Medicine and Health Sciences Commons^™

Chronic Kidney Disease And Depressive Disorders Among Adult Non-Hispanic African Americans And Whites In Georgia, Omatola Gordon-Rose

Walden Dissertations and Doctoral Studies

Chronic kidney disease (CKD), depressive disorders, and mental health are significant health issues in the United States. The purpose of this study was to examine the association of CKD and depressive disorders and days of poor mental health in adults living in Georgia, controlling for race/ethnicity, socioeconomic status, gender, age, diabetes mellitus status, high blood pressure status, marital status, and number of adults in the household. The study was a descriptive, quantitative, cross-sectional design with secondary data analysis, and the framework used was Wilson and Cleary health-related quality of life measures. The 2019 Behavioral Risk Factor Surveillance System Survey weighted …

The Childbirth Experiences And Perceptions Of Sierra Leonean Women Relating To Basic Maternal Rights, Francess Fornah

Walden Dissertations and Doctoral Studies

Sierra Leone faces immense challenges in supporting good quality, woman-centered care, with one of the world's highest maternal mortality ratios of 717 per 100,000 live births. In countries with high maternal mortality, evidence of the fear of disrespect and abuse women usually confront in maternity care is a more solid deterrent to the use of skilled care than commonly recognized barriers, such as cost or distance. This qualitative phenomenological study aimed at understanding the childbirth experiences and perceptions of Sierra Leonean women relating to basic maternal rights. The ecological systems theoretical framework and the respectful maternity care charter conceptual framework …

Adverse Childhood Events And Protective Health Behaviors Among Adults With Diabetes Or Diabetes With Comorbid Heart Disease, Ciara Michelle Rukse

Walden Dissertations and Doctoral Studies

Diabetes is a prevalent and costly chronic condition that can lead to other comorbid conditions such as heart disease. Disease management is essential but can be stressful and complicated, especially for individuals who have developed maladaptive behaviors in response to exposure to adverse childhood events (ACEs), which are chronic stressors that impact physiological and psychological development. There is limited research on the potential relationship between childhood adversity and engagement in protective health behaviors among U.S. populations with diabetes or diabetes with comorbid heart disease. The ACEs pyramid was the theoretical framework of this quantitative cross-sectional study concerning morbidity and early …

African American Women’S Body Image Perceptions And The Built Environment, Andrea Denise Smith

Walden Dissertations and Doctoral Studies

African American (AA) women have a 54.8% overall obesity rate in the United States. This quantitative cross-sectional study’s aim was to determine what factors may have an impact on body image perceptions of AA women in Alabama and New Jersey. A gap in research this study addressed is sociodemographic and geographic differences that may impact obesity rates among AA women. The theoretical framework used for this study was the social cognitive theory. Secondary data were obtained from the 2018 Behavioral Risk Factor Surveillance System. Linear regression (LR) analyses results showed that none of the sociodemographic variables (education level, employment status, …

Diabetes Self-Management Education In The Urban Low Socioeconomic Status Senior Population, Heather Santa Barbara

Walden Dissertations and Doctoral Studies

This exploratory quantitative study used a survey design to address a gap in the literature concerning primary care team perceptions about diabetes care for urban low socioeconomic status seniors with diabetes. Diabetes is a chronic health problem that is often managed in primary care offices, and primary care teams are often the first source of education and support for patients. Standards of management for seniors with diabetes has changed to eliminate tight control of glucose levels, and primary care team members may have differing perceptions about diabetes care depending upon their role in the primary care team and years of …

Chronic Obstructive Pulmonary Disease 30-Day Readmission Rates In California, Illinois, And New York, Theresa Teverbaugh

Walden Dissertations and Doctoral Studies

AbstractThe Centers for Medicare and Medicaid Services (CMS) have implemented financial penalties to reduce hospital readmissions for various conditions, including chronic obstructive pulmonary disease (COPD). As a result, hospital administrators explore ways to prevent financial penalties for excessive COPD 30-day hospital readmissions. The purpose of this quantitative study was to determine if there was a correlation between hospital Medicare reimbursement, quality-of-care measures related to patient satisfaction, and 30-day readmissions rates for COPD patients in California, Illinois, and New York. The quality-of-care measures included communication with nurses, communication with doctors, the hospital staff's responsiveness, and medicine communication. The secondary data were …

Exploring The Behavioral Health Clinician Shortage At A Rural Midwestern U.S. Agency, Tracy L. Wilson

Walden Dissertations and Doctoral Studies

Behavioral health clinician shortages are a significant and ongoing problem in the United States, especially in rural areas, which have higher rates of homelessness, suicide, substance use, and violence rates than urban areas. The purpose of this qualitative case study was to explore factors contributing to the behavioral health clinician shortage in a rural midwestern U.S. public health department. The goal was to gain a better understanding of this shortage and explore strategies and solutions for recruiting and retaining behavioral health clinicians at the agency’s facilities. The Baldrige excellence framework undergirded the investigation. Data sources included interviews with three administrative …

Relationship Between Employee Engagement, Kind Of Initiatives, And Workplace Wellness Program Effectiveness, Alicia Dobrzeniecki

Walden Dissertations and Doctoral Studies

Ineffective workplace wellness programs prevent organizations from decreasing employee health and well-being costs. Workplace wellness managers lose more than $1,100 in decreased productivity each year. Grounded in the theory of planned behavior, the purpose of this quantitative correlational study was to examine the relationship between workplace wellness engagement, kind of workplace wellness initiatives, and workplace wellness program effectiveness. Data were collected from 146 workplace wellness program managers who completed the HERO scorecard. The multiple linear regression analysis results indicated the model was able to significantly predict workplace wellness program effectiveness, F(2, 143) = 85.482, p = < .001, R² = .545. Both predictors provided a significant contribution to the model, with workplace wellness engagement level (t = 8.342, p = < .001, β = .543) providing a higher contribution to the model than kind of workplace wellness initiatives (t = 4.584, p = < .001, β = .298). A key recommendation for workplace wellness program managers is to emphasize employee engagement in workplace wellness programs and choose the appropriate initiatives to ensure workplace wellness program effectiveness. The implications for positive social change include the potential for improved health and well-being within the U.S. workforce.

The Perceptions Of Adult Patients Who Experience Needle Fear During Cosmetic Injections, Julia Hoy

Walden Dissertations and Doctoral Studies

AbstractAdult patients receiving cosmetic injections frequently experience needle fear symptoms which results in patient discomfort, suffering, and poor injection outcomes. The needle fear experience contributes to a decreased quality of life and possible avoidance behaviors involving other medical treatments requiring needles. Researchers have conducted quantitative studies which explored interventions on pain reduction but there are no qualitative studies from the perspectives of adults experiencing needle fear. The purpose of this research study was to explore the perceptions of needle fear in adult patients receiving cosmetic injections in a medical office setting. The interpretative phenomenological approach was used to provide an …

Water/Sanitation, Hygiene, And Risk Factors Associated With Under-5 Mortality In Côte D’Ivoire, Ouda Kamagate

Walden Dissertations and Doctoral Studies

Despite remarkable progress in children’s survival since 1990, the global burden of the under-5 mortality rate (U5MR) remains immense. According to the World Health Organization, about 5.2 million children below 5 died in 2019, with 14,000 dying each day. Literature reveals that the lack and limitation of water, sanitation, and hygiene (WaSH) are linked to deaths in childhood. Cote d’Ivoire still lags behind expectations with 79 per 1000 live births in 2019 rather than 25 and below, so there is a need to uncover to what extent the U5MR is affected by WaSH. Through a cross-sectional design guided by the …

Improving Patients' Engagement And Retention In Intensive Outpatient Substance Abuse Treatment, Leo W. Lavender

Walden Dissertations and Doctoral Studies

Substance use disorder continues to be a major health crisis in the United States. Thousands of people die yearly due to substance use and related criminal activity. Substance abuse treatment is a remedy to the disorder and treatment centers admit thousands of patients yearly to address the dilemma. Throughout the years retention has been an ongoing barrier to successful treatment. This study explored significant obstacles to retention: motivation and engagement. The Baldrige Excellence Framework was utilized to assess the training, supervision, procedures, and leadership roles at an intensive outpatient substance abuse treatment center. This study utilized a qualitative approach case …

Project Spraoi: The Implementation And Outcomes Of A Process Evaluation Of A School-Based Health Promotion Intervention, Yvonne Larrissa O’Byrne

Theses

Large multi-site school-based interventions are challenging to implement and difficult to evaluate due to the complex adaptive nature of schools as a research setting. This study focused on implementing a comprehensive process evaluation of a multicomponent primary school-based health promotion called Project Spraoi (PS), alongside intervention delivery, to aid the translation of outcomes and understand the moderating role of contextual factors on intervention delivery. PS is led by a physical activity (PA) specialist known as an Energizer and aims to improve children’s PA levels and reduce sedentary time by delivering 20 minutes extra daily moderate to vigorous PA (MVPA) during …

Effectiveness Of Responsible Beverage Service Policies In Reducing Drunk-Driving In Maryland, Rhoda Makinde

Walden Dissertations and Doctoral Studies

In the State of Maryland and across the United States, driving under the influence (DUI) has led to a massive loss of lives and disability cases. Hence, responsible beverage service (RBS) policies and programs have been developed to prevent and control DUI incidence. This study sought to identify the effectiveness of these policies in addressing the DUI-related fatalities and injuries among young adults (18–30 years old) in the State of Maryland. Using program theory to evaluate the effectiveness of RBS policies and programs in reducing DUI, this qualitative research sampled bar patrons, club patrons, and alcohol servers/service staff in Baltimore. …

Accessibility To Vaping Products, Vaping, And Use Of Cigarettes Among Adolescents, Sherri Adeosun

Walden Dissertations and Doctoral Studies

There has been a continuous increase in the use of e-cigarettes among adolescents. The growth threatens to nullify the years of successfully reducing cigarette smoking among this age demographic. Additionally, the increase has been a concern for public healthcare workers due to the limited research on the effects of long-term use of e-cigarettes on adolescents. I investigated the possible side effects of exposure to e-cigarette advertisements and the use of e-cigarettes. Additionally, the study reviewed the relationship between the age e-cigarette use was initiated and the subsequent use of cigarettes. The conceptual framework was based on the multi-theory model and …

Vaccine Hesitancy Among Healthcare Workers In The Covid-19 Era, Gabriella Checchi

Capstone Showcase

Vaccination against harmful, deadly pathogens have been an essential tool in the scientific world and have shaped our community as we know it today. They have allowed us to live in a society where members of the community are protected from certain severe disease and can help to decrease the death toll of these diseases. Vaccines have allowed us to eradicate smallpox, a disease that ravaged the world and killed over 300 million people. They have been a one of the most useful advances in medical science so far. And yet today, as SARS-CoV-2 continues to spread rampantly throughout the …

The Program To Reduce Implicit Bias In Carroll Hospital Center Using The Implicit Association Test, Katherine E. Traynor

Capstone Showcase

Natural brain processes make all individuals susceptible to unconscious bias; however, stressful, fearful, or anger-evoking situations as well as the negative influence of media and social surroundings increase the risk of holding obstructive bias, and there is a greater risk of being negatively impacted by this phenomenon when belonging to a minority population (Rose & Flores, 2020). As a result, high rates of infant mortality (10.2 deaths per 1,000 live births for the Non-Hispanic Black population compared to 4.1 in the White population) and cardiovascular related diseases (190.0 cases per 1,000 in the Non-Hispanic Black population compared to 161.3 in …

Understanding The Environmental Implications Of The Microbiome Of Canals In Bangkok, Thailand, Emma Tao

Scripps Senior Theses

The canals of Bangkok, Thailand hold significant economic and social value, yet the increasing urbanization of the city has resulted in increased water pollution. Agricultural runoff and urban waste contribute to the degradation of the water quality, which has impaired its safe usage by the people of the city. This study focused on analyzing the microbiome of the water in the canals in correlation with the surrounding environment, both in and out of the water. Ten sites along the Bangkok canals were analyzed. DNA was isolated for the sequencing of the 16s rRNA gene to determine the microbial diversity of …

Integrating Fema And Scouts For Local Community Hazard Preparedness, Megan Vocatura

Williams Honors College, Honors Research Projects

My goal is to support the development of a comprehensive, evidence-based, plan to connect four counties in eastern Massachusetts with local Scouting resources to enhance preparedness efforts. The counties of Essex, Middlesex, Norfolk, and Suffolk comprise the geographic footprint of the Sprit of Adventure Scout Council (SoA). SoA’s newly established partnership with the Federal Emergency Management Agency (FEMA) needs recommendations on where to stage preparedness and response efforts. My role will be to build a repository of evidence of current and anticipated hazards, vulnerabilities, and risks for the region and specific communities. This part of the project will consist of …

Factors Associated With Mask Use In New York City Neighborhood Parks During The Covid-19 Pandemic: A Field Audit Study, Lisa Hitch, Marie A. Sillice, Hanish Kodali, Katarzyna E. Wyka, Javier Otero Peña, Terry Tk Huang

Publications and Research

Background: Mask use is a cost-effective measure to decrease COVID-19 transmission. Mask mandates intend to increase mask compliance but are often ambiguous when it comes to public outdoor spaces.

Methods: We used a field audit study to examine mask use in New York City neighborhood parks during COVID-19. 1453 park visitors were observed in 13 parks during July–August 2020 using a modified and validated park use audit tool (System for Observing Play and Recreation in Communities) that included items on general and proper mask use (i.e., mask covering both nose and mouth). Generalized estimating equation regression was used to determine …

Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo

Walden Dissertations and Doctoral Studies

Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …

Social Media Use And Mental Health: An Educational Intervention To Reduce Depression And Anxiety In Adolescents, Natalie Catlett

DNP Projects

Background: Most adolescents spend a great deal of their time using various social media platforms. However, excessive and maladaptive social media use is correlated with worsening symptoms of depression and anxiety among adolescents.

Objective: This project aimed to determine whether an educational intervention could help decrease overall time spent using social media and improve mood and mental health outcomes among adolescents with depression or anxiety disorders.

Methods: This was a quasi-experiment with a pretest and posttest design. An educational intervention about the relationship between social media use and symptoms of depression and anxiety among adolescents and strategies to minimize risk …

Healthcare System Responses To Non-Communicable Diseases’ Needs Of Syrian Refugees: The Cases Of Jordan And Lebanon, Chaza Akik, Farah Asfahani, Tatiana Elghossain, Sandra Mesmar, Miriam Rabkin, Wafaa El Sadr, Fouad M. Fouad, Hala Ghattas Ph.D.

Faculty Publications

Introduction:

Since the start of the Syrian conflict in 2011, Jordan and Lebanon have hosted large refugee populations, with a high pre-conflict burden of non-communicable diseases (NCDs). We aimed to explore NCD service provision to Syrian refugees in these two host countries and to identify lessons learned that may inform the global response to the changing health needs of refugees.

Methods: Between January 2017 and June 2018, we conducted 36 in-depth interviews with stakeholders from Jordan and Lebanon, as well as global stakeholders, to understand the context, the achievements, gaps and priorities in the provision and uptake of NCD prevention, …

Teaching And Learning Numeracy In Health Sciences: A High School Health Classroom Case Study, Jasmina Mesic

Graduate Research Theses & Dissertations

High school health science teacher professional development (TPD) is one learning environment where emphasis on numeracy and nutritional health literacy can make lifelong positive impacts on the health and wellbeing of youth. It has been estimated that only 33% of United States adults have limited numeracy skills and that only 12% are health literate. The purpose of this study was to begin the development of a high school health science TPD focused on numeracy and nutritional health literacy and to assist the teacher in delivering subject matter using brain-based learning principles. An exploratory case study design was selected as the …

Online Teaching Of Program Planning & Evaluation, Manoj Sharma

UNLV Best Teaching Practices Expo

Program Planning & Evaluation (PBH 440-1001) offered by the School of Public Health at University of Nevada, Las Vegas was taught asynchronously online by Manoj Sharma to undergraduate students (primarily from public health) in Spring 2021 (n=34). This course is designed to equip students with the knowledge and skills necessary to systematically develop, implement, and evaluate health-related programs, services, and interventions. The specific teaching techniques that were used in teaching this course were organizing the entire course in Canvas and making it available from day 1, recording all lectures beforehand in Panopto, utilizing cases studies in modules, embedding journal articles …

Instrumental And Emotional Social Support Intention And Utilization Among Pregnant And Postpartum Women During The Covid-19 Pandemic, Gracie Minks

All Master's Theses

Postpartum depression impacts 1 in 7 women across the U.S. As a whole population, between 10-16% of women are impacted by maternal depression during pregnancy or the first year postpartum. Those who experience postpartum depression are at risk for repeated depressive episodes and a lower quality of life over time. The postnatal period may reflect the most vulnerable time for mental health concerns such as anxiety and depression. Fear, judgment, and perceived criticism are commonly named as barriers that delay the mobilization of support.

There is a prevailing perception that postpartum depression is a normal part of motherhood which may …

Perceptions Of Physical Activity Guidelines Among Wheelchair Users With Multiple Sclerosis, Stephanie L Silveira, Brenda Jeng, Gary Cutter, Robert W Motl

Faculty, Staff and Student Publications

BACKGROUND: Physical activity guidelines provide prescriptive resources for population-level promotion of behavior change to improve health outcomes. The National Multiple Sclerosis Society (NMSS) recently created and disseminated physical activity guidelines for persons with multiple sclerosis (MS) across the disease spectrum.

OBJECTIVE: This study aimed to assess perceptions of the updated NMSS Physical Activity Guidelines among wheelchair users with MS.

METHODS: One hundred thirty-four wheelchair users with MS participated in a cross-sectional study examining health behaviors. Outcomes were measured using an online questionnaire that included items related to demographic and clinical characteristics and a battery of questions regarding perceptions of the …

The Neighborhood Environment And Hispanic/Latino Health, Natalia I Heredia, Tianlin Xu, Minjae Lee, Lorna H Mcneill, Belinda M Reininger

Faculty, Staff and Student Publications

PURPOSE: Hispanic/Latino adults on the Texas-Mexico border have high rates of chronic disease. Neighborhoods can influence health, though there is a limited research on neighborhood environment and health in Hispanics/Latinos. The purpose of this study was to assess the relation of neighborhood environment with health variables in Hispanic/Latino adults, including physical activity [PA], depression, anxiety, and lab-assessed conditions (type 2 diabetes, metabolic syndrome, and chronic inflammation).

METHODS: Participants were randomly-selected from a Hispanic/Latino cohort on the Texas-Mexico border. Neighborhood environment, self-reported PA, anxiety, and depression were assessed through questionnaires. Laboratory values determined Type 2 diabetes, metabolic syndrome, and C-reactive protein …

Using Implementation Mapping To Develop Implementation Strategies For The Delivery Of A Cancer Prevention And Control Phone Navigation Program: A Collaboration With 2-1-1, Lynn N Ibekwe, Timothy J Walker, Ebun Ebunlomo, Katharine Ball Ricks, Sapna Prasad, Lara S Savas, Maria E Fernandez

Faculty, Staff and Student Publications

Cancer prevention and control (CPC) behaviors, such as cancer screening, human papillomavirus vaccination, and smoking cessation, are critical public health issues. Evidence-based interventions have been identified to improve the uptake of CPC behaviors; however, they are often inconsistently implemented, affecting their reach and effectiveness. Patient navigation is an evidence-based approach to increasing CPC behaviors. Nevertheless, there are few navigation programs that use systematically developed implementation strategies to facilitate adoption, implementation, and maintenance, which affects uptake and outcomes. This article describes the development of a multifaceted implementation strategy designed to facilitate delivery of a CPC phone navigation program to increase breast, …

Acceptance- And Mindfulness-Based Techniques For Physical Activity Promotion In Breast Cancer Survivors: A Qualitative Study, Michael C Robertson, Emily Cox-Martin, Yue Liao, Sara A Flores, Ross Shegog, Christine M Markham, Kayo Fujimoto, Casey P Durand, Abenaa Brewster, Elizabeth J Lyons, Karen M Basen-Engquist

Faculty, Staff and Student Publications

PURPOSE: The purpose of this study was to develop and characterize the relevance and potential utility of an electronically delivered acceptance- and mindfulness-based approaches to physical activity promotion for insufficiently active breast cancer survivors.

METHODS: The acceptance- and mindfulness-based physical activity intervention was delivered to participants electronically over the course of 4-8 weeks. It consisted of didactic videos, experiential exercises, and workbook-type activities that targeted principles from acceptance and commitment therapy (ACT). We conducted semi-structured, in-depth interviews with participants after they completed the intervention. Three coders conducted qualitative data analysis on interview transcripts to identify overarching themes and subthemes.

RESULTS: …

Relationship Between Income, Maternal And Infant Factors, And Infant Mortality Rates In African American Communities, Kristen Newman

Walden Dissertations and Doctoral Studies

Infant mortality is a significant public health issue that provides insight into the health of a community. The purpose of this study was to examine whether a relationship existed between infant mortality and median income by zip code, maternal factors, and/or infant factors in the affluent, African American community of Prince George’s County, Maryland. The research theory chosen for this study was the conceptual framework for action on the social determinants of health based upon its action-oriented focus. The secondary data used for this study was linked birth and infant death data for 2010 to 2016 collected by the Department …