Medicine and Health Sciences Commons^™

Exploring The Lived Experience Of Self-Care In Young Adults With Type 2 Diabetes, Holly Berry-Price

Electronic Theses and Dissertations

Introduction

The prevalence of prediabetes in adults aged 18 or older was as high as 38% between 2017-2020. Youth-onset T2DM is a more aggressive phenotype than T2DM that occurs later in life. Young adults with T2DM have poorer health outcomes, lose an average of 15 years of life, all resulting in significant economic burden impacting the person. Current self-management interventions do not improve health outcomes in young adults with T2DM.

Purpose

The purpose of this research was to explore the self-care experiences of young adults living with T2DM.

Methods

Existential hermeneutic phenomenology informed the research. Inclusion criteria as follows: adults …

Effectiveness Of Antibiotic Stewardship For Healthcare Providers At Urgent Care Clinics, Helen T. Adewole

Electronic Theses and Dissertations

Antibiotics have revolutionized modern medicine; however, the overuse in urgent care and primary care significantly contributes to the global burden of infections resistant to available antimicrobial medicines. Approximately 30% of the antimicrobials prescribed in acute care settings are unnecessary. Patient demand for antibiotics has seemingly skyrocketed following the recent COVID-19 pandemic. Practitioners must be knowledgeable about antibiotic stewardship initiatives, such as the wait-and-see approach, to reduce antibiotic overuse and improve the trajectory of antibiotic resistance and patient health outcomes. The gap in practice was the limited awareness of scientific evidence-based tools to partner with patients and improve antibiotic prescription patterns. …

"Shut Down And Closed Off": A Routine Activity Approach To Investigating The Relationship Between Covid-19 School Closures And Child Sexual Abuse Report Characteristics In Georgia, Spencer E. Riner

Electronic Theses and Dissertations

The COVID-19 pandemic of 2020 created a public health crisis that led to an unprecedented number of school closures. A major concern raised by child advocates, law enforcement, and social service providers was the possible increase in undetected child abuse and maltreatment. Undergirding this concern was the belief that this mitigation effort might place child abuse victims and offenders within proximity for extended periods of time. While this was a significant concern, it has rarely been analyzed empirically. To address this gap in the literature, this thesis investigates how school closures impacted the characteristics of child sexual abuse (CSA) reports …

School Nurses And The Sexual Health And Education Of Public-School Students In Tennessee, Amy Wake

Electronic Theses and Dissertations

Tennesseans have been experiencing increasing rates of sexually transmitted diseases since the year 2000. Those rates are highest among those 15- to 24-year-olds. At the same time, Tennessee policy requires the teaching of abstinence as the primary form of sexual health education and emphasized the use of abstinence-only curriculum. The school nurse represents an available resource in the Tennessee public schools. The purpose of the qualitative study was to explore, describe, and interpret the perceptions and experiences of public-school nurses from rural, suburban, and urban areas of Tennessee related to the sexual health and sexual health education of students. School …

A Case Study Of The Political Determinant Of Health On The Public Health Crisis Of Malaria In Nigeria, Bisola M. Olumegbon

Electronic Theses and Dissertations

Abstract

Globally, there were about 229 million cases of malaria in 2022. The sub-Saharan African region accounted for 92% of the reported cases and 94% of deaths. Nigeria had the highest number of malaria cases and deaths, representing 27% of global cases. This scholarly project was a case study guided by the political determinants of health. Triangulation of data using thematic analysis was used to identify the political determinants of malaria in Nigeria and to understand how the concept of interaction contributes to the persistence of the disease. The analysis involved a deductive and inductive approach based on the literature …

An Educational Program To Improve African American Women’S Knowledge And Self Efficiency In Seeking Treatment For Endometrial Cancer, Lauren Elise Rosenthall

Electronic Theses and Dissertations

In the United States, there is a significant difference in the survival rate for endometrial cancer for African American women when compared to women of other ethnic groups, specifically White women. There is supporting evidence that supports that morbidity and mortality rates for endometrial cancer increase if diagnosed in later stages. There are many contributing factors to a patient receiving an early diagnosis of a disease. One of the key determinants to early diagnosis of endometrial cancer is understanding risk factors, and what symptoms require further evaluation. An educational program was developed to identify knowledge deficits in the African American …

Food Insecurity And Residential Segregation Among Adults In The United States: The National Health And Nutrition Examination Survey 2017- March 2020 Pre-Pandemic Data., Chandre' L. Chaney

Electronic Theses and Dissertations

Food insecurity is when a household has insufficient food supply due to limited economic resources. It is a public health issue that continues to persist. The health, social, and economic impact affects millions of people nationwide. Residential segregation is a primary cause of inequities and health disparities. It shapes the differences in socio-economic conditions between Blacks and Whites living in the U.S. This country is segregated across racial lines in many of our most populated metropolitan cities. Americans worship in different churches, learn in disparate schools, and live in separate neighborhoods. Residential segregation has consequences that impact the economy, professional …

Our Story, Our Song: Assessing And Addressing Black Women's Healthcare Experiences., Jason Deakings

Electronic Theses and Dissertations

Despite advancements in medicine and health sciences, health disparities and declining life expectancy persists among Black women in the United States. Researchers and non-traditional healthcare providers suggest alternative healing (e.g., music and Sister Circles) and research methodologies to achieve a culturally conscious, traumainformed, quality, and holistic care and practice. The intersecting identities and cultural responsibility of Black women highly influences the barriers and facilitators on the uptake of healthcare services. Utilizing a community engaged research approach, this qualitative study assessed the healthcare experiences, as well as the role of music in the lived and retold experiences of Black women navigating …

Sheprep: Examining The Influence Of The Messaging And The Messenger Associated With Prep Uptake Among African American Women, Christian C. Spears

Electronic Theses and Dissertations

African American Women (AAW) make up less than 15% of the female population in the United States but account for over 50% of new HIV diagnoses among females. This largely preventable health disparity can be mitigated by advocating and prescribing Pre-exposure Prophylaxis (PrEP), a preventive HIV medication, to persons at risk. Despite advances in medication options, there are less than 13% of Black people who could benefit from having been prescribed PrEP, and limited research and promotion on the effectiveness of PrEP for AAW. The “ShePrEP Study” aimed to assess awareness, perceptions, and receptivity toward PrEP among AAW. This study …

Medical Providers' Use Of Maternal Mental Health Screening Tools During Prenatal Appointments In Southeast Georgia, Andreka Ewing

Electronic Theses and Dissertations

In the United States, maternal mental health disorders are the most common comorbidities experienced during pregnancy and after childbirth. In particular, the state of Georgia reports that 1 in 7 Georgian mothers experience depression, anxiety, obsessive-compulsive disorders, or psychosis related to these disorders. Research suggests that untreated maternal mental health can have adverse effects on the mother and unborn child. Conditions such as autism, mixed handedness, reduced cognitive ability, and affective disorders can develop while the child is in the womb of a depressed mother. Routine maternal mental health screening using a validated screening tool has been recommended to help …

Factors Associated With Physical Activity Intent Among Adults With Multiple Sclerosis, Biebele Okpeahior

Electronic Theses and Dissertations

Introduction. Although research has highlighted the benefits of physical activity in people with Multiple Sclerosis (MS), they are still more likely to live an inactive lifestyle. There are limited studies that examine the relationship between physical activity and the Theory of Planned Behavior (TPB) among the MS population. This study aimed to explore the factors that associate with physical activity intent of adults with MS utilizing the constructs of the TPB. Methods. This study utilized a cross-sectional online survey done via a social media platform. There were 326 respondents to the survey and ultimately 249 surveys that met the criteria …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Respecting The Ethical Tension Between Surveillance And Privacy In Promoting Public Health And Disease Management, Kamal Althobaiti

Electronic Theses and Dissertations

The recognition of the need to undertake surveillance and to protect privacy is well established. However, the continually changing circumstances and fast-paced development of healthcare today requires a continuing need to respect this ethical tension between surveillance and privacy. Hence, this dissertation is to respect the ethical tension between surveillance and privacy in promoting public health and disease management. This dissertation investigates the ethics of conducting public health surveillance, including the challenges associated with obtaining consent and protecting data from unauthorized access. The dissertation will focus on the ethical consequences of big data, including issues associated with obtaining informed consent, …

Overview Of Transition Care Clinics And Patient No-Shows, Manul Awasthi

Electronic Theses and Dissertations

Introduction

Transition care clinics (TCCs) have proven to be effective in meeting the time-sensitive needs of patients in the post-discharge period and ensuring smooth transitions of patients from hospital to home. These clinics have led to lower readmissions, lower emergency department visits, cost savings, and lower rates of other adverse events following discharge. However, TCCs, including the East Tennessee State University Family Medicine (ETSU-FM) TCC have been facing high rates of patient no-shows.

Aim

The aim of this dissertation is to identify the different components and outcomes of TCC based on the literature. We further aim to analyze the TCC …

Addressing Stress In Graduate Nurse Practitioner Nursing Students, Shandria K. Sawyer

Electronic Theses and Dissertations

This project was developed to address the issue of high stress levels among graduate nursing students, which is a common phenomenon that increases the risks of mental health disorders, professional burnout, and poor-quality patient care among students and professional nurses after earning their degrees. This project sought to utilize a simple educational intervention delivered online to impart coping skills to graduate nursing students to assist them in reducing their stress levels. The intervention was a brief, single-session, self-guided educational module featuring informational and participative elements related to stress causes, the impacts of stress, and stress reduction techniques. In total, 11 …

“…You Can't Unknow It, It's A New Reality": A Case Study Exploring A Social Justice Public Health Intervention's Impact On Critical Consciousness Development In Youth., Monique Williams

Electronic Theses and Dissertations

Even though public health purports to be rooted in social justice, it is not clear how social justice frameworks are integrated in public health research and intervention. The discipline focuses on groups/populations on the margins, without integrating the social and political factors that cause marginalization into the intervention. Seeing communities, and individuals, as assets and experts in their own experiences is key to population-level health improvement. Particularly for public health youth intervention, how youth are labeled and engaged in social change is critical to their healthy development. While public health lags in practically applying asset-based approaches to youth intervention, research …

Nurses Leading In Bridging The Culture Gap: Communicating With The Deaf Community, Veronica C. Leftridge

Electronic Theses and Dissertations

Nurses provide patient care in clinics, hospitals, homes, churches, schools, communities, and military, as well as on emergency medical helicopters. When a nurse is assigned to care for a patient, the patient expects the nurse to be culturally competent, communicate effectively, and provide safe quality care. However, cultural incompetence is observed when nurses provide care for Deaf patients, but they are unfamiliar with Deaf culture. In addition, communication is a fundamental skill nurses learn in nursing school, but course content in nursing programs rarely touches on how to communicate effectively with Deaf patients. Of the approximately 325 million people in …

Public Health Contagion Of White Supremacy: Examining The Pipeline Of Attitudes About Racism And Racial History Education Among High School Students., Trinidad Jackson

Electronic Theses and Dissertations

We are living in compounded states of upheaval. Violence and exemption from it across socioecological levels have shaped how humans survive, thrive, and die. While different violence typologies exist, the U.S., prioritizes interpersonal violence as its primary target of intervention, often through structural means that foster and reinforce interpersonal violence. The omission of structural and cultural agents and outcomes of violence allows perpetrators to infiltrate and reproduce savage, dehumanizing ideologies in perpetuity. Instead of sustaining societal pillars that oppress and destroy, we must fertilize public health research, practice, and sociopolitical activism with pillars that both inform and activate liberatory consciousness …

Understanding Public Emergency Preparedness Before And During The Coronavirus Outbreak: Implications For Effective Public Health And Risk Communication., Raphael Adjetey Fumey

Electronic Theses and Dissertations

The COVID-19 pandemic has resulted in a dramatic loss of human lives globally and presents an unprecedented challenge to public health, the world of work, and our food systems. The social and economic disruption caused by the COVID-19 pandemic is devastating, putting several millions of people at risk of falling into extreme poverty, with over 500 million people being undernourished. It is evident from the data on COVID-19 cases, deaths, and hospitalizations that the United States is the worse hit country, which can be attributed to the lack of preparedness at the individual, environmental, and government levels. This study applied …

Bridging The Gaps: Exploring Factors Associated With Goal Achievement Within An Accountable Care Organization Care Coordination Program, Jessica L. Polk

Electronic Theses and Dissertations

Background: Healthcare cost in the U.S. has been increasing at an unsustainable rate due to the growing population diagnosed with multiple chronic conditions and a fragmented healthcare system. The high-risk patient population includes persons who over utilize the healthcare system with frequent avoidable hospitalizations, emergency room visits, and exacerbations of their chronic conditions. This high-risk population makes up five percent of the U.S. but accounts for over fifty percent of all healthcare spending. Care coordination models have emerged to focus proactive health interventions for the highest-risk patient populations to reduce overutilization and empower patients to improve long-term health. Evidence has …

Exploring The Contextual Factors And Decision-Making Process Of Risky Sexual Behavior Among Homeless Adults In Louisville, Kentucky., Sarah C. Van Heiden

Electronic Theses and Dissertations

Homelessness is a complex public health issue; individuals who experience homelessness are said to engage in risky sexual behaviors at an increased rate and experience a higher prevalence of sexually transmitted infection (STI). While the sexual behaviors of homeless adolescents are commonly studied, little is known about the sexual behaviors of the growing population of older adults, or how they make decisions to engage in sex. Three aims guided this research: 1) to describe the sexual behaviors and sexual decision-making process of homeless older adults, 2) to examine how homeless older adults evaluate the outcomes associated with engaging in risky …

A Program Evaluation Of Nutrition-Based Educational Modules Designed For The University Of Windsor Lancers Varsity Athletics, Justine Van Herk

Electronic Theses and Dissertations

The purpose of this program evaluation was to develop nutrition-based educational modules for the coaches and student-athletes at the University of Windsor and to investigate their effectiveness, usefulness, and applicability. The nutrition-based educational modules were a collaborative effort between the Community Health, Environment, and Wellness (CHEW) lab and the Centre for Human Performance and Health (CHPH). Eight teams voluntarily participated in the 6-week implementation period with the nutrition-based educational modules. Following this implementation period, nine participants (n = 2 coaches, n = 7 student-athletes) volunteered to provide feedback during one-on-one semi-structured virtual interviews. The interview guide was divided into …

“And The Next Day, You Are In Charge”: Policy Recommendations Stemming From A Qualitative Investigation Into The Professional Development Of Early Career Peer Support Specialists In Kentucky., Diane Zero

Electronic Theses and Dissertations

Over the last twenty years, the peer support segment of the behavioral health workforce has grown rapidly. However, few researchers have studied the effects on individuals from transitioning into the role. Likewise, there is limited research examining the professional development process of early career peer support specialists. To begin to fill these gaps in the literature, I conducted a qualitative research study examining workforce development experiences of peer support specialists in Kentucky. This dissertation reports on its findings and includes a policy paper with recommendations for improving policy and practice. Chapter one offers an introduction to the peer support workforce …

Economic Insecurity, Poverty, And Parental Alcohol Misuse, Joey Tucciarone

Electronic Theses and Dissertations

Because parental alcohol misuse is associated with numerous negative outcomes for drinkers and other family members, it is important to examine factors predictive of alcohol misuse patterns among parents living with at least one child under the age of 18. Two possible factors include economic insecurity and poverty. This study sought to address whether measures of economic insecurity (i.e., housing and/or food insecurity in the past 12 months) and a dichotomous measure of poverty predict parental binge drinking and parental heavy alcohol consumption in a large population-based sample. It was hypothesized that economic insecurity and poverty, analyzed separately, would predict …

Tobacco Cessation Counseling Practices Amongst Dental Hygienists In Central Texas, Lacy Murray

Electronic Theses and Dissertations

Although tobacco cessation is an uphill battle for almost everyone who attempts to quit, it is important that dental hygienists do not assume that patients are not interested. Dental hygienists are in an ideal position to offer cessation help to their tobacco using patients. The purpose of this study was to gain a better understanding of the tobacco cessation practices among central Texas dental hygienists. Specifically, dental hygienists were asked about beliefs, motivation, and confidence with regard to their tobacco cessation practice. A positive significant, moderate, relationship was found between beliefs and confidence (r=0.647), beliefs and practices ( …

Sarcopenia Screening By Registered Dietitian Nutritionists (Rdns) In The United States (U.S.), Madison Marcom

Electronic Theses and Dissertations

Sarcopenia is a disease of muscle wasting primarily seen in older adults. Although this term was first coined over three decades ago, there is a lack of consensus on a definition, screening criteria, and treatment protocol for sarcopenia. The primary purpose of this study is to determine whether registered dietitian nutritionists (RDNs) in the United States (U.S.) screen for sarcopenia. Study participants were recruited through a randomized email list and included RDNs throughout the U.S. Respondents completed a survey questioning knowledge of sarcopenia, screening tools and company protocols in place, and the need and desire for sarcopenia education. Data revealed …

"Who's The Man?" Examining The Relationships Between Black Masculinity, Perceived Social Support, And Sexual Behavior In Black Male College Students, James Thomas

Electronic Theses and Dissertations

Introduction: Sexual health disparities in college-aged Black men remains a critical public health issue. Black men are likely to have an earlier sexual debut, acquire sexually transmitted infections (STIs) and HIV at higher rates, and enter fatherhood at earlier ages than their White counterparts. Previous research has identified masculinity and perceived social support as predictors of sexual risk behavior for men in the U.S. However, when exploring masculinity’s influence on sexual behavior, studies that are culturally sensitive to Black men’s experiences and perspectives on manhood are few. The purpose of this study was to explore the relationship between Black masculinity, …

Association Between Prepregnancy Obesity And Health Behaviors, Adverse Conditions, And Birth Outcomes In South Dakota, Lily Sanderson

Electronic Theses and Dissertations

Introduction: Prepregnancy obesity is associated with an increased risk for various adverse outcomes for mother and fetus. These adverse associations exist within the realms of preconception health, prenatal health, birth outcomes, and postnatal health.
Methods: This retrospective cohort study used data from the South Dakota Pregnancy Risk Assessment Monitoring System (SD PRAMS) survey, which is an ongoing statebased surveillance system of maternal behaviors, attitudes, and experiences before, during, and shortly after pregnancy. The 2017 and 2018 SD PRAMS sampled a total of 3,805 mothers who were randomly selected from birth certificate records to be representative of all South Dakota women …

The Association Of Demographic Characteristics And Social Vulnerability With Covid-19 Outcomes, Gloria D. Boone

Electronic Theses and Dissertations

The Association of Demographic Characteristics and Social Vulnerability With COVID-19 Outcomes

by

Gloria Boone

(Under the Direction of Gulzar Shah)

ABSTRACT

This research explored 102 Illinois counties' COVID-19 data to determine whether demographic characteristics and social vulnerability are associated with increased vulnerability to COVID-19 infections and deaths. COVID-19 is disproportionately impacting vulnerable groups and has been deadlier for African American and Hispanic people. The findings of this research will contribute to the knowledge base regarding social vulnerability and assist public health officials in targeting resources and designing interventions. This study used a retrospective cross-sectional design to assess demographic characteristics of …

An Exploration Of Depression In African American Adults With Sickle Cell Disease: Symptoms, Coping Strategies And The Potential Benefits Of Religiosity, Delores P. Quasie-Woode

Electronic Theses and Dissertations

Depressive symptoms in adults with Sickle Cell Disease (SCD) often go unrecognized and untreated. SCD is one of the most common inherited hemoglobin disorders in the United States, affecting 1 in 365 African Americans. Individuals with SCD and co-morbid Depression lead to high hospitalization rates and healthcare utilization. The objective of this study is to explore depressive symptoms and preferred coping strategies among African American Adults with SCD. Furthermore, the aim is to explore the acceptability of religiosity among those who self-identify as religious.

Interviews were conducted with 30 African American adults, recruited during their hematology appointment at the Center …