Medicine and Health Sciences Commons^™

Effective Management Of Diabetes Mellitus Type Ii In A Military Treatment Facility, Jozy Merizier Smarth

Walden Dissertations and Doctoral Studies

In the United States, 34 million people have diabetes and 79 million have prediabetes. Currently, one in nine Americans are diagnosed with diabetes and it is projected that one in five will have diabetes by 2025 and one in three by 2050. The practice-focused question answered by this project addressed the question if implementing a staff education program improved staff’s knowledge about self-management education and intent for providers and staff to promote a formal diabetes self-management education (DSME) program in an overseas military treatment facility. The site has 47% of empaneled beneficiaries with diabetes mellitus Type II with an elevated …

Exploring Promotoras As Influencers Of Physical Activity And Diet Acceptability Among Latinas, Gladys Orock Tataw-Ayuketah

Walden Dissertations and Doctoral Studies

Promotoras are frontline community health workers who help link Latino community members to health and social services. Latino women have high rates of attrition and lack of participation in weight loss programs due to various barriers, and the promotora model is vital to address these concerns. The approach incorporates strong family support and influence to address health and social issues through interdependent ties of promotoras and families who live and work within the community they serve. The purpose of this qualitative study was to explore how promotoras influenced the acceptability of and participation in physical activity and dietary modification programs …

California’S Urban And Rural Asthma Healthcare Access And Asthma Management During Covid-19 Pandemic, Stacey R. Varga

Walden Dissertations and Doctoral Studies

A lack of adequate healthcare access can negatively affect asthma management. The purpose of this study was to understand whether there was an association between source of care and asthma management. This study provides important insights concerning the changing landscape of how individuals receive asthma treatment and manage their asthma during a pandemic. Asthma management and asthma care have been studied; however, results have been inconclusive in relation to the barriers to health that are experienced among various adult age groups. Identifying additional subgroup characteristics could provide insight into where health practitioners, practice management, and policymakers direct healthcare resources. The …

Educating Nursing Staff On Clostridioides Difficle Infection Bundle Use, Amber Lee Winkis

Walden Dissertations and Doctoral Studies

Clostridioides difficile infection (CDI) is a local, national, and global issue impacting patient outcomes and healthcare organizations. CDI is costly to treat, painful, and at times deadly. Given an increase in CDI over the past year at the project site, the current gap in practice is the nonadherence of nursing staff to using a CDI bundle. This project addresses that gap. The practice-focused question targeted at nursing staff (N = 18) on an adult medical-surgical unit in an acute care hospital and asks whether education on use of a CDI bundle would result in a knowledge gain about the importance …

Let My People Go:Improving Nurses’ Knowledge To Decrease Physical Restraint Use, Trisha Marie Zehrung

Walden Dissertations and Doctoral Studies

Despite extensive research revealing the dangers of physical restraint use, it remains a common practice in critical care settings across the globe. Nurses stand at the forefront of clinical decision-making regarding the use of physical restraints but are doing so with a lack of education and evidence-based practices. The project addresses whether an evidence-based educational program regarding the use of physical restraints and alternative measures is an acceptable method for intensive care unit (ICU) nurse education according to six local subject matter experts (SMEs). The project’s purpose was to create an educational program outlining physical restraint evidence and alternative measures …

Preconception Protective Factors Associated With Preterm Birth In Black/African American And Non-Hispanic White Women In Nyc, Joyce Yvonne Hall

Walden Dissertations and Doctoral Studies

Racial disparities in preterm birth have persisted during the past two decades. Though studies have delineated the medical, behavioral, and social risk factors explaining racial disparities in preterm birth, less is known about protective factors. This quantitative, correlational study was conducted to examine the prevalence, association, and risk of preconception health protective factors and sociodemographic covariates between Black/African American and non-Hispanic White women with preterm birth in New York City (NYC). The maternal and child health (MCH) life course approach was the theoretical foundation. The NYC Pregnancy Risk Assessment Monitoring System 2016–2018 Phase 8 survey data, which included 2,161 women …

Lifestyle Modifications To Reduce Hypertension In Obese Patients: A Clinical Practice Guideline, Tiffany Lynn Oates

Walden Dissertations and Doctoral Studies

In the United States, obesity affects almost 50% of the population with estimates of 60–70% of hypertension in adults attributable to adiposity. The practice gap addressed in this project is a lack of standardized patient education on lifestyle modifications aimed at reducing hypertension in the obese patient, which is the recommended first line of treatment for these patients. The practice focused questions were answered when evidence from the literature supported the implementation of a clinical practice guideline developed from evidence-based literature focused on patient education about lifestyle modification as the initial treatment for the reduction of hypertension in the obese …

Association Between Family Structure And Childhood Obesity In Essex County, Nj., Chima Tony Onyeagoro

Walden Dissertations and Doctoral Studies

Obesity is one of the most prevalent nutritional disorders in children in the United States. There are many factors associated with childhood obesity, but there is limited information about the association between family structure and childhood obesity. This quantitative retrospective cross-sectional study, guided by the Social Ecological Model, was carried out to identify the effect of family structure on childhood obesity. For this study, the 2017 National Survey of Children’s Health (NSCH) of children 6-13 years old residing in the state of New Jersey was analyzed. Binary logistic regression was used to determine the relationship between family structure and obesity, …

Assessing Cancer And Heart Disease Occurrence From Groundwater Contaminated With Volatile Organic Compounds, Courtnie S. Owens

Walden Dissertations and Doctoral Studies

This study examined the effects of the toxic chemicals contained in volatile organic compounds (VOCs) on cancer occurrence and heart disease through occupational and environmental exposure to groundwater sources. This study was important because it provided critical insight for the public health community on the association between variations of past and current levels of VOCs in water sources and cancers and heart disease. The key research questions examined what proportion of occupational and nonoccupational individuals in southeastern North Carolina were diagnosed with cancer or heart disease and whether VOCs were associated with the long-term effects of cancer or heart disease …

Children's Body Mass Index Before And After Covid-19 Related Childcare Center Closures, Ericka L. Peterson

Walden Dissertations and Doctoral Studies

Prolonged childcare center closures due to COVID-19 restrictions have changed children’s health-related behaviors that may result in an increased risk in childhood obesity. Grounded in the social ecological model, the purpose of this study was to examine the differences in body mass index (BMI), physical activity, consumption of sugar-sweetened beverages (SSBs), and screen time among preschool aged children enrolled in the Merced County Office of Education Head Start program before and after COVID-19 related Head Start center closures. A quantitative, longitudinal study design using secondary data from ChildPlus was used. The paired t-test and Wilcoxon signed-rank test was used to …

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 …

Faculty Perspectives On Quality Of Online Courses In Health Education And Promotion Programs, Dana Wawrzyniec

Walden Dissertations and Doctoral Studies

The need to make quick transitions online due to COVID-19 challenged many Health Education and Promotion (HEP) faculty to identify how to create quality online HEP courses. A review of the literature identified the need for qualitative research on the quality of online courses from the faculty’s perspective. The purpose of this general qualitative study was to explore the perceptions and experiences of HEP faculty at multiple universities, in terms of the organization and facilitation of their online courses, communication between instructor and student, and assessment of students. The community of inquiry (COI) framework, which evaluates the teaching, social, and …

Nursing Staff Education On The Use Of The American Diabetes Association Guidelines, Terrie Hattie Allen

Walden Dissertations and Doctoral Studies

AbstractDiabetes mellitus is a complex chronic condition that requires continuous care and management. Approximately 34 million Americans are diagnosed with diabetes and around 90%–95% suffer from Type 2 diabetes. The problem identified in this project was the need to follow the American Diabetes Association guidelines in place at the study site clinic but are not adhered to by the staff. Framed within the analysis, design, development, implementation, and evaluation model of instructional design, the purpose of this project was to plan, implement, and evaluate a nursing staff education program on the use of the American Diabetes Association Guidelines for diabetes. …

Typhoid Fever Among Low-Income Women Living In Gujranwala, Pakistan., Tehmina S. Khan

Walden Dissertations and Doctoral Studies

Approximately 21 million individuals suffer from typhoid fever (TF) globally, and most outbreaks occur in Southeast Asia. The incidence of TF is high in Pakistan, particularly in low socioeconomic areas, and a new drug-resistant strain makes it difficult to control the spread of TF. There is a pressing need for up-to-date and accurate data regarding the attitudes, beliefs, and habits leading to the spread of TF infection among individuals living in low socioeconomic areas of Pakistan. This qualitative, phenomenological study was grounded in the health belief model and explored factors that influence the spread of TF among women of childbearing …

Alternative Diet Practices As Predictors For Vaccine Confidence, Nancy Dolin

Walden Dissertations and Doctoral Studies

Perceived risks and side effects have left some with a lack of confidence in the safety and efficacy of vaccines. This may lead to not adhering to the recommended vaccination schedule and result in outbreaks that have the potential to harm those who are unable to get vaccinated due to age or infirmity. It is vital to seek and address the characteristics that may predict one’s confidence in vaccines. The aim of this study was to identify whether an individual’s alternative diet behavior may be able to predict their confidence in the measles, mumps, and rubella (MMR) vaccine. The theoretical …

The Outcome Of Stroke Education And Management On Cerebrovascular Accident Patients In Bermuda, Antoinette Simone Dyer

Walden Dissertations and Doctoral Studies

AbstractIncidence of cardiovascular accident (CVA), also referred to as a stroke, has increased in Bermuda. Understanding key contributing factors is necessary to reduce incidences that are associated with this disease process. This dissertation examined the outcome of stroke education and management on CVA patients in Bermuda. The health belief model, incorporating a reflection of the public health framework, guided the analysis of a quantitative dataset obtained through Bermuda Hospitals Board’s Neurology Department. A cross-sectional study design was used to sample 253 stroke patients over a 2-year period (2019 -2021). The Wilcox test was employed to compare two groups – stroke …

Length Of Stay In A Homeless Shelter And Mitigating Homelessness, Uwemedimo S. Etteyit

Walden Dissertations and Doctoral Studies

AbstractHomelessness is a major public health issue in the United States. Every night, thousands of people have no residence to call their own. Most homeless persons turn to homeless shelters for help. Despite the homeless shelters, the problem of homelessness persists. This study examined the concept that the length of time spent at a homeless shelter is related to the homeless persons mitigating their homelessness through home placement, jobs, and healthcare access. Homelessness was examined using the socioecological model with its attendant levels of influence. On the intrapersonal level, socioeconomic status, education, old age, veteran status, and disability were factors. …

Assessing Violence And Mental Health With The 2019 Nevada Youth Risk Behavioral Survey, Samantha Graham

Walden Dissertations and Doctoral Studies

The effects from childhood trauma can interfere in all aspects of a child’s life, including their education. School delivery systems need to be trained to identify these risks and how to reduce further risks of re-traumatization by applying trauma-informed practices. This study addressed the impact of adverse childhood experiences (ACEs) on mental health and behavioral issues. The study was guided by Bandura’s social cognitive theory and the socioecological model. The correlation between ACEs and mental health as well as ACEs and physical violence were examined based on data from the 2019 Nevada Youth Risk Behavioral Survey, which was a high …

The Impact Of Staff Sexual Misconduct On U.S. Federal Prison Inmates’ Mental And Physical Health, Wanwisa Grover

Walden Dissertations and Doctoral Studies

Prison staff sexual misconduct is an ongoing issue in the United States, but little is known about how inmates’ perceptions of staff sexual misconduct influence their mental and physical health. The purpose of this quantitative research study was to examine the relationship between staff sexual misconduct with federal prison inmates and prisoner mental health and rates of injury, and why inmates are not reporting sexual misconduct encounters. Ecological theory provided the theoretical foundation. The three research questions were designed to examine the relationships between nonconsensual sexual misconduct of prison inmates with prison staff and (a) serious mental health illnesses and …

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 …

Using Social Perspectives On Vaccination To Build Public Trust In Pro-Vaccine Communication, Lindsay Hale

Walden Dissertations and Doctoral Studies

United States public health guidelines for mandating vaccination of school age children for preventable diseases is increasingly ineffective. Little is known, however, about what sociocultural factors influence parents’ and legal guardians’ decisions to adhere to, hesitate against, or refuse to abide by immunization public health guidelines. The purpose of this qualitative study was to discover and better understand sociocultural factors that contribute to or detract from parents and legal guardians’ adherence to recommended vaccination schedules. The theoretical framework for this study was Coleman’s Rational Choice Theory. Research questions involved sociocultural factors and reference groups that influence parents and legal guardians’ …

Marijuana Legalization And Depression Effects On Marijuana Use In African American Late Adolescents, Anthony Olusegun Iroko

Walden Dissertations and Doctoral Studies

State medical marijuana legalization (MML) may contribute to increased cannabis use among older adolescents, especially African American youth and adolescents with depression. This quantitative cross-sectional correlational study, which utilized Smart’s availability-proneness theory of drug use as a guiding framework, had a two-fold purpose: to determine if state MML status and self-reported depression were significantly related to past-month marijuana use and to assess if state MML status significantly moderated between depression and past-month marijuana use. The study utilized data from 1,391 African American late adolescents (aged 16-20) who participated in the 2018 National Survey on Drug Use and Health. Binary logistic …

“Someone You Love” Documentary: Using Narratives In Entertainment Media To Increase Hpv Vaccination In Georgia, Gabrielle C. Darville- Sanders, Jann Macinnes, Kelsey Schwarz

Journal of the Georgia Public Health Association

Background: Although HPV is the most common sexually transmitted disease in the United States, vaccination rates are still lagging among adolescents and young adults. Entertainment-education is a popular strategy for incorporating educational messages into entertainment media. With popular shows on television now integrating health messages into their narrative, there are more opportunities to influence knowledge, attitude and health behaviors. Objective: To (a) determine the effectiveness of the HPV narrative included in the “Someone You love” documentary on HPV risk perception, vaccine self-efficacy and behavioral intention for HPV vaccine uptake on college students and (b) assess the immediate impact of the …

Physical Activity And Sedentary Behaviour Among Children And Adolescents With Intellectual Disabilities During The Covid-19 Lockdown In China, Y. Q. Yuan, J. N. Ding, N. Bi, M. J. Wang, S. C. Zhou, X. L. Wang, S. H. Zhang, Y. Liu, G. Roswal

Research, Publications & Creative Work

Background: In the wake of the COVID-19 pandemic, preliminary research has reported a significant decline in physical activity (PA) and an increase in sedentary behaviour (SB) among typically developed children and adolescents. Limited research has looked at the current situation of PA and SB during this pandemic among children and adolescents with intellectual disabilities (ID). This study investigated the situations about PA and SB among school-aged children and adolescents with ID on China’s mainland during the COVID-19 outbreak.

Methods: In total, 837 parents of children and adolescents (ages 6–18 years) with ID from 15 special education schools of Shandong Province …

Improving Egypt’S Access To Vaccines And Medicines: Communication During Covid-19 / تحسين إتاحة الوصول إلى اللقاحات والأدوية في مصر: سياسة توعية الجمهور خلال أزمة فيروس كورونا, Alaa Abdel-Rahman, Sarah Attef, Helen Gabrah, Reem El-Sayed, Sarah El-Lithy

Papers, Posters, and Presentations

Since the start of the COVID-19 pandemic, the Egyptian government has been following protocol as best as possible when it comes to responding to the needs of the health and economic sectors amid difficult times. From lockdown measures to the WHO’s recommended practices in terms of isolation of cases and treatments, Egypt has been lauded as one of the fastest and most effective countries in terms of COVID-19 emergency response. Authorities have implemented several awareness campaigns directed at citizens to inform them about the pandemic, how to prevent infection, what to do if infected and how to act accordingly. Authorities …

Consumer Reactions To Alcohol Advertising Health Warnings In Ireland: An Experimental Research Study, Vania Filipova

Doctoral

Introduction and Aims As part of several measures to inform consumers about the health risks of alcohol and reduce alcohol consumption, the Irish Government signed into law the Public Health (Alcohol) Act 2018, with Section 13 requiring the implementation of multiple health warnings in all alcohol ads. While health warnings on product labels have been subject to intensive political discussion and academic research, health warnings in alcohol ads have received little attention and empirical support. This doctoral dissertation investigates whether health warnings in alcohol ads can promote cognitive and affective reactions in consumers. Furthermore, this thesis also examines whether the …

A Novel Approach To Reducing Adiposity Among Young Men, Jean M. Reading

Theses and Dissertations

Background

Lifestyle intervention is the first line treatment for obesity. Yet, young men are underrepresented in lifestyle interventions, which is posited to be the result of unmet needs and overall low concern for weight management. The aims of this dissertation are to:

Papers 1 and 2: Test the preliminary efficacy, feasibility, and acceptability of a self-guided lifestyle intervention for young men.

Paper 3: Explore the behavioral and physiological factors associated with changes in adiposity among young men and women enrolled in a more intensive lifestyle intervention.

Results

Papers 1 and 2: The self-guided intervention produced modest weight …

Pharmacists' Role In Opioid Use Disorder And Overdose Prevention And Treatment And Their Attitudes And Perceptions Towards Distributing Naloxone Under A Standing Order, Stephen C. Ijioma

Theses and Dissertations

Background: Opioids are a class of drugs that bind to opioid receptors (mu, delta, and kappa), located in the central and peripheral nervous systems, to exert responses such as analgesia, respiratory depression, euphoria, and miosis. The opioid epidemic is characterized in large part by an increase in opioid overdose deaths. Community pharmacists are one of the most accessible healthcare professionals who frequently interact with patients and can implement OUD and opioid overdose prevention strategies. Treatment for opioid overdose and OUD include naloxone for overdose deaths as well as medication-assisted treatment for OUD.

Objective: The specific aims of this thesis include …

A Quasi-Experimental Correlational Study Of Knowledge, Attitude, Behavior Of Nutrition Paraprofessionals Receiving An Online Nutrition Education Training. A Framework For Training Nutrition Paraprofessionals In Northwest Georgia Wic, Cicely Clarisse Thomas

UNF Graduate Theses and Dissertations

Background In 1998, Georgia Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) adopted the Florida Department of Public Health WIC Nutrition Training Guide. The purpose of adopting the course was to use it as a resource to properly educate and train nutrition paraprofessionals to conduct low risk education to Georgia WIC participants.¹ The Georgia WIC policy requires that each nutrition paraprofessional complete the approved nutrition training prior to educating WIC participants. The current resource for training nutrition paraprofessionals in Georgia WIC is outdated. Last updated in 2007, the formal training no longer accurately trains paraprofessional staff to …

Clinicians Experience Using The Family As A Unit Of Treatment For Black Hiv-Positive Men Who Have Sex With Men, Steffen Gillom

Antioch University Dissertations & Theses

The present study examines the experiences of five licensed clinicians as they attempted to integrate the family as a unit of treatment into the treatment of Black HIV-positive men who have sex with men (BHPMSM). A single 90-minute focus group study using an interpretive phenomenological approach (IPA) was conducted with five clinicians from diverse backgrounds. The results of the study show that clinicians attempting to integrate the family into the treatment of BHPMSM shared common experiences in the areas of building community through encouraging client self-determination, navigating religion, navigating HIV stigma, feelings of incompetence, and feelings of gratification after successful …