Medicine and Health Sciences Commons^™

Non Medical Prescription Drug Use In Rural Communities And Social Work, Izetta Mounice Briggs-Bolling

Walden Dissertations and Doctoral Studies

This study explored the roles and responsibilities of social workers providing services to nonmedical prescription drug users (NMPDU). Researchers have indicated NMPDU disproportionately affects people living in rural communities. The overarching research question sought to explore the concerns of social workers when providing services to patients coping with NMPDU in the rural community of Ulster County, New York. The intention was to examine systemic challenges facing rural social workers when attempting to decrease morbidity risks and increase the health of Ulster County residents. A total of 7 social workers participated in 3 focus groups to explore their ideas for defining, …

Investigating Funding Policies For New Clinics In Rural Northwest Region, Cameroon., Chenwi Mbuoko Ngwa

Walden Dissertations and Doctoral Studies

Abstract

Healthcare policies are complex health promotion strategies used by healthcare policy

designers to create awareness, educate, and develop the capacity of sustainable health

promotion practices in rural communities. The purpose of this phenomenological study

was to investigate an occurrence being experience by rural residents in the NWR of

Cameroon where residents lacked nearby healthcare clinics where they can seek medical

treatment and to determine if there were any funding policy requirements for the

construction of new rural community clinics at the NW Regional Delegation of Public

Health. Using Wright's conceptual framework on policy analysis and evaluation and

Coleman's rational …

Individual And Socioeconomic Factors Associated With Childhood Immunization Coverage In Nigeria, Obinna Ositadimma Oleribe

Walden Dissertations and Doctoral Studies

Immunization remains one of the most successful and cost-effective public health interventions worldwide. The purpose of this study was to examine the individual and socioeconomic factors that influence childhood immunization coverage in Nigeria. The health belief model and the social ecological model were used as the theoretical framework for the study, which examined the effects of individual, parental, and socioeconomic factors on complete immunization among Nigerian children. Univariate, bivariate, and multivariate tests were conducted within a secondary analysis of 2013 Nigerian National Demographic and Health Survey was done. Of 27,571 children aged 0 to 59 months, 22.1% had full vaccination …

A Comparative Study Of Cervical Cancer Among Indigenous Amerindian, Afro-Guyanese, And Indo-Guyanese Women In Guyana, Carol Jones-Williams

Walden Dissertations and Doctoral Studies

Cervical cancer is a major public health problem in developing countries. In Guyana, factors associated with increasing cervical cancer cases among Indigenous Amerindian women (IAW), Afro- women (AGW), and Indo-Guyanese women (IGW) have not been fully examined. In this comparative cross-sectional study, 5,800 cervical cancer cases were selected from Guyanese women age 13 and above for ethnicity (Indigenous Amerindian, Afro- and Indo Guyanese women), geographical region, marital status, and year and stage at diagnosis. Secondary data from Guyana Cancer Registry for the 2000-2012 study periods were analyzed using chi-square test, multinomial logistic regression, poisson regression, and relative risk. Geographical region …

Cardiovascular Disease Risk Factor Assessment And Lifestyle Adjustments In African Americans, Biruk Nigatu Nigatu

Walden Dissertations and Doctoral Studies

Multiple studies have indicated a higher burden of overweight/obesity and exposure to environmental toxins, such as alcohol and tobacco smoke, in association with higher prevalence of cardiovascular disease (CVD) in the African American population. Thus, the purpose of this research was to determine if there was a significant difference in the use of lifestyle adjustments such as moderating alcohol consumption, weight loss, and smoking cessation on the prevalence of CVD in the African American population. The theoretical foundation was social cognitive theory and the social ecological model that posits the interplay of individual, social, and environmental factors. This cross-sectional quantitative …

Public Health Implications Of Oil Pollution In Koluama: Nigeria, Esther Bridget Sako

Walden Dissertations and Doctoral Studies

As the global demand for oil increases, human health implications related to its discovery and transport remain a serious concern. The Niger Delta has been the site of severe environmental degradation since the oil boom of the 1970s. While some researchers have examined the environmental effects of oil procurement, few have explored human health implications in this region. This phenomenological study investigated the human physical and mental health consequences of oil-related environmental degradation through the perceptions and lived experiences of villagers in Koluama, Nigeria. The conceptual framework for the study was based on research conducted by Morello-Frosch, Zuk, Jerrett, Shamasunder …

Caregiver Burden And Emergency Room Utilization For Enhanced Recovery Surgery Cancer Patients, Mindy Sovel

Walden Dissertations and Doctoral Studies

Advances in surgical technique and medical management have led to fundamental changes in surgical care allowing for a paradigm shift from inpatient to outpatient surgery. Enhanced recovery pathways have moved surgical recovery from inpatient to outpatient settings requiring informal caregiver support. The purpose of this study was to determine the prevalence of caregiver burden in this patient population and to explore whether caregiver burden contributes to preventable use of emergency room services. The conceptual framework supporting this retrospective cross-sectional study was Andersen's behavioral model of health services utilization. Data collected from 28 urologic patient/caregiver pairs were analyzed using descriptive statistics …

The Impact Of Palliative Care On Health Status In Hiv-Positive Children, Aabid Abdulmajid Ahmed

Walden Dissertations and Doctoral Studies

HIV-positive children in sub-Saharan Africa have numerous challenges to overcome. These challenges increase psychosocial stress as well as symptom burden including fatigue, weight loss, pain, and mental changes. The symptoms may persist even after initiation of antiretroviral therapy, so such children need additional care. Palliative care lays emphasis on holistic patient-centered care, including physical, psychological, social, and spiritual symptoms, alongside antiretroviral therapy. There is limited data on the impact of integrating palliative care with standard HIV care and treatment in children. The purpose of this study was to fill the gap in the literature by investigating the impact of palliative …

The Lived Experiences Of School Nurses: Transitioning From Hospital To School Worksite, Irene Campbell

Walden Dissertations and Doctoral Studies

School nurses who transition from hospital or clinic-based settings to a school-based work environment often lack sufficient transitioning skills and orientation to cope with the roles and responsibilities of school-based nursing. The result is a high attrition rate among school-based nurses. School nurses may leave their positions due to experiences of marginalization, including isolation, role confusion, and barriers to practice. In this phenomenological study, the lived experiences of 12 school-based nurses who transitioned from hospital or clinical settings were explored. Bandura's self-efficacy and Spreitzer's psychological empowerment theories were used in interpreting the findings. Data were collected via face-to-face individual interviews …

Nutrition Services, Viral Suppression, Cd4, And Retention In Ryan White Program Participants, Theresa Jumento

Walden Dissertations and Doctoral Studies

The Ryan White HIV/AIDS Program (RWHAP) provides HIV-related medical and support services for uninsured and underinsured people living with HIV (PLWH) in the United States. In addition to HIV-related medical care, the program provides medical nutrition therapy and food assistance. The role of nutrition in the health of PLWH is well-documented, especially in resource poor areas; however, the role of medical nutrition therapy and food assistance provided through the RWHAP in resource rich areas is not well documented. This study addressed the association between the nutrition services of food assistance and medical nutrition therapy and the HIV-related health outcomes of …

Ambulatory Registered Nurse Perspectives On Health Literacy Roles And Patient Communication, Gloria Medina Redden

Walden Dissertations and Doctoral Studies

Registered nurses (RNs) have a significant role in communicating health information to patients. The problem addressed in this study was RNs roles with health literacy and communicating health information using words that the patient understands. This study found that ambulatory RN perspectives on their roles in health literacy and patient communication may improve health outcomes and optimal wellness. The purpose of this qualitative study was to examine and describe ambulatory RN perspectives on their roles in health literacy and patient communication, as these are necessary components linked to better health outcomes. The conceptual framework for this study was the nurse …

Brachytherapy And External Beam Radiation And Survival Of Jamaicans With Prostate Cancer, Salome Elizabeth Brown-Williams

Walden Dissertations and Doctoral Studies

Jamaican males are a high-risk population for aggressive prostate cancer (PrCa) due to genetic influences, and identifying empirical data on treatments, which provide survival benefits is a prime challenge for clinicians who manage Jamaican PrCa patients. Thus, the purpose of this investigation was to elucidate treatment effects of brachytherapy and ERBT in the survival of a Jamaican PrCa cohort. Differences in survival outcomes of brachytherapy and ERBT treated Jamaican, and White U.S.-born PrCa patients with localized PrCa were compared. The mechanism of radiation programmed cell death in PrCa carcinogenesis explained in the oxidative stress theory, was the theoretical base for …

Chronic Kidney Disease Awareness And Quality Of Care In Abuja Nigeria, Patience Eze

Walden Dissertations and Doctoral Studies

Chronic kidney disease (CKD) is a non-communicable progressive disease that can lead to kidney failure or end-stage renal disease. In Nigeria, many people do not have access to health care due to extreme poverty, which means that those suffering from diabetes or high blood pressure, or both diseases, which have been identified as the 2 main risk factors, may not know their health status. The purpose of this phenomenological study was to explore the level of CKD awareness among Nigerians and if cultural beliefs affect individuals' health seeking behaviors because of the diverse nature of the Nigerian population. The protection …

Snack Food Reinforcement During Work And Non-Work Hours Among U.S. Office Workers, Sherise Larks

Walden Dissertations and Doctoral Studies

The current epidemic of overweight and obesity has been partly credited to a growing trend for snacking and sedentary work behaviors. The purpose of this quantitative, cross-sectional survey was to investigate whether the difference between snack food reinforcement during work and non-work hours and work food motives predicted BMI among U. S. office workers. This study was based on the theoretical framework of the individual differences theory, in the context of the behavioral choice theory and reinforcement theory. The independent variables were food reinforcement and food motives; the dependent variable was BMI. Descriptive, correlational, and exploratory analyses were used. The …

U.S. Young Adults Stds, Risk Perception, Risk Behaviors, And Health Information Seeking, Amanda Robison-Chadwell

Walden Dissertations and Doctoral Studies

Sexually transmitted diseases (STD) are preventable conditions for which treatment failure (specifically in gonorrhea) is becoming problematic. U.S. young adults (20-29 years) have high rates of STD incidence and prevention of these diseases, but reaching them to provide primary prevention educations is challenging due to low perceived susceptibility to infection and lack of knowledge about how young adults seek health information. The purpose of this quantitative survey study was to assess the association between perceived susceptibility to STDs, sexual risk behavior, and the acquisition of health information as it pertains to sexual health topics in young adults. The Health Belief …

U.S Marine Corps Veterans' Perceptions Of Screening For Posttraumatic Stress Disorder, Tiffany Lawing Schweitzer

Walden Dissertations and Doctoral Studies

Posttraumatic stress disorder (PTSD) is a serious issue for post-deployment United States Marine Corps (USMC) veterans, especially because PTSD can increase the risk of suicide. Marines are screened post-deployment, yet little is known about Marine veterans' perceptions of the PTSD screening process. The purpose of this phenomenological study was to explore USMC male veterans' perceptions of the Post- Deployment Health Reassessment (PDHRA). The social cognitive theory constructs of a triadic relationship among person, environment, and behavior were the framework for understanding this population's perceptions of the PDHRA and potential stigma. Two research questions focused on how people, culture, and behavior …

Mandated Continuing Education And The Competency Of Illinois Physical Therapists, Denise Lynn Hunter Ethington

Walden Dissertations and Doctoral Studies

Continuing education (CE) mandate laws are passed by states because it is in the public interest. The intent behind the passage of Illinois's CE law for physical therapists is to protect public health and safety through ensuring the competency of providers. However, studies into the impact of mandated CE on competency have been mixed. The problem addressed by this study was whether Illinois's CE law was effective in improving the competency of physical therapists and its impact on patient care. The purpose of this study was to understand what role mandated CE played in developing the competency of physical therapists …

Effect Of Intimate Partner Violence On Children Of Puerto Rican Women, Maria Natal-Gopin

Walden Dissertations and Doctoral Studies

Intimate partner violence [IPV] is a preventable and costly societal issue that has reached epidemic proportions. Women are often the victims of IPV, and millions of children are exposed to it annually. The purpose of this study was to explore experiences of Puerto Rican mothers and their perceptions of how IPV exposure may have impacted their children using resilience theory. Data were collected via audiotaped individual interviews with 9 Puerto Rican mothers who endured an array of escalating IPV, often exacerbated by the perpetrators use of alcohol or drugs, and had IPV-exposed children aged 6 -11 years. Data analysis integrated …

Perceptions Of Community-Based Participatory Research From Community And Academic Members, Ivonne G. Kanko

Walden Dissertations and Doctoral Studies

Community-based participatory research (CBPR) is an increasingly popular form of public health research. However, little is known about the application of CBPR and the levels of involvement for partners in specific phases of the partnership. This phenomenological study addressed the application of CBPR from the perspectives of 7 academic researchers and 6 community members experienced in CBPR. Arnstein's ladder of citizenship participation and the community coalition action theory provided the framework for the study. Semi-structured interviews addressed participants' levels of involvement in the CBPR process, as well as challenges, concerns, successes, and recommendations for improvement. Interview transcripts were analyzed by …

Assessing Plant-Based Food Lifestyle To Reduce Obesity Risk, Erna Siregar

Walden Dissertations and Doctoral Studies

Despite an increasing number of healthy lifestyles throughout the country, Americans, including Native Hawaiians, keep gaining weight. Unlike several American lifestyles that have resulted in weight gain within the American population, the vegetarian lifestyle is a scientifically proven method for decreasing body weight and maintaining the weight loss for more than 1 year. This study aimed to compare the lifestyle patterns of 4 vegetarian lifestyles and 1 nonvegetarian lifestyle among Native Hawaiians aged 21 and older using their body mass index (BMI). This quantitative study utilized a correlational design, which is particularly suitable for examining the relationship of BMI to …

Determinants Of Hiv Screening Among Adults In New Jersey After Hurricane Sandy, Nathaniel R. Geyer

Walden Dissertations and Doctoral Studies

HIV screening is recommended to destigmatize the condition, prevent partner transmission, and postpone AIDS progression. However, determinants associated with implementation of opt-out HIV screening are not well understood. The purpose of the study was to examine determinants that predicted odds of HIV screening for persons impacted by Hurricane Sandy, and how these factors differed according to demographic characteristics, geographical attributes, health-related quality of life score, access-to-care, and health insurance status. The social ecologic model provided the framework for this multilevel cross-sectional study that included New Jersey data from the Behavior Risk Factor Surveillance System. Bivariate chi-square, simple logistic regression, and …

Childhood Obesity Comorbitities Awareness Hospital-Based Education, Sandra Mcgrath Mcgrath

Walden Dissertations and Doctoral Studies

As childhood obesity continues to increase, so do the comorbidities and related health issues, putting youth at a greater risk of developing adult-related diseases such as hypertension, Type 2 diabetes, and cardiovascular diseases. Current literature indicates that healthcare organizations have a significant role in the fight against this epidemic, yet most children's hospitals have no policy to accomplish this task. The purpose of this project was to develop a program proposal for a hospital-based, sustainable obesity program that will aid in improving patient and family awareness of the importance of maintaining an ideal body weight to decrease the incidences of …

Assessing Nurses' Demographic Cardiovascular Risk Factors And Pharmacogenetic Testing Knowledge And Acceptance, Stella Chibuzor Ohanuka

Walden Dissertations and Doctoral Studies

The lack of knowledge of pharmacogenetic testing for cardiovascular disease (CVD), coupled with their increased risk for CVD, may impair nurses' cognitions and attitudes toward pharmacogenetic testing for CVD. The purpose of this quantitative cross-sectional correlational study, conducted with 230 RNs without CVD who worked in acute-care settings in Georgia, was to determine if their years of education, years of experience, and gender significantly influenced their perceived risk for CVD (Questions 1-3) and their perceived knowledge of pharmacogenetic testing for CVD (Questions 4-6), and if their perceived risk for CVD significantly influenced their acceptance of pharmacogenetic testing for CVD (Question …

An Evidenced-Based Pain Management Module To Improve Clinicians' Knowledge, Mark A. Wells

Walden Dissertations and Doctoral Studies

Chronic pain syndrome continues to be a national health concern among all medical specialties. It has an impact on the entire health care system and if current trends continue, the economic impact alone will exceed 100 billion dollars. In 2014, 254 million prescription opioids were written in the United States. During this time, an increase in prescription opioid related deaths was seen, with approximately 20,101 deaths occurring in 2015. Properly trained clinicians across the health care system are needed to achieve successful patient outcomes, while reducing cost, morbidity, and mortality. The purpose of the scholarly project was to develop a …

10,000 Step Challenge For Bedside Registered Nurses Working 12 Hour Shifts, Katherine Louise Schnebly

Walden Dissertations and Doctoral Studies

Obesity is a pandemic that directly affects chronic health problems and mortality. Researchers have shown that more than 54% of nurses are obese. The increasing rate of obesity among nurses and the long hours they work make healthy lifestyles, including daily physical activity, difficult. Tracking daily activity using a pedometer or fitness application has shown improved awareness and sustainability of daily physical activity. This project was an investigation of the daily steps of bedside nurses working a 12-hour shift, and their subsequent awareness of their daily physical activity. Pender's Health Promotion Model was used to consider motivating factors for improving …

Wellness Education And Job-Related Injuries And Illnesses For Federal Employees, Eunice Scott

Walden Dissertations and Doctoral Studies

Work-related injuries and illnesses may lead to absenteeism, which affects the level of productivity. The purpose of this study was to determine the success of an employee workplace training program on work-related injury and illness rates at selected federal districts within a federal organization. Newman's model, which describes internal and external factors that may have an effect on an individual's health, was the framework that guided this project. A pre-post design was used to compare data from 2 publically available data sets, the Occupational Safety and Health Administration Illness and Injury and the Voice of the Employee Survey, for the …

The Influence Of Cardiovascular Disease Risk Factors On Exercise Participation, Chadrick Cooper

Walden Dissertations and Doctoral Studies

The study's purpose was to analyze whether the control (sustained healthy level) of independent cardiovascular disease risk factors could be used to significantly predict aerobic exercise status. The health belief and ecological model helped describe health awareness, autonomy, and ecological influences that could also influence the control of each risk factor. Multiple logistic regression analysis of behaviors and demographics was utilized to assess relationships of met aerobic recommendations to hypertension, diabetes, obesity, tobacco/alcohol use, diet, physical activity limitations, mood, and socio-economic status. The study consisted of 340 African American participants (37% male 63% female), between the ages of 30-64 who, …

The Association Between Medical Marijuana Laws And Maternal Marijuana Use, Joseph Timothy Jones

Walden Dissertations and Doctoral Studies

Marijuana is the most common illicit drug that is abused by pregnant women, and recently many states have adopted various levels of relaxed marijuana policies. The purpose of this study was to evaluate a potential association between residing in a state that allows medical marijuana use and maternal marijuana usage. Grounded in the theory of planned behavior, this study evaluated the prevalence and extent of maternal marijuana use in states that allow and states that do not allow medical marijuana use using the National Survey of Drug Use and Health (NSDUH). It was anticipated that more lenient subjective norms toward …

Barriers To Switching Patients To Second-Line Antiretroviral Treatment Among Clinicians In Tanzania, Peter Charles Mgosha

Walden Dissertations and Doctoral Studies

Poor decision making among clinicians to transferring human immune deficiency virus (HIV) patients into second-line antiretroviral therapy (ART) has led to an increase in morbidity and mortality to people living with HIV (PLHIV). No clear barriers are known for clinicians not switching their patients. This is a descriptive qualitative research aimed to discover obstacles that influence clinicians' decision making to transferring patients into second-line ART despite higher level resistance to first-line ART. The researcher applied a participatory action research framework to solve the identified barriers with clinicians. Using the research questions the researcher explored reasons, perceived barriers and enabling factors …

Parental Self-Efficacy, Feeding Practices And Styles, And Obesity In Mexican American Children, Maria Carmen Goodwin

Walden Dissertations and Doctoral Studies

Childhood obesity rates among Mexican Americans have risen along with the concerns of public health professionals. The purpose of this cross-sectional study, based on social cognitive theory, was to investigate the relationships among parental self-efficacy, parental feeding practices and styles, and childhood obesity, as measured by the parental perception of child weight, among Mexican Americans in Texas. Mothers and fathers (n=83; 33 males, 64 females), with at least 1 child between 8 and10 years, formed the sample. Relationships were assessed using the Tool to Measure Parenting Self-Efficacy questionnaire, the Parental Feeding Practices Questionnaire for Mexican American parents, the Parenting Dimensions …