Medicine and Health Sciences Commons^™

The Influence Of Community Support Services In Reducing Potentially Preventable Readmissions, Camille Rose Bash

Walden Dissertations and Doctoral Studies

Recently, the Centers for Medicare and Medicaid Services (CMS) ranked all hospitals based on Medicare readmission rates for heart attacks, heart failure, and pneumonia. CMS offered subsidies to hospitals ranked in the 4th quartile to develop community support services to reduce the problem of potentially preventable readmissions (PPRs). CMS cited 4 of the 5 hospitals in Prince George's County in the 4th quartile. The purpose of this quantitative research study was to investigate the relationship between community support services and the reduction of PPRs in Prince George's County. The Evans and Stoddart field model of health and well-being guided this …

A Sibling Case-Control Study Of Maternal Prenatal Body Mass Index As A Risk Factor For Autism Spectrum Disorder, Ruth Ann Hendrix

Walden Dissertations and Doctoral Studies

The prevalence of autism spectrum disorder (ASD) is estimated to be one in every 150 births. While both genetic and postpartum environmental exposure have been linked to ASD, prenatal maternal weight has not been investigated. The objective of the study is to assess whether overweight or obesity at pregnancy is an important risk factor for the diagnosis of ASD in offspring. A case-control study was designed to answer this question using the public health ecosocial theory. The study population consisted of 70 mothers, who were recruited via the Internet using the viral expansion loop. Multiple logistic regression analysis was used …

Factors Contributing To The Increase In Hiv/Aids And Late Diagnoses Of The Virus Among Older Adults, Lorraine C. Barnett

Walden Dissertations and Doctoral Studies

The Centers for Disease Control and Prevention predicted that the incidence of HIV/AIDS among the American population aged 50 years and over would account for 50% of all HIV/AIDS cases in the United States by 2015. Yet there is little research available about the reason for the high prevalence or the availability of interventions available for this population. The purpose of this study was to explore factors related to HIV/AIDS awareness in a group of older recipients of health care and their health care providers. This study was intended to help fill the information gaps in this area by using …

The Effectiveness Of Exercise And Nutritional Counseling On Decreasing Body Composition And Increasing Fitness Levels In Firefighters, Michelle R. Mcnear

Walden Dissertations and Doctoral Studies

Cardiovascular disease is the leading cause of death in the United States; firefighters are at a greater risk for both the disease and death. Their exposure to stress, toxic fumes and smoke, unhealthy eating habits, excessive weight, and low levels of physical activity are all contributing risk factors to this disease. The purpose of this quantitative study was to determine the effectiveness of a multi-faceted program of exercise and nutritional counseling to decrease body fat composition and increase fitness levels nine months after initial implementation among a sample of 202 firefighters. Social learning theory was the theoretical foundation for the …

Predicting Breast Cancer Screening Among African American Lesbians And Bisexual Women, Cheryl B. Fields

Walden Dissertations and Doctoral Studies

In 2009, 713,220 new cases of cancer were diagnosed for women in the United States with more than a quarter million deaths. African American women and lesbians exhibit behavioral risk factors as well as diminished access to and utilization of breast cancer screening that reduces opportunities for early detection. This secondary analysis of a national convenience-based study examined screening compliance among 647 African American lesbian and bisexual women. Barriers to accessing screening represented the theoretical framework for this study. Bivariate chi square analysis was used to assess the association between independent variables: sociodemographic characteristics; participation in wellness activities; sexual orientation/gender …

Physician Decision Criteria Regarding Omega-3 Dietary Supplements, Warren P. Lesser

Walden Dissertations and Doctoral Studies

American Heart Association officials and other expert cardiologists recommend omega-3 (n-3) dietary supplementation for the secondary prevention of cardiovascular disease, a prevalent health problem in the United States. Physicians' lack of understanding of possible n-3 preventive health benefits results in underprescribing n-3 dietary supplements and lower n-3 dietary supplement product sales. N-3 dietary supplement marketers do not understand physician n-3 prescribing decision criteria enough to optimize high-impact communication to physicians to increase n-3 dietary supplement product use. The purpose of this phenomenological research study was to improve n-3 marketers' understanding of how physicians reach decisions to prescribe or recommend products …

Leadership And Attitudes On Adopting Evidence-Based Practice For Influenza Vaccination, Pamela A. Paparone

Walden Dissertations and Doctoral Studies

The United States has set a 90% benchmark for influenza vaccinations for healthcare personnel. Unfortunately, healthcare personnel fall far short of that mark with current rates as low as 62%. Low vaccination rates are responsible for influenza, nosocomial influenza, influenza-like illness, and mortality during influenza season. The purpose of this quantitative correlational study was to understand the relationship between leadership styles, attitudes towards evidence-based practice, and vaccination intention among New Jersey registered nurses (RNs). Diffusion of innovations theory was the theoretical foundation. The 3 instruments used were the Multifactor Leadership Questionnaire, Evidence Based Practice Attitude Scale, and Behavioral Intention Scales, …

Educational Stakeholders' Perspectives On School-Based Obesity Prevention Programs, Todd Yatchyshyn

Walden Dissertations and Doctoral Studies

Childhood obesity is a worldwide problem that can lead to adverse health conditions. In several rural Pennsylvania communities, over one third of elementary students are characterized as overweight, having a body mass index above the 85th percentile. The purpose of the study was to investigate educational stakeholders' perspectives about school-based obesity-prevention programs. The conceptual framework focused on cognitive theory, the theory of planned behavior, and the trans-theoretical model of health behavior change, which postulates that an individual's readiness to change is the most important factor of intervention programs. Qualitative interview data were gathered from 18 educational stakeholders. Inductive code-based analysis …

The Influence Of Hiv Stigma And Disclosure On Psychosocial Behavior, James Minson

Walden Dissertations and Doctoral Studies

Human Immunodeficiency Virus (HIV) remains a serious public health issue, and many social factors are involved in virus transmission and treatment. The current conceptualization of how HIV status disclosure and perceived stigma of HIV diagnosis interact is undeveloped. This study was based on social cognitive theory and tested hypothesized positive relations between HIV serostatus disclosure, social support, and self-efficacy. In addition, self-rated HIV stigma was examined as a potential mediating variable. Participants were 109 HIV positive, mostly White gay men recruited via an online bulletin board. They completed the medical outcomes study social support survey, the general self-efficacy scale, the …

Hiv Integrated Biological And Behavioural Surveillance Survey (Ibbss) 2010, Federal Ministry Of Health

HIV and AIDS

This report by the Nigerian Federal Ministry of Health highlights the findings of an integrated biological and behavioral surveillance survey (IBBSS) in Nigeria among groups whose behaviors or occupations often place them at higher risk of contracting sexually transmitted infections, including HIV. The main objectives of the study were to assess the knowledge and beliefs of high-risk groups about STI and HIV, determine the prevalence of HIV infection among these groups, and obtain data that will permit identification of trends over time. Since the 2007 IBBSS survey report, a considerable number of interventions have commenced among the study groups.

Social Mobilization Strategy, Family Advancement For Life And Health (Falah)

Reproductive Health

This document outlines social mobilization strategies at the national and community levels of the Family Advancement for Life and Health (FALAH) project in Pakistan. The project aims to improve the health and well-being of women, men, and their children through tackling the major obstacles in adoption of birth spacing to improve maternal and child health outcomes and family well-being, by increasing knowledge of the benefits of birth spacing as well as knowledge, increased demand for, and effective use of contraceptive methods. The strategy aims to achieve a significant increase in couples’ knowledge and understanding of the need for and benefits …

Strengthening The Delivery Of Comprehensive Reproductive Health Services At The Community Level In Kenya, Population Council

Reproductive Health

The Population Council APHIA II Operations Research Project collaborated with the Ministry of Public Health and Sanitation to improve the quality of services offered by community-based midwives in two districts in Western Kenya, to prepare them to offer more comprehensive maternal services through antenatal, obstetric, postpartum, and newborn care. The study found that community midwives can tremendously increase clients’ access to essential maternal health services and other reproductive health services. Therefore Ministry of Health and its partners should scale up community midwives’ activities to enable more women access these services. Furthermore, information campaigns are needed to promote the range of …

Using Positive Deviance For Determining Successful Weight- Control Practices, Heather L. Stuckey, Jarol Boan, Jennifer L. Kraschnewski, Michelle Miller-Day, Erik B. Lehman, Christopher N. Sciamanna

Communication Faculty Articles and Research

Based on positive deviance (examining the practices of successful individuals), we identified five primary themes from 36 strategies that help to maintain long-term weight loss (weight control) in 61 people. We conducted in-depth interviews to determine what successful individuals did and/or thought about regularly to control their weight. The themes included weight-control practices related to (a) nutrition: increase water, fruit, and vegetable intake, and consistent meal timing and content; (b) physical activity: follow and track an exercise routine at least 3×/week; (c) restraint: practice restraint by limiting and/or avoiding unhealthy foods; (d) self-monitor: plan meals, and track calories/weight progress; and …

"Knowing Myself First": Feasibility Of Self-Testing Among Health Workers In Kenya, Sam Kalibala, Waimar Tun, William Muraah, Peter Cherutich, Erick Oweya, Patricia Oluoch

HIV and AIDS

Report of a study exploring the feasibility and acceptability of free HIV home self-testing among health workers in Kenya, within the range of other HIV testing options available.

Evaluation Of The Sageplus Steps Program To Promote Physical Activity And Decrease Cardiovascular Risk In Low-Income Women, Callie Anne Avis

All Graduate Theses, Dissertations, and Other Capstone Projects

There is little known about the effectiveness of the Steps Program specifically used in the SagePlus program in Minnesota to promote physical activity and reduce cardiovascular risk. The purpose of this study was to evaluate the effectiveness of the SagePlus Steps Program for low-income middle-aged women ages 40 to 64 to meet a daily physical activity goal of 10,000 steps and reduce their cardiovascular disease risk, measured by their Framingham Risk Score. A nonexperimental, descriptive correlational design was used to guide data collection for this study. Demographic data, step counts after weeks 1, 4, 12, and 24, activity level at …

Evaluation Of The Informed Consent Process For Male Circumcision Scale-Up In Zambia, Barbara Friedland, Louis Apicella, Katie D. Schenk, Meredith Sheehy, Paul C. Hewett

HIV and AIDS

This report evaluates the informed consent process for male circumcision conducted through the Male Circumcision Partnership for Zambia, led by Population Services International (Society for Family Health, Zambia), in partnership with Jhpiego, Marie Stopes International, and the Population Council. The objectives of the study were to assess male circumcision clients' comprehension of the informed consent process, examine social norms and practices regarding informed consent for adolescents, compare clients' expectations and experiences, and make additional recommendations for improving the informed consent process.

Evaluation Of A Health Newsletter Intended For Sageplus Participants, Karen Lynn Anderson

All Graduate Theses, Dissertations, and Other Capstone Projects

Little is known about the effectiveness of the SagePlus newsletter as a motivational tool for influencing behavior change. The purpose of this study was to determine the reading level of the SagePlus newsletter and to evaluate the effectiveness of the SagePlus newsletter as a communication and motivational tool for SagePlus participants. A nonexperimental, descriptive correlational design was used in this study. Forty English speaking participants were contacted and agreed to participate in the telephone survey from a potential list of 190 participants. A modified questionnaire containing 20 multiple choice and open-ended questions was used in a telephone survey. Data was …

Addicted Youth: The Understanding Of Smoking-Related Health Risks In Female College Students, Rebekah Agnes Ann Morris

All Graduate Theses, Dissertations, and Other Capstone Projects

Young adults are at the greatest risk for initiation of smoking or becoming daily smokers. Smoking has a unique history in the United States and is associated with health risks beyond heart disease and lung cancer, many specifically affecting women. Although the majority of people are aware of the risks for heart disease and lung cancer, many other risks are not recognized. By evaluating the known knowledge of smoking-related health risks beyond and including heart disease and lung cancer in the high risk population of female college students, education programs and cessation teaching can be altered, potentially resulting in lower …

Adolescent Substance Use: Perceptions Of Parents And Teenagers, Anthony Stadtherr

All Graduate Theses, Dissertations, and Other Capstone Projects

Drug use among Minnesota youth is a leading health risk behavior. This study examined rural adolescents' and parents'/guardians' perceptions of teens' substance use. An electronic survey was administered to high school students (n = 62; adjusted response rate = 84.9%) and sent by email to 79 parents/guardians (n = 22; adjusted response rate = 27.8%). Analyses included descriptive statistics, independent and paired sample t-tests, and chi-square. 56.5% of teens reported using alcohol in the past 12 months whereas 12.9% reported using marijuana. During the past 30 days teens reported using alcohol 1.1 days and using marijuana 1.2 days. When teenage …

Use Of Social Marketing Promotional Strategies To Create Awareness Of Worksite Health Promotion Programs: A Survey Of Program Coordinators, Anna Catherine Stahl

All Graduate Theses, Dissertations, and Other Capstone Projects

There is growing interest in evidence-based research supporting worksite health promotion to help alleviate rising healthcare costs associated with unhealthy lifestyle choices of employees. Worksite health promotion programs can be designed and promoted to help prevent and reduce the negative effects of an unhealthy workforce. With that, the purpose of this research study was to assess how social marketing promotional strategies were used by worksite health promotion program coordinators in organizations located throughout the upper Midwest region of the United States. A 12-question survey collected basic demographic information on each participant, in addition to the way social marketing promotional strategies …

Optimal Control Applied To A Discrete Time Influenza Model, Paula Andrea Gonzalez Parra

Open Access Theses & Dissertations

For the last decades, mathematical epidemiological models have been used to understand the dynamics of infectious diseases and guide public health policy.

In particular, several continuous models have been considered to study influenza outbreaks and their controls policies. However, most epidemiological data is discrete; therefore, a discrete formulation is more convenient to compare collected data with the output of the model. We introduce a discrete time model in order to study optimal control strategies for influenza transmission.

In our model, we divide the population into four classes: susceptible, infectious, treated, and recovered individuals.

In particular, we evaluate the potential effect …

Gender Differences In Food Habits, Beliefs, And Fast Food Consumption Among A Predominantly Hispanic College Student Population, Alma Xochitl Ortega Gomez

Open Access Theses & Dissertations

Fast food consumption in the United States (U.S.) has been increasing steadily during the last decades. This trend has been linked to the increased prevalence of overweight and obesity among the population (Barnard, 2010; Currie, Della Vigna, Moretti & Pathania, 2009). Several sociodemographic characteristics that have been associated with the likelihood of frequent fast food consumption include income, ethnicity, gender and age (Block, Scribner, DeSalvo, 2004; Bowman & Vinyard, 2004; Drewnoski & Darmon, 2005; Driskell et al., 2006; Morse & Diskell, 2009; Paeratakul et al., 2003). Most studies related to fast food consumption have been conducted in adult population, only …

Utilization And Maintaining The Spirit Of Motivational Interviewing In Sageplus Lifestyle Interventions, Joan Y. Grotewold

All Graduate Theses, Dissertations, and Other Capstone Projects

Utilizing a descriptive quantitative design to guide data collection and analysis, 11 of the 14 clinics in the State of Minnesota that participate in the SagePlus program were selected by the Minnesota Department of Health (MDH) to participate in this study. The population for this study was the 22 healthcare professionals who were providing the lifestyle interventions in those clinics. The purpose of this study was to determine if the SagePlus healthcare professionals who are providing lifestyle counseling interventions were using Motivational Interviewing (MI) with SagePlus clients and if the healthcare professionals were maintaining the spirit of MI throughout these …

Evaluation Of Health Newsletters As A Motivational Tool To Promote Exercise, Jolene Schlegel

All Graduate Theses, Dissertations, and Other Capstone Projects

Little is known about the relationship between SagePlus newsletters and its effectiveness to motivate physical activity. The purpose of this study is to evaluate the impact of the SagePlus newsletter and its ability to motivate participants to achieve their goals to increase physical activity. A nonexperimental, descriptive correlational design was used in this study. Calls were made until the list of potential participants was exhausted. Forty English speaking participants were contacted and agreed to participate in the telephone survey from a potential list of 190 women enrolled in the SagePlus program. A modified questionnaire containing 19 multiple-choice and one open-ended …

The Association Of Mentorships And Leadership Practices With Nursing Faculty Retention, Lisa M. Rettenmeier

Walden Dissertations and Doctoral Studies

The lack of mentored relationships among nursing educators has the potential to negatively influence perceptions of leadership practices and could decrease the numbers of nursing faculty staying in academia. The purpose of this study was to investigate the perceptions of mentorships and leadership practices of nursing faculty teaching in academia. Watson's caring theory was the theoretical foundation to explain the congruence between mentored relationships, leadership practices, and the association with faculty retention. The first research question focused on differences between mentoring experience, assistance, and characteristics by mentor training type. Question two assessed the relationship between leadership practices by mentor training …

Gatekeeper Suicide Prevention Training And Its Impact On Attitudes Toward Help Seeking, John Angelo Cascamo Jr.

Walden Dissertations and Doctoral Studies

Gatekeeper Suicide Prevention Trainings such as Question Persuade and Refer (QPR) are used to increase suicide awareness and teach participants basic suicide intervention skills. Previous researchers showed that QPR training increases knowledge of suicide risk factors and increases participants' willingness to intervene with individuals at risk of suicide. It was hypothesized that completion of QPR would also increase positive attitudes toward the utilization of mental health services and that this outcome would be more pronounced among male participants. The examination of attitudes was rooted in the theoretical framework of Ajzen's theory of planned behavior. The Inventory of Attitudes toward Seeking …

The Impact Of Nutrition-Teaching Self-Efficacy On Daily Fruit And Vegetable Intake, Leslie E. Rawls Hoglund

Walden Dissertations and Doctoral Studies

Lack of fruit and vegetable (FV) consumption is directly linked to the prevalence of obesity and chronic disease in the United States. The USDA Fresh Fruit and Vegetable Program (FFVP) offers elementary school teachers access to healthy foods as part of the public school classroom experience. The purpose of this study---which was based on self-efficacy theory and the socio-ecological model---was to examine if an association exists between selected factors: (a) daily fruit and vegetable consumption, training status in the USDA Fresh Fruit and Vegetable Program (FFVP), and an established school nutrition policy and (b) nutrition-teaching self-efficacy (NTSE) among elementary school …

Understanding The Decision-Making Process For Health Promotion Programming At Small To Midsized Businesses, M. Courtney Hughes, Donald L. Patrick, Peggy A. Hannon, Jeffrey R. Harris, Donetta L. Ghosh

Faculty Articles, Papers, and Other Scholarship

This study explores the decision-making process for implementing and continuing health promotion programs at small to midsized businesses to inform health promotion practitioners and researchers as they market their services to these businesses. Qualitative interviews are conducted with 24 employers located in the Pacific Northwest ranging in size from 75 to 800 employees, with the majority having between 100 and 200 employees. Small to midsized employers depend most on company success-related factors rather than on humanitarian motives when deciding whether to adopt workplace health promotion programs. They rely heavily on health insurers for health promotion and desire more information about …

Promoting Tobacco Cessation Via The Workplace: Opportunities For Improvement, M. Courtney Hughes, Emily M. Yette, Peggy A. Hannon, Jeffrey R. Harris, Nguyet M. Tran, Terry R. Reid

Faculty Articles, Papers, and Other Scholarship

Introduction: Little research exists on the prevalence of evidence-based tobacco cessation practices in workplaces, employer promotion of state-sponsored quitlines and predictors of these practices.

Methods: Cross-sectional analysis of the 2008 Healthy Worksite Survey, a telephone survey administered to Washington employers with 50 or more employees (n¼693). The objectives were to describe workplaces’ implementation of evidence-based tobacco cessation practices and identify key predictors of implementation in order to highlight opportunities for interventions.

Results: Among these employers, 38.6% promoted quitting tobacco, and 33.8% offered insurance coverage for cessation medications and counselling, 27.5% referred no-smoking violators to cessation services, and 5.7% included the …

First Generation Of Gender And Hiv Programs: Seeking Clarity And Synergy, Judith Bruce, Nicole Haberland, Amy Joyce, Eva Roca, Tobey Nelson Sapiano

Poverty, Gender, and Youth

In the past decade, there have been expanding resources to address the underlying gender dimensions of HIV. This has been particularly urgent in sub-Saharan Africa as the female-to-male infection ratios in young populations has reached 3 to 1 and sometimes above. The phrase “gender and HIV” has become commonplace yet does not provide any specific guidance as to target audiences, content, or measurable results. It can include everything from microcredit programs for HIV-positive women, to workplace programs seeking to change negative male norms, to efforts to increase respect for diverse sexual and gender identities. This review, conducted by the Population …