Medicine and Health Sciences Commons^™

Staff Education: Improving Hypertension Management Among African American Adults, Marie Survie Tunis-Blanc

Walden Dissertations and Doctoral Studies

AbstractHypertension (HTN) is a frequent diagnosis in primary care settings and is disproportionately higher among African Americans. Observed in the clinic were frequent office visits by patients with uncontrolled blood pressure and nonadherence to medication in an outpatient cardiology clinic in Northeast New Jersey. Also, a knowledge gap was noticed among clinical staff on current HTN guidelines. An awareness of evidence-based guidelines was necessary to combat poorly controlled BP in the clinic. The purpose of this Doctor of Nursing Practice project was to create an education program on current HTN guidelines to bridge the knowledge gap among clinic staff. The …

How Black Americans Accessed And Used Mental Health Services During The Covid-19 Pandemic, John K. Anderson

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic created barriers to accessing mental health services for the general population, but for Black Americans, it exacerbated systemic barriers that have historically influenced help-seeking behaviors. Drawing from the concept of obstructed use, this qualitative study explored those barriers and, using a narrative approach, explored how Black Americans described their experiences of accessing mental health services during the COVID-19 pandemic The participants included six men and two women who identified as U.S.-born Black American adults who sought mental health services during the COVID-19 pandemic. Narrative data were analyzed through thematic analysis, identifying themes and subthemes of the participants' …

Impacts Of Mobile Health Technology On The African American Millennial Health Care Experience, Antoine J. Campbell

Walden Dissertations and Doctoral Studies

African Americans are underrepresented and have limited access to health care in the United States due to systemic disparities. The purpose of this qualitative phenomenological study was to develop a better understanding of the relationship that African Americans have with the health care system and the way they interact with it as well as to examine the impacts of mobile health (mHealth) patient engagement applications and their impact on shaping health experiences amongst millennial African Americans. Research questions addressed African American millennials’ perspectives on potential barriers to utilizing health care in the U.S. health care system as well as consideration …

Self-Care And Psychosocial Factors That Predict Sickle Cell Disease-Related Outcomes Among African Americans In The Usa, Datonye Agina-Obu

Walden Dissertations and Doctoral Studies

Existing beliefs and conceptions regarding sickle cell disease (SCD) have had a significant impact on the appropriate management of the condition, including self-care and psychosocial factors, particularly among African Americans. The aim of this study was to examine the influence of self-care and psychosocial factors on SCD-related outcomes among African Americans in the United States. The study was grounded in the self-care management theory and employed a cross-sectional, quantitative design. Regression analyses were conducted to explore the associations between self-care and psychosocial factors and SCD-related outcomes sample of 180 individuals. The results indicated three factors showed significant relationships for sickle …

Impacts Of Mobile Health Technology On The African American Millennial Health Care Experience, Antoine J. Campbell

Walden Dissertations and Doctoral Studies

African Americans are underrepresented and have limited access to health care in the United States due to systemic disparities. The purpose of this qualitative phenomenological study was to develop a better understanding of the relationship that African Americans have with the health care system and the way they interact with it as well as to examine the impacts of mobile health (mHealth) patient engagement applications and their impact on shaping health experiences amongst millennial African Americans. Research questions addressed African American millennials’ perspectives on potential barriers to utilizing health care in the U.S. health care system as well as consideration …

Nutrition And Physical Exercise Prevention Strategies To Reduce Obesity During The Covid-19 Pandemic, Carmesha Vajill Carter

Walden Dissertations and Doctoral Studies

Obesity has reached an epidemic level of 75 million obese adults and 15 million obese children in the United States. The research problem addressed in this study is the lack of information on how obese people manage their weight-loss strategies to prevent or reduce obesity during shut-in place restrictions for the COVID-19 Pandemic. This study included the Prochaska and DiClemente Trans-Theoretical Model of Behavioral Change and the Stage of Change Theory. The phenomenon approach using phenomenology described participants' lived experiences of being obese. The researcher completed data collection and evaluation among sixteen participants using email questionnaires to analyze participant's responses …

Factors Associated With The Uptake Of Hiv Testing Among African American Male College Students, Brittney Sade Washington-Ball,Drph

Walden Dissertations and Doctoral Studies

HIV testing rates are much lower among African American male college students than male college students of other racial groups. Routine HIV testing on college campuses can decrease HIV rates among African Americans and increase students' awareness of their HIV status. This study was an investigation of factors associated with HIV testing among a sample of 140 African American male college students. The health belief model guided the research study and served as the theoretical framework to examine the influence of factors such as the location of testing, STD status, number of sexual partners, insurance coverage, health information, and alcohol …

Improving Nurses’ Knowledge To Provide Diabetes Self-Management Education For African Americans, Jakeyla Reed

Walden Dissertations and Doctoral Studies

African Americans are at high risk for type II diabetes compared to other ethnic groups due to biological, socioeconomic, and psychosocial risks. Specifically, African American adults are nearly two times more likely than White individuals to develop type II diabetes. The meaningful gap-in-practice addressed by this doctoral project was nurses’ lack of diabetes knowledge affecting their ability to provide diabetes care and diabetes self-management education (DSME) to their patients with diabetes. The clinical practice-focused question asked whether an education intervention for outpatient clinic nurses could improve their knowledge of DSME. Orem’s self-care model, Bandura’s self-efficacy theory, and Lewin’s change theory …

Internet Use, Perceived Social Support, And Obesity Among African American Young Adults, Cynthia Adams

Walden Dissertations and Doctoral Studies

African Americans are disproportionately affected by obesity. Public health practitioners have an incomplete understanding of the social-environmental risk factors and how they affect obesity. The purpose of this quantitative, cross-sectional study was to explore whether internet use and perceived social support predicted obesity among African American young adults. The social cognitive theory guided this study. Secondary data were analyzed from the 2017 Behavioral Risk Factor Surveillance Survey. The sample consisted of 6,765 African American young adults age 18 to 34 and represented the U.S. population using weighted estimates. A Bonferroni correction was performed to reduce Type I error due to …

Healthcare Access For Elderly African American Type 2 Diabetics On Medicare, William Alexander Floyd

Walden Dissertations and Doctoral Studies

AbstractPrior research has shown that African Americans have less access to healthcare than do White Americans. The study’s purpose was to determine the association between race/ethnicity and quality care measures in a population of Medicare recipients with Type 2 diabetes, aged 65 75 years and over. Covariates predicted satisfaction with doctor care, compassionate doctor care, and indifferent doctor care using Andersen’s health behavior theory. The Medicare Current Beneficiary Survey (MCBS) sample consisted of 1,716 people with Type 2 diabetes, with most (76.6%) being non-Hispanic Whites, and the remainder non-Hispanic Blacks (10.8%) and Hispanics (12.6%). Race/ethnicity were associated with quality-of-care measures …

Increasing Nurse Knowledge Of The Underutilization Of Hospice Services For African Americans, Vicki Schmidt

Walden Dissertations and Doctoral Studies

The focus of this doctoral project was increasing knowledge of underutilization ofhospice services for African Americans (AAs) and the need to increase cultural competence among nurses regarding this issue. The identified gap in practice was nurses’ lack of cultural competence and knowledge regarding the underutilization of hospice specific to AAs. The practice-focused question focused on whether a staff educational intervention increased nurses’ knowledge of the cultural implications regarding the introduction of hospice services for AAs. The education was guided by the Purnell model for culturally competent health care, Healthy People 2030, and the National Hospice and Palliative Care Organizations AA …

African Americans Beliefs Regarding Skin Cancer And Prevention, Tamara Wesley

Walden Dissertations and Doctoral Studies

Skin cancer is becoming more prevalent in African Americans. African Americans' mortality rate is significantly higher than any other race due to lack of awareness. The purpose of this qualitative study, guided by Rosenstock's health belief model, was to gain an understanding of African Americans' beliefs and perceptions regarding skin cancer. Ten telephone interviews were conducted with African Americans who were 18 years old or older, no history of cancer, and who were members of a church in a rural town in the southeastern United States. The interview transcripts were manually transcribed verbatim. The data were analyzed by using codes …

Barriers That Influence The Underuse Of Mental Health Services By African Americans Diagnosed With Schizophrenia, Pamela Gail Stackhouse-Hinsey

Walden Dissertations and Doctoral Studies

African Americans diagnosed with schizophrenia have longer wait times to be treated by mental health care professionals, resulting in their underuse of mental health services. This problem has motivated medical professionals to reexamine the ways in which services are rendered and then make appropriate improvements. The purpose of the study was to explore the lived experiences of African Americans diagnosed with schizophrenia and identify the reasons for their underuse of mental health services. A phenomenological research design was used to understand and explore the participants’ lived experiences of the phenomenon. Participants were recruited from an independent living facility. Purposive sampling …

Neighborhood Factors, Depression, And Body Mass Index Among Patients With Lupus In Georgia, Aisha L. Hill

Walden Dissertations and Doctoral Studies

Elevated BMI (overweight and obesity) is a common health-related issue and affects more than half of the lupus population. Weight issues lead to additional health-related issues, such as heart disease and disabilities in the lupus population. To address the shortage of research focusing on this specific issue in the lupus population, one approach is a novel outlook on how neighborhood factors have the capability of determining or altering behaviors, such as physical activity, healthy eating, and healthy social relationships. Another variable to consider is depression and its capability of altering interactions, relationships, self-esteem, or even the inflammatory state of the …

Identifying Strategies That Address Race-Based Traumatic Stress Of African Americans In Rural Mississippi, Syrenia Johnson

Walden Dissertations and Doctoral Studies

There has been a dramatic increase of race-based encounters that have had an extensive health impact on African Americans. Social workers and other mental health professionals play a crucial role in working with African American adults who experience race-based traumatic stress. The purpose of this qualitative study was to identify strategies to address race-based traumatic stress from a mental health perspective. Racial encounter coping appraisal and socialization theory (RECAST) guided this study where eight social workers from the local community mental health center in rural Mississippi completed an open-ended questionnaire to identify and determine culturally competent treatment strategies for African …

Association Of Social Support And Depressive Symptoms Among African Americans, Jacketta Renee Cobbs

Walden Dissertations and Doctoral Studies

Depression affects over 120 million individuals worldwide; in the United States, depression is a leading cause of disability for individuals’ ages 15-44 years. Social support can affect both physical and depressive symptoms; therefore, most patients with heart failure (HF) need support from family and/or friends to effectively manage their health condition. This indicates family and/or friends are expected to be the core support system for long term care of those with HF. The purpose of this study was to determine whether social support contributes to depressive symptoms among African Americans with HF. The research questions examined the experience of different …

Perceptions And Beliefs Of African American Men And Women 30 Years And Older About The Health Care System In The United States, Jacqueline Chadwick Mcnair

Walden Dissertations and Doctoral Studies

This qualitative study described perceptions and beliefs of African American men and women ages 30 and over regarding their experiences with the health care system in the United States. The health belief model was the theory that drove this research, and it was grounded in the concept of cultural competency. The study used grounded theory methodology as well as phenomenology to describe the lived experiences of the participants and ethnography to describe the cultural characteristics of African American men and women ages 30 and over as related to their perceptions and beliefs about health care in the United States. The …

Medical Skepticism And Diabetes Management In African Americans, Pamela Bouyer

Walden Dissertations and Doctoral Studies

Type 2 diabetes (T2DM) in African Americans is a manageable disease, and self-management interventions reduce complications and hospital stays. However, in the African American population, traditional T2DM self-management interventions do not produce long-term effects on lifestyle and behavior changes. Researchers have analyzed the barriers and interventions associated with the disease, but the problem still exists. Medical skepticism may influence T2DM management and health outcomes in African Americans. However, there is scarce literature addressing the relationship between medical skepticism and health outcomes (eye and kidney problems). The purpose of the study is to assess the relationship between medical skepticism and outcomes …

Perspectives Of African Americans Diagnosed With End Stage Renal Disease And Their Perceptions Regarding Accessibility Of Care, Toya Williams

Walden Dissertations and Doctoral Studies

End stage renal disease (ESRD) is the final phase of kidney disease. African Americans make up 35% of all ESRD cases, which is rising. They lead all other racial groups and are 3 times more likely to be diagnosed with ESRD. Researchers have reported quantitative results involving this population, but none have focused on their experiences. The researcher sought to capture the experiences of these patients and their perceptions regarding access to healthcare to determine the role that access to care played in their condition. Interviews were conducted to gain an understanding of their experiences related to their use of …

Factors Contributing To High Readmissions For Congestive Heart Failure Among African Americans, Shavonda Caprice Devereaux

Walden Dissertations and Doctoral Studies

Abstract

African Americans are disproportionately affected by heart failure, with prevention and treatment of heart failure being a public health concern in the United States. The purpose of this retrospective quantitative study was to examine the primary variable race, specifically African Americans, and how this variable relates to 30-day readmission post discharge when controlled with geographic location (urban vs. rural), gender, and insurance status. The expanded chronic care model was used as a framework to shape health promotion, prevention efforts, and social determinants of health and to enhance community involvement related to chronic disease issues. The research questions were focused …

Embracing Ujima: A Grounded Theory Of African Americans Choosing The Counseling Profession, Rashida Karriem Fisher

Walden Dissertations and Doctoral Studies

Racial and ethnic diverse populations experience discrimination in educational and career attainment and remain underrepresented in the counseling profession. The current literature provides limited guidance for the counseling profession and academic institutions for successfully recruiting racial and ethnic minority students in a master's level counselor training program. Social Constructivist theory and Adlerian/ Individual Psychology are the theoretical foundations of the study. This constructivist grounded theory study sought to understand the career decision-making process of African Americans choosing to enter in the counseling profession and the influence of racial and ethnic identity on this decision-making process. Utilizing semistructured interviews via video-conferencing; …

Association Of Social Support And Patient-Provider Communication And Medication Adherence, Laquasha Arenese Gaddis

Walden Dissertations and Doctoral Studies

The prevalence of hypertension in African Americans is the highest of any population in the United States, and this population also demonstrates lower rates of adherence to mediation. Social support and patient-provider communication have been considered as reinforcing factors to help hypertensive patients achieve optimal blood pressure control. The purpose of this study was to examine the association of social support and patient-provider communication and medication adherence for hypertensive African American men and women. The study was guided by the theory of reasoned action. This study was conducted to determine whether social support and patient-provider communication was associated with medication …

Risk Factors That Predict Asthma Among Adult, Foreign-Born African Americans In California, Alphajor Umaru Barrie

Walden Dissertations and Doctoral Studies

The purpose of this quantitative study was to examine possible risk factors that predict asthma among adult, foreign-born African Americans in California. A total of 794 foreign-born African Americans (87 asthma cases) were included from the 2017-2018 California Health Interview Survey database. Data analysis included both descriptive and inferential statistical methods including chi-square analysis and multiple logistic regression techniques. The socioeclogical model was used to help understand and interpret the findings. The dependent variable was asthma status and the independent variables were the risk factors (tobacco smoking, alcohol use, health insurance, income level, and education level). Confounders included in the …

Exploring The Mechanisms Of Racial Disparity In Infant Mortality: A Grounded Theory Approach, Barry Chukwugekwu Eneh

Walden Dissertations and Doctoral Studies

Infant mortality (IM) is a critical health-disparity problem in the United States. Of the 23000 infants who die each year, the highest number occurs among African Americans. Previous studies implicated a mix of health determinants and risk factors, but no study has explored the mechanisms by which IM predictably persists among African Americans. This study uncovers the complex network of risk factors that underlies racial death disparities in infants. Two theoretical lenses chosen for this study were social systems theory (SST) and critical race theory (CRT). SST explains human behavior as an intersection of interrelated systems. CRT interrogates inherent social …

Self-Concealment, Perceived Discrimination, And African American Treatment Choices For Major Depression, Danita Morales Ramos

Walden Dissertations and Doctoral Studies

African Americans have a higher proclivity to depression than other ethnic groups in the United States and also have a greater propensity to avoid seeking professional mental health treatment. The available research has shown that racial and cultural barriers such as perceived discrimination and self-concealment are the primary factors that negatively affect African Americans' attitudes toward mental health itself and mental health treatment. Perceived discrimination and self-concealment may also negatively affect whether African Americans seek help for depression and from whom, but further investigation was needed. The quantitative survey study provided answers to which factors influence whether and where African …

Utilization Of Preventative Care Services By African Americans Post-Affordable Care Act, Madalyn Mcknight

Walden Dissertations and Doctoral Studies

Preventative care services allow patients to be fully equipped with the knowledge, tools, and other resources to help them discover and treat many diseases and illnesses so that the burden of costs will not fall on patients and their families. Since the passage of the Affordable Care of Act (ACA) by President Barack Obama, the requirement for health insurance coverage has not translated to utilization of preventative care services. The purpose of this study is to determine the motivation for African Americans who have insurance coverage and access to care who are not taking advantage of opportunities for screenings and …

Religious Coping And Ptsd Symptom Management Among African Americans: A Clergy Perspective, Barbra Talley

Walden Dissertations and Doctoral Studies

Data indicated that although African Americans reported fewer occurrences of traumatic events than that of their racial/ethnic counterparts, however, the degree of traumatic events experienced by African Americans tends to be more serious and violent in nature. More so, lower recovery outcomes associated with PTSD among African Americans have been attributed to varying factors, such as financial restrictions, strained health care access, ineffective coping strategies as well as a mistrust of medical and clinical approaches, thus leading African Americans to seek faith-based approaches. This phenomenological study investigated clergy perspectives on religious coping constructs relative to the management of PTSD symptoms. …

The Influence Of Family History Of Type 2 Diabetes Mellitus On Positive Health Behavior Changes Among African Americans, Donny D. Ard

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus (T2DM) is a disease that affects the body's ability to metabolize glucose effectively. The disease is predicted to be prevalent in over 300 million people by the year 2030. African Americans (AA) have the highest prevalence rates in the United States. Lifestyle modification and awareness of risk factors, including family history, are important aspects for prevention of developing T2DM. The purpose of this study was to understand if a family history of T2DM played an influential role in individuals making positive health behavior changes for T2DM prevention. The phenomenological study was grounded in the health belief …

Colorectal Cancer Awareness And Screening Guideline For African American Populations, Keyna Omenukor

Walden Dissertations and Doctoral Studies

Colorectal cancer is the 3rd leading cause of cancer-related deaths. Early screening

provides the best prospects for preventing the morbidity and mortality associated with the

disease. Nurses have the duty to promote health and prevent diseases. However, low rates

of colorectal cancer screening continue to be reported, especially among African

Americans who continue to suffer disproportionately from the disease. There is a need for

a culturally-sensitive clinical practice guideline that nurses can use to educate patients

appropriately on colorectal cancer. The practice focused question for this project was

designed to explore whether a culturally-sensitive clinical practice guideline to increase

colorectal …

Stroke Risk Factor Knowledge, Attitude, Prevention Practices, And Stroke, Adaku Ngozika Madubuko

Walden Dissertations and Doctoral Studies

Regardless of the advances that have been made in stroke research and treatment and the overall decrease in stroke mortality, the stroke mortality rate for African Americans is still high at 45.2/100,000 and is still the leading cause of adult disability. Knowledge of the risk factors of stroke is paramount to reducing the morbidity and mortality of stroke, but knowledge of stroke risk factors has been found to be suboptimal in the African American population. The purpose of this study was to examine if there is a relationship between the knowledge, perception, and sources of stroke information of risk factors …