly Therese Thompson

Walden Dissertations and Doctoral Studies

Individuals with poor nutritional vitamin K status can suffer from atrial fibrillation (AF) due to misinterpretation of warfarin instructions by healthcare providers. The purpose of this quantitative study was to determine if there was an association between inadequate dietary vitamin K intake in AF patients and stroke outcomes to address the lack of research surrounding stroke outcomes in patients with true vitamin K deficiency. Grounded in the health belief model, this study assessed if individual beliefs from health education influenced the nutritional quality of their diet and health outcomes. The study is a secondary data analysis of the Framingham Heart …


Factors Influencing Human Papillomavirus Vaccination Among Hispanic Youth In Bexar County, Texas, Timothy Edward Wallum Jan 2022

Factors Influencing Human Papillomavirus Vaccination Among Hispanic Youth In Bexar County, Texas, Timothy Edward Wallum

Walden Dissertations and Doctoral Studies

A high number of Hispanic youth in Bexar County, Texas, face morbidity and mortality related to human papillomavirus (HPV) infection due to inadequate vaccination coverage youth. A better understanding of the factors that influence vaccination might help public health authorities to increase coverage. The aim of this quantitative, cross-sectional study, which was based on the socioecological model and involved analysis of weighted survey data from the 2016 to 2018 National Immunization Survey-Teen, was to better understand the multilevel factors influencing HPV vaccine use among Hispanic youth. The weighted sample was representative of the study population in terms of survey characteristics …


Gestational Weight Gain, Level Of Education, And Infant Mortality Among African American Women, George Lee Amanambu Jan 2022

Gestational Weight Gain, Level Of Education, And Infant Mortality Among African American Women, George Lee Amanambu

Walden Dissertations and Doctoral Studies

Abstract

African American (AA) women in Mississippi have a higher burden of infant mortality, especially those with low income and educational levels, as compared to other regions of the country. However, it is unknown if abnormal gestation weight gain (GWG) is contributing to this increased burden. This quantitative cross-sectional study examined the association between GWG (25-35lbs), level of education, income, and infant mortality among AA women with normal prepregnancy body weight who were between 30 to 47 years old in the state of Mississippi from 2016 to 2018. Biopsychosocial and ecosocial models were used as the theoretical foundation to design …


Comparative Effectiveness Study Of Acute Ischemic Stroke Care Between Stroke Belt And Non-Stroke Belt Hospitals Using The Get With The Guidelines-Stroke Program, Michael Earl Brown Jr Jan 2022

Comparative Effectiveness Study Of Acute Ischemic Stroke Care Between Stroke Belt And Non-Stroke Belt Hospitals Using The Get With The Guidelines-Stroke Program, Michael Earl Brown Jr

Walden Dissertations and Doctoral Studies

Stroke is a leading cause of mortality in the United States, particularly in a cluster of states termed the stroke belt. This study examined the efficacy of the Get With The Guidelines (GWTG)-Stroke program in stroke belt hospitals (SBHs) compared to non-stroke belt hospitals (NSBHs) regarding disparities related to mortality and acute ischemic stroke (AIS) treatment (i.e., recombinant tissue-type plasminogen activator [r-tPA] rates, Door-to-Needle [DTN], Door-to-Imaging [DTI]). Use of the GWTG-Stroke program was assessed to determine if SBHs and NSBHs were quantitatively equivalent in terms of specific core stroke measures. This quantitative employed an equivalence study design with over 2.9 …


The Impact Of Electronic Cigarettes Use On Traditional Cigarette Uses Among U.S. Adolescents, Ismail Mensah Dwumfour-Poku Jan 2022

The Impact Of Electronic Cigarettes Use On Traditional Cigarette Uses Among U.S. Adolescents, Ismail Mensah Dwumfour-Poku

Walden Dissertations and Doctoral Studies

The increased usage of e-cigarettes among adolescents in the United States (U.S.) is a major public health concern. According to the Centers for Disease Control and Prevention (CDC), nicotine, an active ingredient in e-cigarettes, is the most addictive drug in use today. The purpose of the current study was to explore the relationship between smoking of e- cigarettes and the risk of smoking traditional cigarettes among middle and high school students in Grades 6 through 12 in the U.S., and to determine if demographic factors contribute to this predisposition. This, quantitative cross-sectional study used the social ecological model as the …


Risk Factors Associated With Type 2 Diabetes Among Adults In Alabama, Peter Okeke Jan 2022

Risk Factors Associated With Type 2 Diabetes Among Adults In Alabama, Peter Okeke

Walden Dissertations and Doctoral Studies

In the 21stcentury Diabetes mellitus is recognized as one of the most important public

health challenges that carry a substantial individual and community burden.

It is necessary to do a detailed search regarding DM2 from adolescence till adulthood is in

Alabama which should aim to provide recent information. T2D is influenced by a many

factors including demographics including age, sex, income level, educational, BMI,

physical activities, etc. Identification of the associated risk factors is very important to

inform decision making by concerned bodies and T2D management. The study aimed to

examine the risk factors associated with T2D in adults aged …


Association Of The Use Of Combination Therapy Self-Management Of Prediabetes And Type-2 Diabetes Mellitus In Adults, Celestina Reed Jan 2022

Association Of The Use Of Combination Therapy Self-Management Of Prediabetes And Type-2 Diabetes Mellitus In Adults, Celestina Reed

Walden Dissertations and Doctoral Studies

Diabetes is a long-lasting chronic health condition that encompasses three types: Type 1, Type 2, and gestational diabetes. The disease affects how the body breaks down food into energy. It is an insulin-deficient disease and causes heart disease, vision loss, and kidney disease. Investigators of the Centers for Disease Control and Prevention and the American Diabetes Association evaluated patient treatment preferences to determine the upsurge in patient health-related quality of life (HRQOL) and optimum health. The literature revealed that patients' preferences consisted of therapies and achievable goal setting using the health belief model (HBM) framework. This quantitative research aimed to …


Treatment Outcomes And Associated Factors In Tb/Hiv-Coinfected Patients In Namibia, Esland Shilongo Jan 2022

Treatment Outcomes And Associated Factors In Tb/Hiv-Coinfected Patients In Namibia, Esland Shilongo

Walden Dissertations and Doctoral Studies

AbstractHIV and TB have merged into a deadly co-epidemic in Namibia. Currently, though, TB and HIV data at the national, regional, and district level might be underreported and insufficient to understand the full burden and outcome rates of TB and HIV. Targeting the TB outcomes rate among TB/HIV-coinfected individuals is an effective strategy for decreasing future TB burden and furthering the gains in the control of both diseases. The objective of this study was: to assess the outcomes of patients registered for anti-TB treatment in //Karas Region which has the largests burden of TB in Namibia. A 5-year retrospective cohort …


Relationship Between Early Years’ Activities Of Daily Living And Alzheimer’S Disease Onset, Linyi Fan Jan 2022

Relationship Between Early Years’ Activities Of Daily Living And Alzheimer’S Disease Onset, Linyi Fan

Walden Dissertations and Doctoral Studies

A few promising studies have indicated that activities of daily life (ADL) may be a useful way of predicting Alzheimer’s Disease (AD). However, the existing cross-sectional studies fail to show how ADLs in early years predict AD, and how social factors influence health either in addition to or in interaction with individual risk factors. Using a social epidemiology framework, this study examined the relationship between early years’ ADL and the development of AD in later years. This quantitative study included 4,526 participants derived from the Health and Retirement Study (HRS) dataset. The dependent variable was whether the participant has been …


Primary Care Physicians’ Knowledge, Attitudes, And Practices Regarding Lyme Disease In High- Versus Low-Incidence Lyme Disease Midwestern States, Alexander Karnga Jan 2022

Primary Care Physicians’ Knowledge, Attitudes, And Practices Regarding Lyme Disease In High- Versus Low-Incidence Lyme Disease Midwestern States, Alexander Karnga

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this quantitative cross-sectional study, guided by the barriers to physician behavior change (BPBC) framework, was to address the gaps in the Lyme disease empirical literature by examining whether there were significant differences in Lyme disease knowledge, attitude, and practices between primary care physicians in Wisconsin, a high-incidence Midwestern Lyme disease state, and Michigan, a low-incidence Lyme disease Midwestern state. The study was conducted with 65 physicians (53.8% male and 46.2% female). The study hypotheses were tested by conducting a one-way multivariate analysis of covariance (MANCOVA), controlling for physicians’ years of practice (the number of patients seen per …


Risk Factors Of Infant Mortality Among Sub-Saharan Immigrants In The United States, Roland Lankah Jan 2022

Risk Factors Of Infant Mortality Among Sub-Saharan Immigrants In The United States, Roland Lankah

Walden Dissertations and Doctoral Studies

While prepregnancy body mass index (BMI), gestational weight gain (GWG), and birthplace have been suggested to play a key role in predicting infant mortality outcomes, they have not been thoroughly investigated across all races/ethnicities. The purpose of this study was to examine the associations between prepregnancy BMI, GWG, birthplace as independent variables, and infant mortality as the outcome variable within the United States Sub-Saharan African Immigrants (SSAI). A quantitative cross-sectional study design grounded in the biopsychosocial model was used. Data were extracted from the 2017-2018 natality-linked birth/infant death file from the Centers for Disease Control and Prevention Wonder Database. It …


Depression, Drug Use, And Hsv-2 Among Women Who Have Sex With Women, Viani Picchetti Jan 2022

Depression, Drug Use, And Hsv-2 Among Women Who Have Sex With Women, Viani Picchetti

Walden Dissertations and Doctoral Studies

Herpes simplex virus type 2 (HSV-2), the main cause of genital herpes, is an incurable sexually transmitted infection responsible in 2018 for 18.6 million infections in the United States. HSV-2 is twice as frequent in women than in men. Women who have sex with women (WSW) have a higher prevalence of depression and drug use than women who have sex exclusively with men (WSM), which are each related to HSV-2 as they increase the likelihood of engaging in risky sexual behaviors. The purpose of this study was to assess the predictive relationship between depression status, nonprescription drug use status, and …


Diabetes, Obesity, Geographic Location Of The Patient And Clostridium Difficile Infection In The United States, Mary (Maribeth) Greenway Jan 2022

Diabetes, Obesity, Geographic Location Of The Patient And Clostridium Difficile Infection In The United States, Mary (Maribeth) Greenway

Walden Dissertations and Doctoral Studies

AbstractClostridium difficile infection (CDI) is a major nosocomial threat to be reckoned with in the current health care setting in the United States. Advancing age, underlying chronic disease associated with inflammation (including Diabetes Mellitus Type I ([DMI]), Diabetes Type II ([DMII]), and obesity), trauma, immunodeficiency and other factors that diminish the overall health of an individual, and increase an individual’s susceptibility to CDI. The ecological framework was used to determine the relationship between geographic, chronic diseases and the occurrence of infectious diseases. To continue enhancing knowledge related to CDI susceptibility this quantitative study used the 2010 National Hospital Discharge Survey …


Attitudes Of State Public Health Laboratory Directors Towards Iso/Iec 17025 Accreditation, Christine Kilonzo Jan 2022

Attitudes Of State Public Health Laboratory Directors Towards Iso/Iec 17025 Accreditation, Christine Kilonzo

Walden Dissertations and Doctoral Studies

The impact of ISO/IEC 17025 accreditation in state public health laboratories (SPHLs) is understudied. There is a scarcity of research on SPHLs involving behavioral intent regarding ISO/IEC 17025 accreditation. The theory of planned behavior (TPB) was utilized to evaluate SPHL directors’ attitudes towards and intent to seek or maintain ISO/IEC 17025 accreditation. To test the questions of whether the three constructs of the TPB, attitude, subjective norms and perceived behavioral control are significant predictors of intent to seek or maintain ISO/IEC 17025 accreditation, and whether there are significant differences in these constructs towards the accreditation between SPHL directors based on …


Gestational Weight Gain, Level Of Education, And Infant Mortality Among African American Women, George Lee Amanambu Jan 2022

Gestational Weight Gain, Level Of Education, And Infant Mortality Among African American Women, George Lee Amanambu

Walden Dissertations and Doctoral Studies

Abstract

African American (AA) women in Mississippi have a higher burden of infant mortality, especially those with low income and educational levels, as compared to other regions of the country. However, it is unknown if abnormal gestation weight gain (GWG) is contributing to this increased burden. This quantitative cross-sectional study examined the association between GWG (25-35lbs), level of education, income, and infant mortality among AA women with normal prepregnancy body weight who were between 30 to 47 years old in the state of Mississippi from 2016 to 2018. Biopsychosocial and ecosocial models were used as the theoretical foundation to design …


Risk Factors Associated With Access To Intermittent Preventive Treatment For Malaria Among Pregnant Women In Uganda, Mayanja Simon Peter Jan 2022

Risk Factors Associated With Access To Intermittent Preventive Treatment For Malaria Among Pregnant Women In Uganda, Mayanja Simon Peter

Walden Dissertations and Doctoral Studies

Intermittent preventive treatment of malaria in pregnancy (IPTp) is an intervention consisting of the full course of therapeutic antimalarial medicine administered to pregnant women during routine antenatal visits regardless of whether the woman is infected with malaria. The use of intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) has been reportedly low in most of the malaria endemic areas, including Uganda. The coverage of IPTp in Uganda has been estimated to be as low as 17%. An in-depth secondary data analysis using the 2016 Uganda Department of Health Services survey was conducted to understand the causal relationships between …


Major Depressive Disorder And Perceived Everyday Discrimination Among The Jamaican Diaspora In The United States., Warren Williams Jan 2022

Major Depressive Disorder And Perceived Everyday Discrimination Among The Jamaican Diaspora In The United States., Warren Williams

Walden Dissertations and Doctoral Studies

Overt racial discrimination in the United States has been supplanted by subtle forms of everyday discrimination known as microaggressions. Researchers have found perceived everyday discrimination (PED) to be associated with major depressive disorder (MDD) among African Americans but have often treated the African American subpopulation as a homogeneous group. The purpose of this cross-sectional study grounded in the theory of microaggression was to illuminate probable associations between microaggressions based on weight, age, gender, ethnicity, and race and lifetime MDD among the Jamaican diaspora in the United States. Secondary data from the Collaborative Psychiatric Epidemiologic Surveys were analyzed. Statistically significant associations …


Factors Associated With Accidental Drug Exposure In U.S. Adults Over 65 Years Of Age, Edwin Raj Jan 2022

Factors Associated With Accidental Drug Exposure In U.S. Adults Over 65 Years Of Age, Edwin Raj

Walden Dissertations and Doctoral Studies

Medication errors are a major public health issue and a leading cause of fatalities in the United States and globally. Older adults who rely on medications to address age-related health issues are at higher risk of medication errors. Accidental exposure to drugs is a major type of medication error that impacts older people more than other age groups. The purpose of this quantitative correlational study was to examine the association between patient gender, age group, and reporter type and accidental exposure to drugs in older people. The ecological model was used to guide the study. Logistic regression analysis was used …


The Influence Of Race And Ethnicity On The Prevalence Of Social Stigma For People With Type 1 Diabetes Mellitus, Donielle Hyde Jan 2022

The Influence Of Race And Ethnicity On The Prevalence Of Social Stigma For People With Type 1 Diabetes Mellitus, Donielle Hyde

Walden Dissertations and Doctoral Studies

Various studies attempting to evaluate the prevalence of health-related social stigma in people with type 1 diabetes mellitus (T1DM) identified themes that coincide with increased prevalence including anxiety, low self-esteem, depression, fear of judgement, anger, and feeling ashamed. This phenomenon is believed to be due to the lack of knowledge and understanding about the differences between the diagnosis, treatment, and prevention strategies for T1DM and type 2 diabetes mellitus (T2DM). The Resilient, Empowered, Active Living intervention dataset (n=115) was utilized to further examine this phenomenon by determining whether race and ethnicity influence the prevalence of the following health-related social stigma …


External Validation And Modification Of A 30-Day Readmission Risk Prediction Model For Heart Failure Patients, Debra Kelly Jan 2022

External Validation And Modification Of A 30-Day Readmission Risk Prediction Model For Heart Failure Patients, Debra Kelly

Walden Dissertations and Doctoral Studies

The development and validation of 30-day readmission risk prediction models, such as the LACE index, have been of interest to researchers and healthcare organizations, especially since the Centers for Medicare and Medicaid Services began to impose monetary penalties on hospitals with higher than expected 30-day readmission rates. However, there is a lack of consensus concerning the efficacy of the LACE index in the heart failure population. The purpose of the study was to examine the discriminative accuracy of the LACE index to predict all-cause 30-day readmission for heart failure patients and to build a modified 30-day readmission risk prediction model …


Evaluating The 2012 Vaccination Reporting Mandate: Applications To Adventist Health Network, May Abdalla Jan 2022

Evaluating The 2012 Vaccination Reporting Mandate: Applications To Adventist Health Network, May Abdalla

Walden Dissertations and Doctoral Studies

Influenza is a public health concern that claims up to 56,000 lives annually in the United States, though it is a vaccine-preventable disease. Influenza vaccination among health care personnel (HCP) is highly encouraged to prevent influenza transmission in health care settings. The objective of this study was to examine the relationship between mandatory reporting of HCP influenza vaccination rates (implemented in 2012) and HCP influenza vaccination intake in a health care network with 20 hospitals. The protection and motivation theory was used as the theoretical framework. Data collected from surveys of hospital administrators and archives of the Center for Medicare …


Health Department Prevention/Education Plans And Perceived Risks Of Zika Infection, Lacey Jacques Jan 2022

Health Department Prevention/Education Plans And Perceived Risks Of Zika Infection, Lacey Jacques

Walden Dissertations and Doctoral Studies

AbstractZika virus is an infectious disease caused by the bite of an infected mosquito that has been linked to increased rates of microcephaly and other devastating birth defects. The existing body of knowledge has focused on the individual-level factors that influence a person’s decisions about prevention activities and risk perceptions related to Zika virus. The purpose of this study was to determine the relationship between state-level plans for prevention and education and individual-level risk perceptions. Rosenstock’s health belief model lays a foundation for why individuals make the health decisions they do and helps explain how these can be influenced for …