Medicine and Health Sciences Commons^™

Analysis Of The Impact Of Family Structure And Type 2 Diabetes Among Adolescents, Danny Lee Self

Walden Dissertations and Doctoral Studies

Type 2 diabetes (T2D) has increased among the adolescent population in the United States within the past 30 years. While the increase in T2D is linked to obesity and a lack of physical activity, it lacks contextual analysis within the structure of the non-traditional family unit. The purpose of this quantitative study was to examine family structure and prevalence of T2D among adolescents. Krieger’s ecosocial theory guided the study. The research questions were designed to investigate whether family structure directly impacts T2D prevalence or indirectly through socioeconomic status. The research design was quantitative with cross-sectional analysis of secondary data. The …

Treatment Interventions For Tobacco Cessation At An Inpatient Mental Health Facility, Stephanie Marie Stansell

Walden Dissertations and Doctoral Studies

Tobacco use is the leading cause of preventable death and disease in the United States. According to the Centers for Disease Control and Prevention, 36.5% of adults with any mental illness use tobacco compared to 25.3% of adults without a mental illness; however, there are limited data to determine the best approaches for tobacco cessation among the mentally ill. The purpose of this quantitative, quasi-experimental study was to investigate the differences among 1-on-1 counseling versus group counseling in tobacco cessation rates among psychiatric patients aged 18 years old and older who were identified as a tobacco user upon admission to …

Sociodemographic Factors Associated With Abortion Rates Among Black Women In The United States, Lincoln Don Washington

Walden Dissertations and Doctoral Studies

Abortion has been a public health issue since the procedure became legal 47 years ago and, clinicians have performed 60,069,971 abortions from 1973 to 2017 in the United States. In 2014, a significant decline in abortion rates has been recorded in almost every state, as well as across different subpopulations when segregated by age, race/ethnicity, education, income, or geographic locations. However, abortion rates were still significantly higher among Black women relative to the U.S. average, prompting the need to examine the causes of this disparity. The main purpose of this quantitative study was to investigate and determine the sociodemographic causing …

Nursing Home Caregivers’ Knowledge Of Decubitus Ulcer Prevention Strategies, Shola Akinfiresoye

Walden Dissertations and Doctoral Studies

Decubitus ulcers (DUs) were a constant concern among the residents of the nursing home in this project. Prolonged immobility, sensory impairment, and urinary incontinence are some of the factors found in the literature as the causes of the disease. However, the lack of useful knowledge regarding evidence-based practices (EBPs) to prevent and treat DUs also contributed to the higher incidence rates at the nursing home. The purpose of this DNP- project was to evaluate the caregivers’ knowledge of EBPs to prevent and treat DUs at the facility. The IOWA Model of Evidence-Based Practice, which healthcare practitioners use to guide clinical …

Relationship Between Health Risk Behaviors And Obesity Among American High School Students, Jacques Jean-Paul Cherry

Walden Dissertations and Doctoral Studies

Adolescent obesity is a serious health condition that affects more than 55% of students aged 12 to 19 years in the United States. Recent statistical data have noted that the rate of adolescent obesity has more than quadrupled during the past few decades. Genetics and factors such as tobacco use, alcohol use, and marijuana use have contributed to this critical public health issue. Although uniqueness of prevalence has often been linked to gender and race, associations related to these health risk behaviors and increased body mass index remain relatively unexplored among today’s U.S. youth. Adolescence has been described as a …

A Staff Educational Model For Prevention Of Type 2 Diabetes In The Primary Care Setting, Mieshia Staples Clark

Walden Dissertations and Doctoral Studies

Type 2 diabetes is a chronic, debilitating disease affecting millions of Americans. Though preventable, it is the most common form of diabetes in the United States, costing the U.S. health care system billions of dollars annually. Lifestyle modifications taught, encouraged, and supported in established, evidence-based diabetes prevention programs (DPP) are proven to be more effective than medications alone in preventing Type 2 diabetes. While DPPs are cost-effective and can reduce or delay the incidence of Type 2 diabetes, they are greatly underutilized due to primary care providers’lack of knowledge about the benefits and availability of these programs and also due …

Improving Care Of Patients With Asthma Through Staff Education, Nicholas Moscatelli

Walden Dissertations and Doctoral Studies

Chronic asthma is a health epidemic and an increasing problem in the pediatric population. The purpose of this project was to raise nursing staff awareness of symptom recognition, treatment protocols, preventive measures, and detrimental effects of asthma for children. Adult learning theory provided the framework to support the staff education program on asthma. The project site stakeholders and the DNP student identified educational opportunities to assist staff in meeting caregiver needs, improving symptom recognition, and improving asthma outcomes. Prior to presentation of the educational program to the clinic nursing staff, it was reviewed by an expert panel including the clinic …

Public Health Leadership In The Philippines: Effective Approaches In Malaria Surveillance, Gethro Nullan

Walden Dissertations and Doctoral Studies

Leadership traits that affect and shape cost-effective practices ensure the long-term

growth and success for any organization. The purpose of this single case study was to explore leadership traits that may contribute to cost-effective approaches in a malaria surveillance program in the Philippines. The National Health Service Leadership Framework provided the conceptual framework for this study. The participants included 12 public health leaders/managers who have worked or been involved in malaria surveillance programs with budgetary oversight. Data were collected through in-depth interviews and document analysis. Values coding was used for data analysis, in which participants’ perspectives were coded using the …

Program Evaluation Of A Black Barbershop Health Outreach Campaign, Berkina Denise Porter

Walden Dissertations and Doctoral Studies

Black-owned barbershops in the Black community lack barber administered interventions to provide education and health screenings to Black men. Increasing knowledge of health assessments in a black barbershop setting increases the number of health screenings and preventative care among Black men. Grounded in general systems theory, the purpose of this qualitative summative program evaluation was to explore the extent to which a nonprofit Black barbershop health program aligns with the Health Research (HR) program objectives. The evaluation was performed for a nonprofit organization located in Maryland, 6 years after the organization implemented the HR Program Network of barbers and salon …

Predictors Of Condom Use Among High School Students In North Carolina, Danielle Cierra Robinson

Walden Dissertations and Doctoral Studies

The spread of sexually transmitted diseases is a major ongoing public health issue in North Carolina. Adolescents between the ages of 13 and 19 years have consistently contributed to this trend. Researchers have found that condom use among high school students has decreased. High school students continue to engage in sex with multiple partners, with lack of knowledge about sexually transmitted diseases, even though sex education and prevention programs have been recommended. The purpose of this quantitative study was to evaluate the predictors of condom use among adolescents. The socioecological model theoretical framework was applied to guide this research involving …

Socioeconomic And Sociocultural Factors Associated With Parenting Choice And Fertility Experience Among Lesbian And Nonlesbian Women, Annette Silvia

Walden Dissertations and Doctoral Studies

Minorities including lesbians may face disparities that contribute to minority stress, which leads to adverse health outcomes. The purpose of this social epidemiology study was to examine the association between insured status, perceived stress, and parental status among lesbians and nonlesbians. The theoretical foundation was minority stress, and the design was quantitative with a convenience sample of women aged 18 years and older. Data on demographics, perceived stress, fertility quality of life, and lesbian identity disclosure were collected via online survey. Among the 314 respondents, 102 self-selected as lesbian (49% parents), and 212 self-selected as nonlesbian (73.1% parents). More than …

Obesity And Overweightness Among African-American Adolescent Population And Health-Related Quality Of Life, Emmanuel Anene

Walden Dissertations and Doctoral Studies

Obesity and overweightness are a significant public health problem and a risk factor for many chronic diseases. The purpose of this study was to find the associations between gender, race, physical activity, and health-related quality of life (HRQOL) among obese and overweight African American adolescents aged 12 to 19 years. An improved understanding of the health issues could help this population live a longer quality life and prevent serious health implications in adulthood. A quantitative approach with a sample size of 331 was used. The control variables were age and household income, the dependent variable was HRQOL, and the independent …

The Lived Experience Of Child Marriage And Its Health Effects Among Young Mothers In Nigeria, Anastasia Iliwo Ashi

Walden Dissertations and Doctoral Studies

Child marriage has life-threatening implications for the mental, physical, and psychological development of the girl-child. In Sub-Saharan Africa, and other resource poor settings, child brides and very young mothers undergo various negative experiences including economic hardship and health challenges such as obstetric fistulas, birth complications, and even death. The purpose of this phenomenological study was to describe the lived experiences of child marriage and its effect on maternal health among young mothers in Nigeria. The social ecological model provided the conceptual framework for this study. Ten young women ages 18-24 years who had been child brides when age 12-16 years …

Attitudes And Beliefs Related To Risk Of Sexually Transmitted Infection In Swingers Who Do Not Use Condoms, Deborah Brown

Walden Dissertations and Doctoral Studies

Sexually transmitted infection (STI) affects the public as a hidden epidemic of contagious disease with significant economic and health impacts. There are 110 million living with STI in the United States, with 20 million new infections annually. Condom use can reduce STI, but some people have sex without condoms, with risk for contracting or transmitting STI increasing when a person is in the same sexual network. Swingers are a growing sexual network and are a group at high risk of developing and spreading STI. The purpose of this generic qualitative study was to develop an understanding of the attitudes and …

Group Education Program To Increase Obesity Knowledge In Cardiac Care Nurses, Ethel Emenogu

Walden Dissertations and Doctoral Studies

Obesity increases the severity of cardiac disease, leading to increased mortality and morbidity. The need to address obesity is critical in reducing obesity-associated complications such as heart failure, strokes, heart attacks, and even death. Obesity is also a risk factor for many chronic diseases such as heart disease, cancer, diabetes, hypertension, and depression. Evidence has shown that obese individuals with cardiac disease are at increased risk of developing complications. The practice-focused question for this doctoral project asked whether a group educational program could increase obesity knowledge among cardiac care clinic nurses. The purpose of this DNP project was to provide …

Demographic, Environmental, And Clinical Variables Associated With Dengue In Saint Lucia, Brendan Lee

Walden Dissertations and Doctoral Studies

Dengue is the most important arboviral disease of public health concern on the world stage. In Saint Lucia, the disease has been endemic for years. Little research has been published on the specific epidemiology of dengue in Saint Lucia, and this study sought to identify the risk factors associated with the disease specific to the island. This study was underpinned by ecological theory, which is used to explain the possible relationships between risk factors and the occurrence of dengue. This three-manuscript study was used to evaluate the relationship between demographic, environmental, and clinical variables and the occurrence of dengue as …

Healthcare Providers Perception Of Their Ability To Recognize Boys As Victims Of Human Sex Trafficking In A Pediatric Emergency Room, Deborah Susan Mican

Walden Dissertations and Doctoral Studies

The purpose of this dissertation was to explore the perceived barriers to pediatric emergency room (ER) providers’ identifying boys as victims of child sex trafficking (CST), to understand how providers working in a pediatric ER compared to a general ER believe they are better able to identify boys as CST victims, and to understand how the New Jersey-mandated human trafficking training affected the confidence of the healthcare providers’ to identify boys as CST victims using a grounded theory approach. In-depth interviews were conducted using a sample of 10 healthcare providers, including physicians, nurse practitioners, and physician assistants at a suburban …

Socio-Economic Determinants Of Risky Sexual Behavior In Sub-Saharan Africa, Frida Tende

Walden Dissertations and Doctoral Studies

Risky sexual behavior (RSB) is a major public health concern due to health outcomes, such as HIV/AIDS, sexually transmitted infections, and unwanted pregnancies. RSB has been identified as 1 of the main components contributing to the high HIV incidence rate in sub-Saharan Africa. The purpose of the current research was to investigate RSB and its association with education and economic status among men and women in 3 sub-Saharan African countries (i.e., Rwanda, Zimbabwe, and Cameroon) while controlling for gender, age, religion, and place of residence. The social cognitive theory provided the framework for this cross-sectional study that included data from …

Access To Healthcare For American Indians Residing In The Northeast United States, Kristine D. Thomas-Jones

Walden Dissertations and Doctoral Studies

Urban American Indians/Alaskan Natives (AIs/ANs) have limited access to health care in comparison to non-Hispanic Whites (NHWs), which furthers health disparities for indigenous communities. The purpose of this quantitative, nonexperimental study, which was guided by the socioecological model, was to examine the relationship between access to health care and healthcare utilization among urban AIs/ANs and urban NHWs in the Northeast United States. The research questions addressed the difference in access to healthcare based on health insurance, difference in healthcare utilization, and whether there is an association between health care access and health care utilization for AIs in the Northeast United …

Nurse Practitioner Approach To Care For Peripheral Vascular Disease, Jessica R. Wozniak

Walden Dissertations and Doctoral Studies

The Amputation Coalition indicates that there were approximately 2 million people with limb loss in the United States primarily caused by peripheral vascular disease in 2019. Those with amputation related to vascular disease have a 5-year mortality rate. The gap in clinical practice at the facility used for this project is that there were no comprehensive program guidelines for nurse practitioners and other health care professionals working with people who are at risk for vascular intervention or limb loss. The practice-focused question was answered that an interprofessional team did develop a prototype for a comprehensive peripheral vascular program that serves …

Association Between Obesity, Socioeconomics, Mental Illness, And Education In Native American Communities, Darrell D. Wright

Walden Dissertations and Doctoral Studies

Obesity is a profound health epidemic that adversely affects the health of all ethnicities. This growing health crisis has been found to be linked to several chronic diseases such as stroke, diabetes, and several forms of cancer. As in Native American populations, increased morbidity and mortality rates associated with obesity prevalence in minority populations has been linked to variables such as income, education, mental illness, and age. The purpose of this research was to examine the association of obesity with socioeconomic status, education, mental illness, and age in Native American populations. The theoretical framework used in this study was based …

Changes In Operating Performance In Rural Hospitals From 2012 To 2019, Oluwaseyi Tami Young-Harry

Walden Dissertations and Doctoral Studies

Rural hospitals treat patients while dealing with the challenges of an inadequate workforce, limited financial resources, and an isolated geographic location, leading to difficulties in achieving financial viability. The purpose of this quantitative study was to analyze the operating performance of rural, general, medical and surgical hospitals in the United States and to determine if performance had changed from 2012 to 2019. Guided by x-efficiency theory, this study addressed whether hospital ownership explained variation in performance and if performance had changed from 2012 to 2019. A random sample of 394 rural hospitals was used, with data drawn from the American …

Impact Of Medicare Utilization On Mortality And Readmission Rates Of Heart Failure Patients 65 Years And Over, Joanna Alexander

Walden Dissertations and Doctoral Studies

Roughly 25% of individuals 65 years and over hospitalized with heart failure are readmitted within 30 days after discharge. Elderly individuals identified with heart failure possess a 5-year mortality approaching 50%. The purpose of this study was to determine if there is a relationship between Medicare-covered services for care, mortality rates, and readmission rates for beneficiaries 65 years and over with heart failure. To address this topic, the chosen approach was retrospective and quantitative. The theoretical foundation was the Chronic Care Model. The research questions sought to determine if there is a relationship between the Medicare-covered services for care and …

Recovering Illicit Substance Users' Perspective About Mandatory Drug Testing In Schools, Julie Bowser

Walden Dissertations and Doctoral Studies

The purpose of this exploratory qualitative study was to examine recovering substance

abusers' perceptions about the usefulness of mandatory drug testing in schools for adolescent substance abuse. Illegal substance abuse has reached epidemic proportions as more than half of U.S. adolescents, aged 12 to 17 years, have engaged in illicit drug use. Substance abuse information has been a part of school health education programs since the United States Drug Free Schools and Communities Act of 1986. Despite substance abuse education and school programs about the effects of drug use, many high school students abuse illicit drugs. Face-to-face interviews were conducted …

Voluntary Male Circumcision And Risk For Human Immunodeficiency Virus In Homa Bay, Kenya, George Obhai Gabriel

Walden Dissertations and Doctoral Studies

The role played by the belief about voluntary medical male circumcision (VMMC) in predicting HIV status has not been examined. The purpose of this study was to investigate whether there were any differences between belief about VMMC, unprotected sex, age, number of sexual partners, relationship status, and HIV status among circumcised males aged between 18-49 years in Homa Bay County, Kenya. Drawing from the health belief model and case-control study design, 936 men were recruited based on their HIV status (468 HIV cases and 468 controls). A bivariate logistic regression was applied, and the results indicated that unprotected sex, age, …

Obesity, Snoring, Sleep Apnea, And Coronary Heart Disease, Maryam Khalilah Muhammad

Walden Dissertations and Doctoral Studies

Coronary heart disease (CHD) is a significant public health issue that affects communities across all socioeconomic and demographic groups. Risk factors for CHD include sleep apnea and snoring. Obesity with short sleep duration also places individuals at higher risk for CHD. Although limited research has been conducted on CHD and its relationship to obesity, sleep apnea, and snoring as individual risk factors for CHD, a gap exists as these factors had not been studied as paired in this study. The purpose of this quantitative, cross sectional study was to determine if a significant relationship existed between obesity, snoring, sleep apnea, …

Factors Associated With Hepatitis B Vaccination Among Asian Adults (≥ 18 Years) In The United States., Naana Abena Ohemeng-Tinyase

Walden Dissertations and Doctoral Studies

In the United States, hepatitis B disproportionately affects Asian and Pacific Islanders (AAPIs). Hepatitis B related liver cancer is the leading cause of cancer deaths among Asian Americans. Despite the proven significant economic, health, and social effect of hepatitis B virus, immunization rates remain low. The purpose of this study is to examine the association between sociodemographic factors (age, marital status, gender, work experiences), health status factors (chronic disease, nonchronic disease), health behavior factors (smoking, alcohol intake, tobacco use, physical activity), and hepatitis B vaccination among Asian adults (≥ 18 years) in the United States. The main theory that frames …

Education To Improve Health For Rural Africa American Women With Diabetes, Monique Deidre Pendleton

Walden Dissertations and Doctoral Studies

Diabetes (DM) is the 7th leading cause of death in the United States. Minorities like Hispanics and African Americans (AA) are at greater risk of developing DM. The prevalence and outcomes affecting diabetes are attributed to socioeconomic status, sex differences, ethnic, cultural, and religious status. Diabetes-related mortality is a major health problem in AA in rural America. The focus for this project was to identify the best evidence regarding educational counseling on lifestyle modifications that positively impact adult AA women with diabetes living in Rural America. The social-ecological theory and health belief model informed this project because these models incorporate …

Relationship Between Clostridium Difficile Testing Method, Antibiotic Treatment, And Clinical Symptoms, Jennifer L. Sanguinet

Walden Dissertations and Doctoral Studies

Clostridium difficile (C. difficile) infection is a leading cause of morbidity and mortality in the United States, making the infection a top public health priority. Early and accurate identification of disease is a critical factor in successful management, including clinical symptomology. The testing methods for C. difficile have improved in efficiency and sensitivity, which potentially causes over- or underprescribing behavior. Guided by the symbolic theory, the purpose of this study was to examine the association between C. difficile testing method by case year (2015 and 2018) and antibiotic treatment with the potential moderation of clinical symptoms. The secondary correlational analysis …

Association Between Mentoring Interventions And Drug Abuse Among African Americans Aged 10-24 Years, Anthonia Ifeyinwa Dunkwu

Walden Dissertations and Doctoral Studies

Drug abuse represents a significant public health problem worldwide, with socioeconomic consequences shaped by a cluster of behavioral, cognitive, and physiological phenomena and serious social, physical, emotional problems. The purpose of this study was to assess the association between mentoring interventions and drug abuse among African American young people. The health belief model was the theoretical framework. The secondary data analysis was done using the data set from the 2014 National Survey on Drug Use and Health. The dependent variable was drug abuse, while the independent variable was mentoring interventions. The Chi-square analysis revealed an association between participation in school-based …