Medicine and Health Sciences Commons^™

Health Literacy And Diabetes Among Refugee Women Residing In Arizona, Aline Nina Indatwa

Walden Dissertations and Doctoral Studies

There is limited research available linking health literacy and diabetes knowledge to poor health outcomes among refugees. The aim of this study was to determine the levels of health literacy and diabetes knowledge and examine whether different factors (age, education, employment status, number of years lived with diabetes and length of stay since resettlement) are associated with health literacy and diabetes knowledge. A cross-sectional study was performed among 82 refugee women with a known diagnosis of diabetes and residing in Maricopa County, Arizona. A modified two part questionnaire (self-reported health literacy extracted from the European Health Literacy Questionnaire [HLS-EU-Q16] and …

Physicians’ Perceptions Of Facilitators And Barriers In Electronic Health Record Education, Alice Keene Martin

Walden Dissertations and Doctoral Studies

A significant focus in health care is quality documentation to lower patient safety risks. The local problem at a healthcare organization in the northeastern United States is that some physicians are falling short with quality documentation of patient care in athenaNet, a cloud-based electronic health record (EHR). This qualitative case study was conducted to explore physicians' perceptions of the facilitators and barriers that impact the educational process for quality documentation in EHRs. Attention also focused on identifying physicians' recommendations for enhancing the educational process for quality documentation. Knowles’ adult learning theory served as the conceptual framework. Purposeful sampling was used …

Familial Caregivers’ Perceptions Of Alcohol Use Among Mature Adults Residing In Assisted Living Communities, Lemeshia Meshana Agee Chambers

Walden Dissertations and Doctoral Studies

Research suggests that alcohol abuse is among the 8 primary causes of death for mature adults, which includes individuals age 65 and older. Alcohol use is a growing, unaddressed, public health concern among this referent population. Additionally, as mature adults enter the retirement phase of their lives, many of them transition to residing in assisted living communities. The purpose of this study was to explore mature adults’ alcohol use in assisted living communities and how such use, as perceived by the familial caregivers, affected the mature adults’ ability to age successfully. The population under study consisted of 8 familial caregivers, …

Staff Instruction On Patient Health Questionnaire And Collaborative Care Model In Primary Care, Jennifer Carton

Walden Dissertations and Doctoral Studies

The DNP project examined the effectiveness of the Patient Health Questionnaire-9 (PHQ-9) and the Collaborative Care Model (CCM) as a practice protocol for patients suffering from depression in primary care to address the problem of a shortage in mental health specialists. Research reveals an increase in Americans suffering from depression. Many primary care clinics do not have a practice protocol in place to screen and manage depression. The project's purpose was to develop a lesson plan to instruct staff on the PHQ-9 and CCM to implement into their practice. The project questions were if the lesson plan developed by the …

Impact Of Demographic Characteristics And Therapy On Tuberculosis Incident Cases, Iliedor Garcon

Walden Dissertations and Doctoral Studies

For more than two decades, tuberculosis (TB) has ranked second among the top killers of infectious diseases, with an estimated 10.4 million incident cases in 2018. Demographic characteristics and drug susceptibility influence TB incidence worldwide. Using a retrospective cohort design, the purpose of this quantitative study was to investigate whether race/ethnicity, age, sex (gender), therapy completion within one year (COT), and testing for isoniazid and rifampin susceptibility (TIRS) were predictors of 672 cases of TB in New York-Newark-Jersey City from 1993 to 2017. Guided by the epidemiological triad theory, this research was conducted using a secondary TB dataset from the …

Positive Behavior Support-Based In-Home Services For Traumatic Brain Injury, Charles Jack

Walden Dissertations and Doctoral Studies

Researchers have demonstrated the effectiveness of positive behavior support (PBS) services in the in-home (IH) setting but few studies examined its use with traumatic brain injury (TBI) clients, and most of these were small sample cases. Additional research on IH PBS services for TBI clients was recommended, in particular using larger samples. The purpose of this study was to address that need by examining the effectiveness of IH PBS services in treating TBI-related challenging behaviors on a larger sample. The theoretical foundations for PBS, behaviorism, cognitive constructivism, social learning theory, and the biopsychosocial model of behavior, are described. The research …

Comparison Of Health Factors And Outcomes Between Accredited And Nonaccredited Health Departments, Deborah Koester

Walden Dissertations and Doctoral Studies

The launch of the Public Health Accreditation Board in 2012 established national public standards. This study examined possible correlations between the accreditation status of local health departments and specific indicators for health, including communicable disease, disease prevention and health promotion, and maternal child health factors, and outcomes of premature death and infant mortality. The population for the intervention group included all 212 local health departments accredited from September 2012 through December 2017. Accredited health departments were matched with nonaccredited health departments based on population, rurality, agency type, governance authority, and state public health structure. Linear regression analysis was performed on …

Factors Affecting Seatbelt Use Among The Deaf And Hard-Of-Hearing, Deidre G. Mott

Walden Dissertations and Doctoral Studies

In the United States, despite the proven significant economic, health, and social benefits of seatbelt use, millions of Americans do not use seatbelts. It is known that some factors, including obesity, reduce the rates of seatbelt use; however, a lack of research exists regarding whether individuals who are deaf or hard-of-hearing (HOH) have different rates of seatbelt use. The purpose of this study was to examine the difference in seatbelt use between deaf or HOH individuals and hearing individuals after adjusting for individual-level factors (BMI, marital status, education, and access to health care). The theoretical foundation for this study was …

Bioterrorism: Exploring Factors For Improving Nurse Preparedness, Policies, And Practices, Leone Okey Tom-James

Walden Dissertations and Doctoral Studies

Ebola virus release/attack in New Jersey could go unnoticed but have immediate and long-lasting effects on the broader population and security. The risk underscores the need to prepare and enhance the state’s efforts to deal with a release and treat the confirmed cases. This descriptive single case research explored factors for improving nurses’ preparedness, policies, and practices for a bioterrorism release/attack. The epidemiological triangle conceptual framework was used descriptively in exploring, and developing a knowledge base of Ebola virus pathogenicity, characteristics, routes of transmission, and infection. The unit of analysis was Summit Ridge Genesis Healthcare Center. The theory of robust …

Social Cognitive Theory Constructs That Predict Betel Nut Chewing Among Secondary Students, Lepani Waqatakirewa

Walden Dissertations and Doctoral Studies

After alcohol, tobacco, and caffeine, areca or betel nut is the 4th most common substance of abuse in the world, and its prevalence of use in the Solomon Islands is estimated at 68% in young people. Long-term use of betel nut can result in detrimental health outcomes such as oral cancers and metabolic syndrome. Guided by the social cognitive theory (SCT), the purpose of this quantitative cross-sectional study was to determine whether the constructs of SCT predict betel nut use in Year 12 secondary students in the Solomon Islands. Five SCT constructs of expectations (outcome expectations and outcome expectancies), self-efficacy, …

Predictors Of Intention To Use Health Literacy Strategies Among Physicians In Grenada, Arlette Wildman

Walden Dissertations and Doctoral Studies

Low health literacy is linked to poor health outcomes. Adequate health literacy depends on effective communication between patients and their healthcare providers, so it is important physicians use health literacy strategies. Grounded in the theory of planned behavior, the aim of this quantitative correlational study was to investigate the relationship between health literacy knowledge, health literacy experience, gender, the region of training, years of practice, and intentions to use health literacy strategies among physicians in Grenada. One hundred and eighteen physicians were sampled using a cross-sectional survey method. The results of the multiple linear regression analysis were significant, F(5, 112) …

Predictors Of The Health Effects Of Marijuana Use On The Hepatic Function, Makafui Kokou Gbogbo

Walden Dissertations and Doctoral Studies

The quantity of marijuana use, the length of time it was used, and the age of initiation of the drug are at the core of the discussions about the potential health effects of marijuana use on the liver. Results of recent studies regarding how the drug affects human health have resulted in a number of conflicting conclusions. Nevertheless, based on these findings, marijuana users are being denied liver transplants. The objective of this study was to identify predictors of the health effects of marijuana on the liver and provide guidance in the care management of marijuana users. To address the …

The Relationship Between Practice Environment, Role Overload And Job Satisfaction Of Nurses In Canada, Olabisi Amao Olaniyan

Walden Dissertations and Doctoral Studies

Abstract

The shortage of nurses is a global phenomenon. The problem is particularly pronounced in rural areas and contributes to the health disparities experienced in the healthcare sector. Many factors had been shown to adversely impact the recruitment and retention of nurses, most especially in the rural areas. No study has examined how some factors such as the practice environment variation; geographical locations; and role overload impact job satisfaction of nurses. The Herzberg two-factor theory, with constructs of Motivation and Hygiene factors guided the study. In this quantitative, cross-sectional study, correlational approach was used to examine the association between the …

Staff Education On Type 2 Diabetes Mellitus, Joan P. Williams

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a major health concern that affects the physical and financial facets of communities. During the past 4 years, a multidisciplinary health care clinic in a northern state reported an increase in the number of type 2 diabetes (T2D) patients. Forty-three percent (43%) of adults with T2D had an elevated glycated hemoglobin A1c of 7.5% or higher. Yet, the staff at the clinic lacked current knowledge of T2D, quality of care, and prevention strategies for patients with T2D. This resulted in increased serious health care issues, associated costs, and increased complications of the patients with T2D. The purpose …

Practitioners’ Perceptions Of Medical Compliance Among Homeless Clients With Hiv And A Mental Health Diagnosis, Kyle Samuel Berkley

Walden Dissertations and Doctoral Studies

Previous research on HIV medical adherence has focused on incentive-based interventions, while previous research with the chronically homeless has focused on substance abuse, mental illness, and health disparities. This qualitative study focused on the experiences and perceptions of medical providers in a metropolitan area who work on medical adherence with homeless people living with HIV and mental illness. Ecological systems theory provided foundation to explore how medical providers form interventions based on clients’ ecosystems. The data were collected via audio-recorded, semi-structured interviews with 15 case managers, mental health therapists, nurses, and primary care physicians who worked at outpatient medical centers. …

Health Literacy And Health Beliefs With Adherence To Antihypertensive Medications In An Urban African American Cohort, Karen Ranae Dukes

Walden Dissertations and Doctoral Studies

African Americans aged 40 to 65 are more likely to be diagnosed with hypertension, and adherence to prescribed antihypertensive medication regimens is important in controlling their blood pressure levels. The purpose of this quantitative study was to examine the relationship between health literacy and sociodemographic and clinical factors with adherence to antihypertensive medications among African American adults. The theoretical framework for this study was the health belief model. A quantitative research design was used with participants recruited from churches with African American congregations in the city of Detroit. A convenience sampling method was used to obtain a sample of 79 …

Predictors Of Larc Use In High School Adolescent Females In The Unitedstates, Gloria J. Mabry

Walden Dissertations and Doctoral Studies

Teen pregnancy is a major public health problem in the United States of America. Among many contraceptive methods, long acting reversible contraception (LARC) is popular and effective. However, there was no adequate research study performed to show if minority teenagers are less likely to use LARC. The purpose of this study was to explore the relationship between adolescent sexual behavior and activity and the use of LARC in females, ages 14 to 19, in high schools across the United States. The theoretical framework used for this study was the health belief model. The study population was 1,496 White, Black/African American, …

Clostridium Difficile Incidence In Acute Care Hospitals: Patient And Hospital Characteristics, Angela Nwachuku

Walden Dissertations and Doctoral Studies

Hospital acquired infections (HAIs) calls for the attention of public research because it allows for investigation of the health practices, resources, and barriers of different health facilities and their surrounding communities. This research study examined the relationship between hospital acquired clostridium difficile infection (CDI) and patient, socioeconomic, and hospital characteristics in the state of New Mexico to determine their correlation with the increased incidence of CDI between 2013 and 2015 and if significant differences exist. The research questions were explored with the implication of the fundamental cause model and the pathways model. New Mexico patients over the age of 18 …

Process, Factors, Resources, And Health Consequences Of Burnout In Psychiatrists, Brittany Elise Plaven

Walden Dissertations and Doctoral Studies

Burnout among psychiatrists in the United States is prevalent; however, scholarly literature lacks studies exploring why psychiatrists are burnt out, what resources mitigate burnout, and the health implications of burnout, which is needed to improve health education programs for psychiatrists. Understanding the reasons for psychiatrist burnout, the resources that can mitigate burnout, and the health implications of burnout provided the purpose for this dissertation and foundation for the four research questions. The multidimensional theory of burnout, job demands-resource model, and the conservation of resources theory grounded the study. A qualitative, exploratory, multiple case study was conducted using data gathered from …

Sociodemographic Factors, Culture, And Suicide In Guyana, Kay Shako

Walden Dissertations and Doctoral Studies

Suicide in younger populations is a major public health concern and it significantly impacts third world countries like Guyana. Some challenges related to suicide are poor recording of suicide risk factors and customized prevention programs to address this significant issue. The purpose of this study was to examine which sociodemographic factors (age, gender, occupation, method of suicide, and region) are associated with suicide and method of suicide among people aged ≥ 15 years in Guyana. Also, because studies show that culture plays a pivotal role in suicide, this study investigated if there is a link between culture (ethnicity/race and religion) …

Knowledge And Use Of Health Services Related To Mother-To-Child Transmission Of Hiv In Nigeria, Uduak Bassey

Walden Dissertations and Doctoral Studies

HIV has remained a global public health issue despite efforts to curb the trend; especially in sub-Saharan African countries where more than 50% of those infected are women, creating implications for infant transmission. The purpose of this study was to assess trends in knowledge of prevention of mother-to child transmission (PMTCT) of HIV and use of PMTCT-related maternal health services (measured by antenatal care [ANC] in health facilities, use of HIV counseling and testing [HCT] during ANC, and use of skilled birth attendant at delivery [SBA]); as well as the association between knowledge and use of health services among reproductive …

Depression And Awareness Of Mental Health Resources Among Minority And Non-Minority College Students, Henry David Browne

Walden Dissertations and Doctoral Studies

Minority college students experience higher levels of psychological stress and depression, and lower utilization of mental health resources (MHR) compared to the general student population. The purpose of this quantitative study was to examine the association between self-reported depressive symptoms and awareness of mental health services among college undergraduate minority and non-minority students, controlling for sex, interest in MHR information, and history of mental illness. The self-determination theory guided the study. The study utilized a cross-sectional research design using secondary survey data from the National College Health Assessment (NCHA). The NCHA dataset included 354,262 respondents from 52 self-selected U.S. colleges …

Demographic, Lifestyle, And Psychosocial Predictors Of Obesity Among Nigerian Igbo Immigrants, Ahamefula Arthur Duru

Walden Dissertations and Doctoral Studies

Obesity is known as a risk factor for chronic diseases, and a contributor to health disparities among minorities and vulnerable persons. There is a paucity of data on Nigeria Igbos on obesity risks in the United States; therefore, studying obesity in this population may help policymakers tailor interventions that could reduce the prevalence of obesity. The purpose of the study was to examine the predictors of obesity among Nigerian Igbo immigrants in the United States. This study sought to examine lifestyle, psychosocial, and demographic factors as unique predictors of obesity in Nigeria Igbo immigrants. The social-ecological model and acculturation theory …

Moderate-Intensity Risk Reduction Counseling And Acquisition Of Sexually Transmitted Infection, Cindy M. Farina

Walden Dissertations and Doctoral Studies

Sexually transmitted infections (STIs) are a public health problem in the United States, with adolescents and young adults to age 25 bearing a disproportionate burden of infection. Risk reduction counseling (RRC) as a strategy to decrease STI incidence has been a focus of scholars. Research examining RRC efficacy has suggested that RRC is effective for 6 to 12 months after treatment. However, study samples have varied by age, ethnicity, race, gender, and geographic location. Whether RRC is effective for more than 1 year is unknown. The purpose of this post hoc chi-square study was to examine the efficacy of moderate-intensity …

Epidemiology Of Marijuana Use And Mental Health In The Context Of Changing Policies, David G. Harvey Ii

Walden Dissertations and Doctoral Studies

There is a growing body of evidence supporting the association between cannabis use and the development of mental health disorders, but few studies have addressed this association following the recent increase in marijuana legalization laws. Therefore, using the social ecological model and the self-medication theory of addiction as theoretical frameworks, the purpose of this retrospective database study was to assess the relationship between marijuana use and major depression and suicidal ideation in both adults and adolescents in 2008 and 2017. Data from the National Survey on Drug Use and Health were analyzed using logistic regression at the p < .05 threshold for statistical significance. Results demonstrated positive, statistically significant relationships between marijuana use and both major depression and suicidal ideation for both adults and adolescents in both 2008 and 2017. Further, the strengths of these relationships generally increased between 2008 and 2017, coincident with the increase in marijuana legalization laws. These findings provide empirical support to the association between cannabis use and the development of mental health disorders, and that the strength of these associations is increasing following the increase in marijuana legalization laws. This study has important implication for positive social change by identifying significant relationships between cannabis use and the development of mental health disorders and revealing that these relationships are strengthening over time, coincident with the increase in marijuana legalization laws.

Association Of Landfall Atlantic Tropical Storms And Human Cases Of Locally Acquired West Nile Virus Infection In Florida, Jackson G. Mosley

Walden Dissertations and Doctoral Studies

West Nile virus (WNv) is the most widely distributed flavivirus and considered a vector-borne pathogen of global significance. During the study period from 2002 to 2018, WNv had the highest incidence of locally acquired human cases when compared to any other mosquito borne illness in Florida with 373 cases documented during the study period. The purpose of the study is to determine if there is an association between Florida landfall tropical storms (LTS) and the incidence of locally acquired human WNv cases from 2002 through 2018. The study used a retrospective ecological study design guided by the epidemiological triad model …

Population-Level Determinants Of Cholera Incidence In African Countries, Ngoy Nsenga

Walden Dissertations and Doctoral Studies

Cholera remains endemic in Africa, with limited access to safe drinking water and inadequate sanitation as 2 of the main drivers of its dissemination. Few studies have examined the impact of health system capacity, even though it plays an important role in prevention, early detection, and response to a cholera outbreak. Grounded in the ecosocial theory of infectious disease dissemination, this quantitative ecological study explored the effect of social vulnerability (as measured by access to safe drinking water and sanitation, rate of open defecation, poverty, income inequality, gender inequality, and adult literacy) and health system (as measured by health financing …

How Older Nigerians View The Impact Of Migration On Their Health, Jayne Nwankwo

Walden Dissertations and Doctoral Studies

Migration into the United States opens windows of opportunity, but also involves difficult experiences that impact the health of migrants. In this qualitative study, the meanings that Nigeria migrants (aged 65–80) placed on their migration experiences were explored in relation to their health and well-being. Literature revealed no prior migration study on this population. The social constructivist approach provided the framework for this study. Purposive sampling was used to recruit 13 participants that fell within the selection criteria. Face to face interview was used to obtain participants’ view of health; their challenges to adaptation to the United States; the impact …

Demographic Factors Associated With Childhood Obesity Among Women, Infants, Children (Wic) Participants In 2014, Olukayode Wisdom Oduwole

Walden Dissertations and Doctoral Studies

In the past few years, there has been an alarming increase in childhood obesity in the United States and worldwide, however there is little consensus around how to respond to the problem. What has now become an epidemic, was uncommon decades ago. This study assessed the demographic factors associated with childhood obesity among WIC participants in 2014. The study utilized demographic data from 3,011,119 participants in 2014 nationally representative National Health and Nutrition Examination Survey, and social cognitive theory (SCT) to understand the demographical factors associated with childhood obesity. Adjusted odds of obesity were calculated to assess association between males …

Readiness Of Stakeholders To Adopt Community Paramedicine Programs In Tennessee, Roger Lloyd Ritchie

Walden Dissertations and Doctoral Studies

Abstract

Community paramedicine is an emerging model of care that promulgates EMS in a more community-based and integrated role within the broader health care system. A hallmark characteristic of community paramedicine is that programs are designed to meet the specific needs of a given community, rendering programs unique but perplexing. A need for research aimed at exploring possible barriers that may impede the adoption and implementation of community paramedicine programs has been identified by the National EMS Advisory Board, the North Central EMS Institute, and the Joint Committee on Rural Emergency Care. The purpose of this study was to explore …