Medicine and Health Sciences Commons^™

Safety Planning: Self-Management Approaches For Intimate Partner Violence In Ohio, Yvette Clemons

Walden Dissertations and Doctoral Studies

AbstractIntimate partner violence (IPV) is a global health education and promotion burden that has affected one in four women in the United States between the ages of 18-24, who are at increased risk of subsequent negative health outcomes of sexually transmitted inflections, mental health and substance abuse disorders, exacerbated suicidal ideations, and death. Exploring the health education needs and learning preferences of women affected by IPV who have utilized self-management strategies during safety planning interventions was the purpose for this phenomenological qualitative study and aligned the four research questions. SurveyMonkey was used to conduct interviews of 30 women align with …

Impact Of Social Barrier Removal On Primary Care Use By Managed Care Enrollees, Pamme Lyons-Taylor

Walden Dissertations and Doctoral Studies

Personal health represents a complex relationship among social, physical, and emotional factors that can be influenced by health-seeking behaviors. Prior research indicates that greater use of preventive services leads to longer life and lower healthcare costs. For some populations, evidence suggests that social barriers hinder access to preventive services. To better understand the relationship between social factors and the other personal-health factors, de-identified healthcare claims and social service encounter data for 4,480 low-income individuals enrolled in Medicare Advantage or Managed Medicaid at one national health insurance were examined using a retrospective, quasi-experimental design for services rendered between October 1, 2014 …

Lived Experiences Of African American Women Coping With Breast Cancer In Rural Northeastern North Carolina, Denise Germaine Belle

Walden Dissertations and Doctoral Studies

This qualitative study examined the phenomenology of breast cancer among seven African American female participants who reside in rural, medically underserved communities in Northeastern North Carolina. The aim of this descriptive study was to explore the answers to the overarching question of how African American women with breast cancer self-manage the emotional, physical, financial, and social issues associated with the diagnosis and treatment. The transactional model of stress and coping provided the theoretical framework for examining the role of social reinforcements, beliefs, attitudes, and intentions on the health behavior of African American women with breast cancer in some rural, resource-stricken …

The Impact Of Socioeconomic Status And Ethnicity On Chronic Obstructive Pulmonary Disease Patients, Donald Garret Abshier

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating respiratory condition that leads to significant medial and financial burdens. For many patients with COPD, multiple socioeconomic factors contribute to health disparities, including income, education, employment status, and race/ethnicity. The purpose of this study was to examine the impact of SES and race/ethnicity on COPD patients. For this cross-sectional study, using secondary data analysis, the Social-Ecological Model (SEM), which discusses five levels of influence, was utilized. Data from over 3,222 participants aged 18 and over, living in Nevada were obtained from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) study. …

Physical Distress And Psychological Outcomes: An Examination Of Hurricane Katrina Rebuilders, Danita M. Muse

Walden Dissertations and Doctoral Studies

AbstractHurricane Katrina made land fall in New Orleans on August 29, 2005. When Hurricane Katrina came ashore at the mouth of the Mississippi River it struck with such vengeance that the protective levees surrounding the New Orleans area were breached. The purpose of this quantitative research is to broaden the understanding the relationship between two phenomena: physical distress and posttraumatic growth among Hurricane Katrina rebuilders who rebuilt their lives 15 years following a natural disaster along the Gulf Coast. The Conservation of Resources and Self-Efficacy Theory were the theoretical framework for this study. The research questions examined if statistically significant …

Age-Of-Consent Policies And Hiv Among Adolescents In Sub-Sahara Africa, Suzanne Marie King

Walden Dissertations and Doctoral Studies

Age of consent policies have recently been identified as a barrier to HIV testing among adolescents in HIV endemic Sub-Sahara Africa. Grounded in the modified social ecological model, the purpose of this study was to determine if these policies were related to HIV testing rates and prevalence. In this quantitative research secondary data sets from the Demographic Health Survey were used. This study included all sexually active respondents aged 18 years or below (N=37,015) and then was further limited by respondents that had HIV test results (N=25,107). Binary logistic regression showed that respondents with lower age of consent had higher …

Social Determinants And Academic Success For Online Undergraduates Mediated By Mental Health, Jamie Michelle Claus Getz

Walden Dissertations and Doctoral Studies

AbstractSocial determinants of health (SDH) are social and economic systems that directly contribute to health disparities and inequalities. This study examined SDH and their relation to education, also an SDH. The relationship between SDH and online undergraduate achievement, as measured by grade-point average (GPA), was studied. Cumulative inequality is the theoretical framework that guided the study; it underscores the complexity of interaction between personal, social, and environmental stressors in relation to a student’s academic performance. The quantitative survey design allowed for potential relationships between variables to be observed and studied based on the survey responses per self-report from 212 online …

The Predictive Relationship Of Allostatic Load In Asthma, Mohamed Mustafa Hassan

Walden Dissertations and Doctoral Studies

Research on populations emphasizes the influence of allostatic overload, a marker of biophysical and biochemical stress, in driving adverse health outcomes. Unknown is the impact of allostatic load and its cardiovascular, metabolic, and inflammatory components as they pertain to asthma prevalence in U.S. populations. Specifically, there is a need to understand the nature of the relationship between allostatic load and asthma in light of confounders such as socioeconomic status, race, education, and gender. Using Bronfenbrenner’s bioecological model as a theoretical underpinning and binary logistic regression as a statistical modality, the predictive relationship between allostatic load and asthma was examined in …

Perspectives Of Key Court Personnel On The Prosecution Of Domestic Violence Cases, Crystal M. Schoeder

Walden Dissertations and Doctoral Studies

Domestic violence (DV) continues to be a public health and criminal justice problem. Several criminal justice system changes have been made to combat DV, such as mandatory arrest policies, no-drop prosecution policies, and specialized DV courts. Perspectives on these policies, DV, and the criminal justice system have been obtained from the victims, police officers, and victim advocates. However, perspectives from those within the criminal justice court system are missing. The purpose of this qualitative phenomenological study was to obtain the perspectives of key court personnel in small rural communities regarding the prosecution of DV cases. Narrative policy framework was used …

Relationship Among Health Literacy Superstitious Beliefs And Self-Care Among Diabetic Patients In Warri, Nigeria, Nkemakolam Simpson Ukpabi

Walden Dissertations and Doctoral Studies

AbstractDiabetes imposes significant burdens in medical expenditures, medication use, outpatient visits, and treatment of its chronic complications. Self-care behaviors such as medication adherence and foot care have been shown to reduce hospitalizations and complications, and high health literacy levels have been positively associated with self-care adoption. However, the effect of superstition on this relationship has not been studied among diabetic patients in Warri, Nigeria. This study was conducted to determine the moderating effects of superstitious or cultural beliefs on the relationship between health literacy and self-care adoption among diabetes patients in Warri, Nigeria. A quantitative, observational, cross-sectional design guided this …

Strategies To Reduce Fall Rates In A Long-Term Care Facility, Kimberly H. Brewer

Walden Dissertations and Doctoral Studies

AbstractFalls among residents of long-term care facilities (LTCFs) pose significant threats to their health and quality of life, as falls often lead to life-threatening injuries such as traumatic brain injury and hip fractures. The etiology of the falls is multifactorial and complex; thus, interventions to reduce the falls typically combine two or more evidence-based interventions. The objective of this doctorate project was to develop an evidenced-based clinical practice guideline (CPG) outlining a multifaceted, evidenced-based bundled set of interventions for a fall prevention program to reduce falls for elderly patients living in the LTCFs. Lewin’s 3-step model of change was used …

The Influence Of Community-Based Interventions On Behaviors Of Hiv+ Persons In Congo-Kinshasa, Max Ebengho Bokelo

Walden Dissertations and Doctoral Studies

AbstractSub-Saharan African communities bear the highest burden of HIV/AIDS in the world. Because of identifiable cultural links and local beliefs, people are more likely to engage in sexual mores that could negatively impact their lives. Starting in early 2000, Congolese HIV+ patients have undergone a variety of inputs designed to decrease HIV risk behaviors among people. The purpose of this inquiry was to understand the impact of those actions within the community. Data grounded on the socioecological model were collected regarding any changes in (1) behavioral rejection of condoms, (2) Kintwidi phenomenon, (3) levirate and (4) sororate marriage, (5) sexual …

Experiences Of Spanish-Speaking Patients Using Interpreter Services With Their Physicians, Rafael Raul Caycho

Walden Dissertations and Doctoral Studies

In the United States, many patients cannot speak English well enough to communicate with their medical providers. Many of these patients use professional interpreter services offered by their medical organizations to help with communication, which can lead to miscommunication due to the translation process between patients, interpreters, and physicians, and to incorrect diagnosis and poor health outcomes for the patient. The purpose of this study was to explore the experiences of Spanish-speaking patients who used interpreter services with their physicians. The transmission model was the theoretical framework used to explore the experiences and outcomes for the participants. In this study, …

Nurse Perspectives Of Trauma-Informed Care, Lee Ann Blazejewski

Walden Dissertations and Doctoral Studies

There is growing interest in trauma-informed nursing methods to better respond to the needs of patients with histories of adverse childhood experiences and other traumatic events. Recent advances in the understanding of how trauma can negatively affect long-term health outcomes have fostered a shift towards trauma-informed care as a method to decrease patient retraumatization in nursing practice. With the implementation of trauma-informed care in many areas of healthcare and public health, several challenges have been exposed. The purpose of this study was to examine nurses’ lived experience of implementing trauma-informed care into nursing practice for the care of patients with …

A Quality Improvement Evaluation Of A Hospitalist Telemedicine Program, Kelly Marie Awes

Walden Dissertations and Doctoral Studies

Critical access hospitals (CAHs) encounter unique challenges in terms of providingquality resources to their community, often lacking quality measures and continuity comparable to larger regional and tertiary hospitals. One CAH in rural Minnesota implemented an overnight hospitalist telemedicine service to address concerns with provider resources and quality practice. An evaluation of quality improvement implementation was completed to address data regarding ER transfers and inpatient length of stay (LOS). Following the triple aim framework to improve patient care, population health, and decrease costs, Donabedian’s model of quality improvement was utilized. Three months of pre and postimplementation data were collected one year …

Antenatal And Postnatal Care Services And Maternal Mortality In Nigeria, Lucy Evans

Walden Dissertations and Doctoral Studies

Nigeria has had a high maternal mortality rate per 100,000 live births since the 1990s. A possible contributing factor is that many Nigerian women are not aware of prenatal and postpartum pregnancy care-related services. The purpose of this study was to investigate the association between pregnancy-related care (access to antenatal services, maternal health education, and knowledge of prenatal and postpartum care) and maternal mortality in Nigeria. The theory of planned behavior forms the basis of this study. A cross-sectional quantitative study design was used to determine whether maternal mortality is influenced by pregnancy-related care. Secondary data collected by the Demographic …

Examining Clinicians' Perspectives Screening For Depression In Patients With Type 2 Diabetes Mellitus, Vickie Lavette Bland

Walden Dissertations and Doctoral Studies

The United States has a significant diabetes problem. This chronic disease affects the body physically and mentally. One of the emotional effects of diabetes is depression. Depression is often present in individuals with diabetes, chiefly in those with type 2 diabetes mellitus (T2DM). While depression is common in T2DM and can interfere with treatment adherence, clinician screening for depression in T2DM patients is low. The purpose of this study was to examine clinicians' attitudes, behaviors, and perceptions concerning screening patients with T2DM for depression. Through a qualitative case study approach centered on reasoned action theory, 3 physicians and 5 nurse …

Exploring The Influences Of Culture On Hand-Hygiene Beliefs Of Foreign-Born Healthcare Workers, Sheila Blanche Davis

Walden Dissertations and Doctoral Studies

AbstractThe hand-hygiene practices of nonadherent health care workers (HCWs) are a major threat to patient safety and thus continue to be a concern for healthcare leaders and administrators worldwide. Healthcare-associated infections (HAIs), which are linked to HCWs' unclean hands, are prevalent throughout global healthcare settings. Global migration in the nursing profession and intercontinental travel among direct patient care providers make it challenging for healthcare leaders to sustain HCWs' adherence to hand-hygiene practices. The purpose of this grounded study was to explore the influence of the cultural beliefs about hand-hygiene practices of foreign-born HCWs. The theory of planned behavior was used …

Food Insecurity In Community College Students In The Central Valley Of California, Leah Carter

Walden Dissertations and Doctoral Studies

AbstractMany college students struggle with having enough money to pay for the costs of college and basic necessities, such as adequate food, which leads to food insecurity. Food insecurity results in a more challenging time focusing on studying and less success in school. This study addressed the lack of a profile of a food-insecure California community college student at Hiker’s Community College (HCC; pseudonym) in the Central Valley of California. The purpose of this quantitative study was to determine the profile of a food-insecure student and to determine relationships between food insecurity and ethnicity, gender, being a first-generation college student, …

Reproductive Health Factors And Maternal Mortality Of Internally Displaced Women In Nigeria, Fatima Mahmood Jibirilla

Walden Dissertations and Doctoral Studies

Approximately 529,000 women die from pregnancy-related causes every year, with 99% of these maternal deaths occurring in developing countries. Each year, about 59,000 maternal deaths occur in Nigeria, with a mortality rate of 576 deaths per 100,000 births. Women constitute about half of the 33.2 million internally displaced persons (IDPs) worldwide. The purpose of this retrospective cross-sectional study was to explore the association between the reproductive health factors and maternal mortality of internally displaced women in Borno state, Nigeria. McCarthy and Maine’s model for determinants of maternal mortality informed this study. A secondary dataset of 400 women (age 14-49 years) …

Misuse Of Prescription Pain Relievers Among Pregnant Women In The United States, Winnie Chebet Rono

Walden Dissertations and Doctoral Studies

The non-medical use of prescription pain relievers has increased remarkably, posing social and public health concerns particularly in developed countries such as the United States. The management of pain experienced by pregnant women poses a challenge to clinicians considering the effects of the regimen on unborn babies. Guided by the health belief model, which aims to predict health-related behavior in terms of certain health beliefs and explain change and behavior maintenance as well as to guide health behavior interventions, this cross-sectional study aimed to understand the associations between misusing pain relievers and social determinants of health such as education level …

Effects Of Trained Providers And Naloxone Distribution On Prescription Opioid Use Disorder, Samuel Sarpong

Walden Dissertations and Doctoral Studies

AbstractOpioid abuse and overdose are associated with substantial morbidity and mortality rates, as well as social and economic costs. The purpose of this study was to evaluate the independent and interactive effects of state-sponsored prescription drug monitoring program (PDMP) trained healthcare providers and community-based naloxone distribution program related factors in the states of Florida and Georgia for the prevention and reduction of prescription opioid use disorder, overdose, and deaths. The research theory adopted was the socio-ecological model with an emphasis on risk factors such as age. The study used secondary data from 2014 to 2018 from the Florida and Georgia …

Issues Facing Community-Based Social Workers When Providing Female Offenders With Reunification Services, Karen N. Vertti

Walden Dissertations and Doctoral Studies

AbstractThe goal with this action research project was to understand how community-based social workers (CBSWs) could address female offenders’ and their children’s needs while striving to reintegrate them into the community of Central Los Angeles County, California. Postrelease female offenders with children suffer from a variety of issues related to housing, employment, and personal childhood trauma. The trauma exacerbates the risk of revictimization and recidivism. CBSWs play a pivotal role in helping female offenders overcome barriers to successful reentry and reunify with their children. This study incorporated Bronfenbrenner’s ecological systems theory which provided a systems lens to this project. The …

Risk Factors For Foodborne Illness Outbreaks In Retail Food Establishments, Brendalee Viveiros

Walden Dissertations and Doctoral Studies

Despite policies and interventions over the last two decades, foodborne illness remains a significant public health concern. According to the CDC’s Foodborne Disease Outbreak Surveillance System, 60% of reported foodborne illness outbreaks involved food that was prepared at a restaurant. Reducing foodborne illness outbreaks that occur at restaurants would have a significant impact on the overall number of foodborne illnesses that occur each year. The purpose of this study was to quantitatively analyze the differences in risk factors in food establishments that have had a foodborne illness outbreak compared to food establishments that have not. This study used Reckwitz’s theory …

Social Determinants Of Health And Type 2 Diabetes Among Enrollees Of California Children’S Services Program In Fresno County, California, Daniela Marie Aghadjanian

Walden Dissertations and Doctoral Studies

Despite extensive study in adults, Type 2 diabetes (T2D) has been the subject of little research concerning young adults or children. Doctors believed T2D to develop only in a person’s later years until health care providers found younger individuals developing this disease. The purpose of this cross-sectional quantitative analysis was to determine correlations between T2D and social determinants of health in Fresno County, California, based on children and adolescents. The 2017-19 data came from the Fresno County Department of Public Health. The theoretical foundation for the study was the socio-ecological framework focusing on individuals’ traits having a bidirectional impact on …

Parental Education As A Potential Predictor Of Adolescent Substance Use Status, Haruna Bida Aliyu

Walden Dissertations and Doctoral Studies

AbstractAdolescents in the United States commence substance use as early as 12 to 14 years old and as late as 15 to 17 years old. Several factors influence adolescent substance use/abuse status, including environment, boredom, friends, teachers, and parental influence. The influence of parental communication with adolescents about the danger of substance use/abuse (SUA) required further study. The purpose of this quantitative cross-sectional study was to understand the influence of parental knowledge and communication with adolescents as potential predictors of substance use/abuse status. The social cognitive theory and social determinants of adolescent risky behavior provided the theoretical framework of this …

Understanding How Religious Practices Influence Self-Care In Black Churchgoers Diagnosed With Hypertension, Taquina C. Davis

Walden Dissertations and Doctoral Studies

Religion plays an essential role in managing health; however, there is limited research on religious practices among Black churchgoers diagnosed with hypertension. This research aims to understand how religious practices influence self-care in Black churchgoers diagnosed with hypertension. The sample consisted of 21 Black men and women, ages 29 to 70 years, with a clinical diagnosis of hypertension. Participants were recruited from two local, predominately Black churches in South Carolina and administered semistructured interviews to participants. A grounded theory design was used, and the data analysis consisted of constant comparison. Two core concepts were identified. One core concept identified was …

Inhaled Insulin, Afrezza, Educational Module For Health Care Providers, Sara Lynn Doolin-Thompson

Walden Dissertations and Doctoral Studies

Abstract Inhaled Insulin, Afrezza, Educational Module for Health Care Providers

bySara Doolin-Thompson

MSN, Walden University, 2014 BSN, University of Phoenix, 2004 ASN, Kentucky Wesleyan College, 1994

Project Submitted in Partial Fulfillmentof the Requirements for the Degree of Doctor of Nursing Practice

Walden University August 2021 Abstract Diabetes is on a global rise and there is a definite gap in providing care for the diabetic population. Two of the largest contributors to this gap in care are the lack of collaboration between health care professionals and the lack of education for health care providers on the evolution of diabetes treatment plans. …

Breastfeeding Information And Breastfeeding Duration Among African American Women With A Family History Of Breast Or Ovarian Cancer, Aleatha Johnson

Walden Dissertations and Doctoral Studies

Decades of research supports the notion that breastfeeding may help prevent breast and ovarian cancer in women. Women with a family history of these cancers are at greater risk. African American women have the lowest breastfeeding rates, yet the highest breast and ovarian cancer mortality rates. No studies have been conducted exploring the impact of being informed about breastfeeding from health care providers, breastfeeding support services, or family and friends and the relationship between their knowledge of family history of breast or ovarian cancer and breastfeeding duration for African American women. The purpose of this quantitative study was to determine …

Impact Of Out-Of-Pocket Fees On Under-5 Infant Mortality In Cameroon, Amelie Olga Mafotsing Fopoussi

Walden Dissertations and Doctoral Studies

Health facilities in Cameroon charge fees for treatment and services, which can affect health outcomes for those unable to pay for services. Some studies have shown that the removal of user fees had a positive impact on child health outcomes in selected African countries. The aim of this quantitative, cross-sectional study was to understand whether there is a link between out-of-pocket expenses and under-5 mortality in Cameron. The study was guided by the social ecological framework. Secondary data from the 2011 Cameroon Demographic Health Survey were used in the study. Chi-square, binary logistic regression, and multicollinearity analyses were used to …