Medicine and Health Sciences Commons^™

The Effect Of Maternity Care Practices On The Duration Of Breastfeeding, Lisette Rodriguez

Walden Dissertations and Doctoral Studies

The natural practice of breastfeeding has been strongly noted as one of the most cost-effective, health promoting, disease-prevention strategies of the 21st century. Although primary health organizations recommend exclusive breastfeeding for the first 6 months of life with added complementary foods and continued breastfeeding up to 2 years of age or longer, many mothers do not breastfeed their infants for the recommendation length of time. Applied policies and health practices, such as those described under the 10 Steps to Successful Breastfeeding and The International Code of Marketing of Breast Milk Substitutes, have been noted as contributing factors that can considerably …

The Association Between Leapfrog's Healthcare Organizational Grades And 30-Day Mortality Rates, Steven Michael Armstrong

Walden Dissertations and Doctoral Studies

U.S. healthcare consumers have access to various provider ratings from several organizations that are meant to assist in selecting their healthcare providers. Leapfrog Hospital Safety Grades is one such rating system that professes to allow consumers the ability to select the best hospital for their care. However, since consumers ranking mortality risk as their most important concern, it is essential to determine if Leapfrog grades align with consumer expectations. Andersen's Phase-4 behavioral model of healthcare utilization was used as the foundation for understanding healthcare consumer preferences. This study was designed to determine if Leapfrog grades are predictive of CMS 30-day …

Incentive Size Alignment With Accountable Care Organization Performance, Kristie D. Racca

Walden Dissertations and Doctoral Studies

Changes to the country's health care political landscape in 2012 resulted in the development of federal programs aimed at containing costs and improving the quality of care delivered. Accountable Care Organizations (ACO) emerged linking performance to rewards. Guided by Conrad's value-based performance incentive theory as the theoretical foundation, the purpose of this quantitative study was to determine the relationship between financial incentive size and ACO performance measures. The research questions examined the predictive relationship of incentive size and acute care readmission rates, emergency department (ED) visits, and per capita spending of the ACO Medicare Shared Savings Program population. The study …

Implementing Aromatherapy For Falls Reduction In The Inpatient Hospice Population, Kimberly Kay Pistek

Walden Dissertations and Doctoral Studies

Falls among the elderly is a health concern affecting multiple patients annually. Hospice patients and those with multiple comorbidities are at the greatest risk of falling and sustaining injuries from falls. Aromatherapy has been used for reducing multiple symptoms as well as for decreasing falls. The practice-focused question explored whether an education program on using aromatherapy for fall prevention would increase knowledge of this intervention for an interdisciplinary group of hospice staff. The design was developed using Knowles's theory of andragogy and Bloom's taxonomy. Thirteen staff members from the same facility participated in the education program. The program was targeted …

Cultural Health Beliefs And Influenza Vaccination Among Caribbean-Born Students, Dona S. Walcott

Walden Dissertations and Doctoral Studies

This purpose of this quantitative study was to examine health beliefs among Caribbean-born university students regarding acceptance or rejection of influenza vaccination among populations at institutions of higher education. In addition, acculturation was addressed as a factor affecting cultural health beliefs. A survey was completed by 98 students enrolled at Florida International University during the spring 2018 semester. Linear regression was used to analyze whether cultural health beliefs and acculturation were predictive of beliefs about influenza vaccination and beliefs about perceived barriers to influenza vaccination. The study findings showed cultural health beliefs of the students were statistically significant predictors of …

Improving Early Mobilization In Acute Stroke Patients Through Best Practice Education, Angela Christine Middleton

Walden Dissertations and Doctoral Studies

Nonadherence to best practice guidelines in early mobilization in acute stroke increases the time from admission to mobilization and may increase residual long-term stroke effects. Early mobilization following an acute stroke is known to decrease long-term and secondary disability. The purpose of this project was to decrease the time from admission to mobilization in the acute stroke patient population by improving knowledge of best-practice guidelines in early mobility using an educational intervention for advanced practice nurse practitioners, physicians, and registered nurses. The practice-focused question for this project asked whether a staff educational program based on best-practice guidelines would decrease the …

Parents' Knowledge Of Child-Passenger Safety And Child-Passenger Restraint Usage, Amanda Cadore

Walden Dissertations and Doctoral Studies

Although occupant protection laws exist, limited research has been conducted on how current child passenger safety (CPS) issues and CPS marketing strategies relate to child passenger safety seat (CPSS) usage. The purpose of this cross-sectional study was to analyze the relationship between parents' perception and knowledge of CPS issues and CPSS usage rates. The diffusion of innovation and the social marketing theories provided the frameworks for this study. The overall research question for the study examined the correlation between parents' knowledge of CPS issues and CPSS usage. Data (participants' surveys, car seat check-up information, and observational statistics) were collected from …

Relationship Between Adolescent Perception Of Harm, Electronic Cigarette Use, And Texas Antitobacco Campaigns, Candace Rasheedah Campbell

Walden Dissertations and Doctoral Studies

The increase in use of e-cigarettes in adolescents is a major public health concern that must be addressed. Research studies showed some e-cigarettes contained varying amounts of nicotine and sever cancer-causing chemicals. The purpose of this quantitative, cross-sectional study was to assess the perception of harm (dependent variable) from using e-cigarettes and being exposed to state and school-based antitobacco programs (independent variable) and to determine if the association was modified by socioeconomic status or area of residence. Attitude-social influence-self-efficacy theory was the chosen theory for research and suggests that attitude, social influence, and self-efficacy variables can be persuaded via specific …

Cited And Underprepared; The Call For Improved Emergency Preparedness In Ltc Facilities, Dawn M. Ide

Walden Dissertations and Doctoral Studies

This research investigated the connection between the Medicare star rating system and E-tags on emergency preparedness of nursing homes for disasters in Hampton Roads, Virginia. Emergency preparedness in nursing homes has been a topic of growing interest within the past decade. Hampton Roads, Virginia, has a history of natural disasters including hurricanes and flooding, which necessitates a proper and efficient emergency preparedness plan in nursing home facilities. The primary purpose of this research was to review the secondary Centers for Medicare and Medicaid Services (CMS) data regarding the star rating system and E-tag surveys of each of the 37 nursing …

Racial Disparities, Fragmentation Of Care, And Adverse Outcomes Associated With Ectopic Pregnancy, Angela Rosa Jourdain

Walden Dissertations and Doctoral Studies

Ectopic pregnancy (EP) is a rare condition that occurs in 1% of all pregnancies. However, women of lower socioeconomic status (SES) and ethnic minority groups are at greater risk of adverse outcomes associated with EP than White women. The purpose of this study was to examine data from the 2014 National Inpatient Sample to identify predictors of complications from EP in 2,626 females ages 15-44 in the United States. The theoretical framework used to guide this study was the theory of fundamental causes to explain why the association between SES and mortality has persisted despite progressive advances in the diseases …

Staff Education: Hypertension Management For Adults In Primary Care Settings, Doris Adediwura Obaze

Walden Dissertations and Doctoral Studies

Management of hypertension and its complications requires health care providers to

understand the reason for developing the disease. Complications of hypertension (HTN)

are more prevalent when patient interventions are not consistently performed by staff. A

gap in staff knowledge regarding the management of patients with HTN was noted at an

outpatient clinic in the southwestern United States. A staff education project based on

the Eighth Joint National Committee (JNC-8) guidelines for HTN management was

developed to address the gap in knowledge. This DNP project sought to understand the

impact of an evidence-based staff education program in improving the knowledge of …

Utilizing Food Safety Knowledge In Comprehensive Patient Care Among Harlem Hospital Physicians, Sean Alexander Shivers

Walden Dissertations and Doctoral Studies

According to the World Health Organization (WHO), people throughout the world become sick every year from consuming contaminated foods, which impacts countries’ socioeconomic development, straining their healthcare system, travel and tourism, and foreign trade markets. To help alleviate the impact foodborne illness (FBI) has on society, scholars suggest physicians incorporate food safety in their standard work practice. The purpose of this study was to determine if Harlem Hospital physicians utilized food safety knowledge in comprehensive patient care with a diagnosis of FBI, in addition to how physicians passed this food safety information onto the patient. A qualitative methodology using an …

Mothers' Parenting Discipline Style And Their Early Puberty Daughters' Engagement In High-Risk Behaviors, Yvette C. White

Walden Dissertations and Doctoral Studies

Some early puberty girls engage in high-risk externalizing behaviors such as early sexual activity, delinquent behavior, and disruptive behaviors. Harsh parenting experienced by girls who develop early has been associated with delinquent and disruptive behaviors. The purpose of this quantitative correlational study was to examine predictive relationships between the style of parental discipline by mothers of early puberty girls and the likelihood and frequency of the girls' engagement in high-risk behaviors. Parenting style theory, including the authoritarian, authoritative, and permissive style of parenting, served as the theoretical foundation for the study. Survey data were collected from 28 mothers who identified …

Factors That Influence Physical Activity Among African American Mothers At Recreation Centers, Nichole Leigh Glover

Walden Dissertations and Doctoral Studies

Physical activity is a critical factor in preventing obesity and other chronic illnesses. African American women experience higher rates of physical inactivity than the general population. As a key figure in the family, African American mothers should model healthy behaviors to the family, especially their children. This qualitative study explored the physical activity attitudes of African American mothers who frequently visit a recreation center in the Columbus, Ohio, area. The research questions focused on the possible barriers and motivators for physical activity engagement. The theory of planned behavior, which emphasizes behaviors, intentions, and attitudes when exploring health behaviors, guided the …

The Use Of Mobile Healthcare Clinics To Expand Access To Underserved Populations: A Rapid Review, Alejandro Jimenez

Undergraduate Honors Theses

Access and utilization of health care is essential for the maintenance of overall health and prevention of chronic diseases. Several factors contribute to healthcare access disparities, including race, ethnicity, poverty, and rurality. Mobile healthcare clinics can be used to travel to medically underserved areas and reduce healthcare disparities. This rapid review examined the scope and impact of mobile healthcare units, and their use in reducing healthcare disparities. The exploration was done in 4 stages (1) identification of existing and relevant research studies, (2) selection of studies using prespecified eligibility criteria, (3) extraction of data from collected studies, and (4) summarization …

Snake Bite, Meghna Arora, Rajendra Prasad

Digital Journal of Clinical Medicine

No abstract provided.

Examining Patients’ Satisfaction In Jordanian Emergency Departments Through Business Process Improvement Implementation, Mohammed Shaker Ibrahim

Master's Theses and Doctoral Dissertations

There have been recent advancements in healthcare services provision to enhance patients’ satisfaction. Previous research has concluded that Jordanian ratings of service quality and quality of care provided in public hospitals are lower compared to other nations in the region and abroad. These studies, however, failed to utilize any standardized customer satisfaction tools. At the same little empirical research has attempted to investigate the link of business process improvement in Jordanian hospitals to the enhancement of patients’ satisfaction. This research bridges the gap in the literature by first testing and validating SERVQUAL, a customer satisfaction tool, in Jordanian hospital environments …

Meaning And Hope In Health Behavior Change: An Examination Of Health Coaching For Individuals With Disabilities, Krys Standley

Graduate Student Theses, Dissertations, & Professional Papers

Introduction:In an effort to expand the reach of health-promotion efforts for people with disabilities, a one-on-one health promotion intervention titled Health My Way was piloted. This intervention incorporated health coaching and health-promotion curriculum designed specifically for people with disabilities.

Purpose:The intervention was evaluated for its effects on health behavior change. Additionally, personal sense of meaning and hope were examined as potential mechanisms of influence in the hypothesized behavior change process.

Methodology:A convergent-parallel mixed-methods research design was used to examine the research questions. Pre- and post-intervention surveys were used to evaluate changes in levels of meaning, hope, and …

Assessment Of Pediatric Residents’ Attitudes Toward Anticipatory Counseling On Gun Safety, Daon D. Juang, Diane L. Mcdonald, Elizabeth A. Johnson-Young, Tierra D. Burrell, Dana L. Silver, Yan Wang, Richard Lichenstein

Communication & Digital Studies Articles

Guns remain a major cause of injury and death among children. We determined pediatric residents’ familiarity with gun safety campaigns and their gun safety counseling practices. We determined pediatric residents’ comfort with the Asking Saves Kids (ASK) campaign, which recommends that parents ask about gun safety and storage where their children play. Methods: Cross-sectional 27-item electronic survey was distributed to three pediatric residency programs in Baltimore, Maryland, USA. Residents were asked to respond to statements using a seven-point Likert scale on familiarity with three gun safety campaigns and their attitudes toward gun safety counseling. Results: 82% of respondents were not …

Factors Associated With Hospital Readmissions Among United States Dialysis Facilities, Amber B. Paulus

Theses and Dissertations

Hospital readmissions are a major burden for patients with end stage renal disease (ESRD). On average, one in three hospital discharges among patients with ESRD are followed by a readmission within 30 days. Currently, dialysis facilities are held accountable for readmissions via the ESRD Quality Incentive Program standardized readmission ratio (SRR) clinical measure. However, little is known about facility-level factors associated with readmission. Additionally, unlike other standardized measures of quality in the dialysis setting, incident patients within their first 90-days of dialysis are included in the performance calculation. This study analyzed CMS Dialysis Facility Report data from 2013 to 2016 …

Effects Of Psychiatric Hospital Closures On Local Jail Administrators, Correctional Staff, And Inmates, Mark Christian Lasko

Walden Dissertations and Doctoral Studies

A series of psychiatric hospital closures has led to a movement of care for individuals with mental illness from state-run facilities to managed care centers. Many of the individuals who no longer reside in psychiatric hospitals have become ensnared in the criminal justice system. Correctional facilities have an increased burden to care for the needs of the mentally ill, but lack the training and facilities to do so adequately. In this study, the lived experiences of correctional staff who have experienced the process of a hospital closure were examined. Psychiatric rehabilitation and gatekeeper theories served as the theoretical framework for …

Lived Experiences Of African American Females With Breast Cancer Treatment Access, Tamika Chantey Smith

Walden Dissertations and Doctoral Studies

Breast cancer (BC) is a significant condition that can result in devastating outcomes without treatment. The purpose of this phenomenological study was to explore barriers to health care disparities among young African American females. The findings of this study may help to address gaps in knowledge, obtain insights in treatments, and comprehend lived experiences with BC. The theoretical framework for this study was Bronfenbrenner's social ecological theory. Data were collected from face-to-face interviews with 10 African American women ages 20 to 40. Data were then transcribed and coded. The findings of the study indicated that women required treatment plans, informative …

Social-Emotional Support As A Mediator Of Household Structure And Mental Distress In Women, Trisha Jeanine Walker

Walden Dissertations and Doctoral Studies

Mental illness affects more women than men in the United States. Poor mental health in reproductive-age women has negative implications on population health. The purpose of this quantitative, correlational study was to examine the relationship between household structure and frequency of mental distress, with consideration of the mediation social-emotional support provides for reproductive-age women. The social ecological model was the theoretical framework for this research, in which frequency of mental distress related to the individual-level of the human-environment interaction construct. Household structure and social-emotional support were examined at the relationship-level. Pearson's correlation coefficient and linear regression were used to conduct …

Simulated Clinical Experience: An Investigation Of Emotion Understanding And Management, Neena White Jones

Walden Dissertations and Doctoral Studies

Many investigators have documented that lack of emotional intelligence (EI) in professional nursing correlates with patient dissatisfaction, negative patient outcomes, and litigation. However, much less information is available to nurse educators for an effective instructional strategy to increase EI skills, specifically emotion understanding and management (the most influential branches of EI) in nursing students. Grounded in the theory of EI and the theory of simulation, the purpose of this quantitative quasi experimental study was to introduce educational technology as a useful strategy for influencing EI in a convenience sample of 88 second semester students in a baccalaureate program. Research questions …

Natural Environment Associations With Mental Health And Obesity Status, Adam Edwin London

Walden Dissertations and Doctoral Studies

Mental health and obesity were ranked among the health priorities of the 2014 and 2017 Community Health Needs Assessments in Kent County, Michigan. Exposure to nature is correlated to improved health outcomes across a variety of morbidities including poor mental health and obesity. This cross-sectional study set within the frameworks of attention restoration theory, environmental health, and pathways to health benefits from nature assessed county survey data including self-reported nature exposures/interactions separated into 3 domain areas: access to nature, attitudes about nature, and physical activity in nature or in nature-based activities. Binary logistic regression analyses of the 653 respondents found …

The Role Of Glucose Level On The Performance Of The Framingham Risk Score, Uohna June Thiessen

Walden Dissertations and Doctoral Studies

Cardiovascular diseases (CVD) are responsible for more deaths than any other disease, continue to threaten the quality of life for many, and is a major burden to the health care system. The Framingham Heart Study (FHS) identified the major CVD risk factors that became essential to effective CVD screening strategies and the Framingham Risk Score (FRS), is used to assess CVD risk. Based on the concepts of the health behavior model and CVD as a cardiometabolic disorder, multivariate logistic regression analysis was used to evaluate the association between fasting blood glucose (FBG) levels and a CHD event, and to determine …

A Geographic Study Of Lung And Bronchus Cancer Rates In Kentucky, Gabriel Njoh Dikong

Walden Dissertations and Doctoral Studies

The average age-adjusted incidence and mortality rates of lung and bronchus cancer is 55% and 56% higher in Kentucky than the national averages in the United States, respectively. Populations with low income and educational attainment, and those who live close to the mining regions across Kentucky are more affected by the high prevalence and resulting mortality rates of lung and bronchus cancer. This study was conducted because of the high incidence of lung and bronchus cancer and resulting mortality rates in the state of Kentucky that may not be caused solely by social and demographic factors. The theoretical foundation for …

Associations Between Healthcare Utilization Factors And Diabetic Retinopathy Among Adult African Americans, Olusina Adesanya

Walden Dissertations and Doctoral Studies

African Americans are disproportionately affected by diabetes mellitus (DM) and complications that include diabetic retinopathy and its disease and socioeconomic burdens. This study examined the relationships between diabetic retinopathy and health care utilization factors, such as gender, DM comorbidities of hypertension and hyperlipidemia, and health care access, among sampled African Americans with DM in the United States. The Andersen health care utilization model was the framework for the study. In this correlational cross-sectional study, data from the 2011-2016 National Health and Nutrition Examination Survey datasets were analyzed. Results of complex samples logistic regression showed that there were no significant associations …

Caregiver Review Of Nonpharmacological Interventions For Behavioral Symptoms Associated With Dementia, Karla Chaney Ballew

Walden Dissertations and Doctoral Studies

Alzheimer’s disease (AD) is the most common form of dementia and affects an individual’s overall cognitive function, including orientation, memory, and executive function. Most AD patients in the United States reside in residential care facilities or private homes under the care of individuals with little education on the challenges of the AD patient. Among the challenges faced by caregivers are behavioral and psychological symptoms related to dementia (BPSD). Education has been shown to improve caregivers’ treatment of BPSD in AD patients and to improve caregiver retention. The purpose of this project was to develop an evidence-based education module guided by …

Effects Of Pregnancy-Related Depression On Low Birth Weight Infants, Kimberly J. Bauer-Schaub

Walden Dissertations and Doctoral Studies

Maternal depression during pregnancy can have a negative impact on the developing child. Numerous studies have focused on postpartum depression and the influences on infant outcomes; however, there are limited data on pregnancy-related depression. The problem addressed in this study was the inadequacy and insufficiency of depression screening during the pregnancy period and access to quality-related health services for women. The purpose of this quantitative retrospective study was to test social cognitive theory on low birth weight and prenatal care adherence to pregnancy-related depression in women residing in Colorado. This research measured an association between pregnancy-related depression and both low …