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Articles 331 - 360 of 6102
Full-Text Articles in Medicine and Health Sciences
A Multilevel Analysis Of Prescriber-Reported Buprenorphine Induction Challenges In Fentanyl-Endemic Settings, Alyssa Vawn Long
A Multilevel Analysis Of Prescriber-Reported Buprenorphine Induction Challenges In Fentanyl-Endemic Settings, Alyssa Vawn Long
Walden Dissertations and Doctoral Studies
The emergence of illicitly manufactured fentanyl has increased clinical uncertainty during buprenorphine induction in medication-assisted treatment for opioid use disorder. The purpose of this quantitative, retrospective cohort study, guided by the Transtheoretical Model (TTM), was to examine whether prescriber-level buprenorphine induction practices and experiences with precipitated withdrawal were associated with reported buprenorphine induction challenges, and whether county-level fentanyl prevalence contributed to these challenges after accounting for geographic clustering. Secondary, de-identified archival data were obtained from the National Institute on Drug Abuse Clinical Trials Network study CTN-0134 and included 64 prescribers practicing in fentanyl-endemic settings. Buprenorphine induction challenges were operationalized as …
Risk Factors Affecting Functional Outcomes Of Traumatic Brain Injury Patients During Long-Term Acute Care Hospital Rehabilitation, Arturo Olazabal
Risk Factors Affecting Functional Outcomes Of Traumatic Brain Injury Patients During Long-Term Acute Care Hospital Rehabilitation, Arturo Olazabal
Walden Dissertations and Doctoral Studies
Traumatic brain injury (TBI) is a major public health concern associated with long-term disability and high healthcare utilization. Evidence guiding post-acute rehabilitation for medically complex TBI populations remains limited, particularly in long-term acute care hospital (LTACH) settings serving medically unstable patients. This study examined clinical and system-level factors associated with functional rehabilitation outcomes among adults with moderate-to-severe TBI in LTACHs. Guided by the Socioecological Model, recovery was conceptualized as interactions across individual, clinical, and organizational levels. This dissertation included three manuscripts using cross-sectional logistic regression and CMS Section GG measures. In Manuscript 1, longer time from injury to LTACH admission …
Relationship Between Hepatitis B Virus Screening, Vaccination, And Spread In Sierra Leone, Muhammed Sarmodu Mansaray
Relationship Between Hepatitis B Virus Screening, Vaccination, And Spread In Sierra Leone, Muhammed Sarmodu Mansaray
Walden Dissertations and Doctoral Studies
Hepatitis B virus (HBV) presents a significant public health burden in Sierra Leone. Although the estimated prevalence was 8.7% in 2021, comprehensive statistical data has been limited in general. Programmatic interventions for HBV control such as systematic screening and vaccination have remained limited as well. The purpose of this quantitative cross-sectional study was to examine the relationship between screening and vaccination practices and HBV prevalence in Sierra Leone while controlling for age, sex, education and health care access. The theoretical framework incorporated the Integrated Screening Action model, which highlights screening as a critical disease prevention strategy, and the Social Ecological …
Staff Education To Improve Nursing Knowledge Of Catheter-Associated Urinary Tract Infection Prevention Practices, Maylin Fernandez
Staff Education To Improve Nursing Knowledge Of Catheter-Associated Urinary Tract Infection Prevention Practices, Maylin Fernandez
Walden Dissertations and Doctoral Studies
In this Doctor of Nursing Practice quality improvement project, I used a staff education intervention to address nursing knowledge gaps related to catheter-associated urinary tract infection (CAUTI) prevention in a large outpatient urology clinic in the southeastern United States. Registered nurses (N = 28) participated in a single, 45-minute, in-person education session comprising PowerPoint slides, facilitated discussion, and printed job aids based on national guidelines. I used a single-group pre-/posttest design to evaluate the effect of the intervention. The primary outcome was staff knowledge measured using a paper-based, 17-item knowledge test administered immediately before and after the session. The secondary …
Perioperative Pressure Injury Prevention Education Program, Stephanie M. Reed
Perioperative Pressure Injury Prevention Education Program, Stephanie M. Reed
Walden Dissertations and Doctoral Studies
Pressure injuries (PIs) are localized injury to the skin and/or underlying tissue, usually over a bony prominence, resulting from sustained pressure including pressure associated from shear. Surgical patients are estimated to represent 42% of hospital acquired PIs. PIs result in poor patient outcomes, increase length of stay, add billions to heath care costs are no longer reimbursed by Centers for Medicare/Medicaid Services. Prevention of PI is different in the perioperative setting due to the complexities of surgery. This project focused on developing, delivering, and evaluating a robust education program for perioperative staff on PI prevention in the perioperative setting. The …
Association Between Childhood Exposure To Family Substance Abuse, Mental Health Issues, And Cervical Screening Among Women Ages 18-65 In South Carolina, Ashley Laine Hamm
Association Between Childhood Exposure To Family Substance Abuse, Mental Health Issues, And Cervical Screening Among Women Ages 18-65 In South Carolina, Ashley Laine Hamm
Walden Dissertations and Doctoral Studies
Adverse childhood experiences (ACEs) have been associated with adverse health outcomes in adulthood; however, less is known about their relationship with preventive health behaviors such as cervical cancer screening. The purpose of this quantitative, correlational study was to examine associations between selected ACEs and cervical cancer screening among women aged 18–65 in South Carolina. Data were drawn from the 2020 South Carolina Behavioral Risk Factor Surveillance System (BRFSS) and included 1,323 women. Binary logistic regression analyses were used to examine unadjusted and adjusted associations between ACE exposures and being up to date with Pap testing, controlling for age, race/ethnicity, income, …
Sociodemographic Factors And Dating Violence Among Adolescents Living In Rural Southern U.S. Communities, Kiara Patricia Sims-Thrasher
Sociodemographic Factors And Dating Violence Among Adolescents Living In Rural Southern U.S. Communities, Kiara Patricia Sims-Thrasher
Walden Dissertations and Doctoral Studies
Adolescent dating violence (ADV) is a significant public health issue that disproportionately affects youths in southern rural communities, yet these populations remain underrepresented in research. The purpose of this quantitative cross-sectional study was to examine the association between ADV and sociodemographic factors (gender, race, age, and education level), alcohol consumption, and bullying among adolescents in Alabama, Arkansas, and Mississippi using data from the 2021 Youth Risk Behavior Surveillance System. Guided by the social-ecological model, binary logistic regression analyses were conducted to assess relationships between ADV victimization and the selected predictors. Results indicated that females had significantly higher odds of reporting …
The Association Between Advanced Technology Use And Quality Of Life Among Those With A Disability, Sarah Antus
The Association Between Advanced Technology Use And Quality Of Life Among Those With A Disability, Sarah Antus
Walden Dissertations and Doctoral Studies
Advanced medical technology use among individuals with physical disabilities remains understudied, creating a significant gap in understanding its impact on quality-of-life (QoL) outcomes across demographic and age groups. Guided by the social ecological model, the purpose of this quantitative study was to examine associations between advanced medical technology use, disability status, demographic factors (age, gender, and race/ethnicity), and QoL outcomes using 2017–2018 National Health and Nutrition Examination Survey data. The sample included 9,254 individuals age 6 years and older with physical functional limitations and complete technology-use and QoL data. Advanced medical technology use was significantly associated with improved QoL (p < .001). Disability status demonstrated a statistically significant but modest association with technology use, OR = 0.84, 95% CI [0.83, 0.85], p < .001. Age-stratified analyses indicated that advanced technology use significantly predicted improved QoL among adults aged 20 years and older, OR = 6.90, 95% CI [6.89, 6.91], p < .001, but not among youths aged 6–19 years (p = .929). Gender was a significant predictor of technology use, with females having higher odds than males, OR = 1.07, 95% CI [1.06, 1.08], p < .001. Race/ethnicity was also significantly associated with technology use; compared with non-Hispanic White adults, Mexican American (OR = 0.43, 95% CI [0.42, 0.44], p < .001), other Hispanic (OR = 0.58, 95% CI [0.57, 0.59], p < .001), and non-Hispanic Black adults (OR = 0.79, 95% CI [0.78, 0.80], p < .001) had lower odds of advanced medical technology use. The study may inform health care stakeholders about strategies to promote equitable access to advanced medical assistive technologies for social change
Staff Education To Improve Nursing Knowledge Of Follow-Up Adherence Support Strategies In A Large Outpatient Urology Clinic, Ivette Dieguez
Staff Education To Improve Nursing Knowledge Of Follow-Up Adherence Support Strategies In A Large Outpatient Urology Clinic, Ivette Dieguez
Walden Dissertations and Doctoral Studies
Site monitoring identified inconsistent adherence to scheduled follow-up care as an operational concern, underscoring the need for standardized nursing strategies to enhance follow-up communication. This staff education project aimed to determine whether a focused educational intervention could improve nursing knowledge of adherence support strategies, with confidence measured as a secondary outcome. Guided by the ADDIE instructional design model and the Johns Hopkins evidence-based practice model, the project was implemented in a large outpatient urology clinic with 18 participating registered nurses. Participants completed anonymous paper-based pretests and posttests surrounding a single 45-minute, live group education session. Educational content covered common barriers …
Developing Nursing Education On The Assessment Of Asthma Patients With Symptoms Of Shortness Of Breath In Urgent Care, Abigail Akorfa Adase
Developing Nursing Education On The Assessment Of Asthma Patients With Symptoms Of Shortness Of Breath In Urgent Care, Abigail Akorfa Adase
Walden Dissertations and Doctoral Studies
This quality improvement project aimed to enhance the assessment of dyspnea in patients presenting with shortness of breath, particularly those with asthma, through a staff education program. At the practice site, staff primarily relied on SpO₂ readings to evaluate dyspnea, which often led to misassessment and delays in care. The project addressed this gap by providing urgent care staff with training on comprehensive assessment techniques, including evaluation of respiratory rate, work of breathing, ability to speak, patient history, and use of validated tools such as Borg’s scale and peak flow meters. Twenty triage staff members participated, including licensed practical nurses, …
Fast-Food Consumption And Metabolic Syndrome Risk In African Children And Adolescents, Norkinsha Willis
Fast-Food Consumption And Metabolic Syndrome Risk In African Children And Adolescents, Norkinsha Willis
Walden Dissertations and Doctoral Studies
Childhood obesity and excessive fast-food intake represent a significant public health concern among African American children. Grounded in the social-ecological model, this quantitative, cross-sectional study examined whether frequency of fast-food or pizza meal consumption and reliance on low-cost food was associated with total cholesterol (mg/dL) and waist circumference among African American children and adolescents aged 6–15 years while controlling for key sociodemographic factors (age, gender, parental education status, and annual household income). Secondary data from the 2017–2018 National Health and Nutrition Examination Survey were analyzed (N=184). Descriptive statistics, nonparametric analyses, and a multiple linear regression model were used to analyze …
Improving Medication And Lifestyle Adherence Through A Standardized Clinical Practice Guideline, Chazemba Shamaila
Improving Medication And Lifestyle Adherence Through A Standardized Clinical Practice Guideline, Chazemba Shamaila
Walden Dissertations and Doctoral Studies
Medication and lifestyle nonadherence remains a persistent and costly problem within healthcare systems and represents a critical gap in nursing practice. Approximately half of adults prescribed long-term medications do not adhere to recommended regimens, contributing to poor disease control, preventable hospitalizations, increased mortality risk, and substantial healthcare expenditures. These challenges are particularly pronounced in outpatient mental health settings, where symptom burden, cognitive impairment, treatment complexity, and social determinants of health further compromise adherence. Addressing medication and lifestyle nonadherence aligns with nursing priorities related to patient safety, quality improvement, and health equity. This Doctor of Nursing Practice (DNP) project focused on …
Lived Experiences Of Shingles Vaccine-Hesitant Adults Over Age 50 In Riverside County, California, Michelle Beatrice Loomis
Lived Experiences Of Shingles Vaccine-Hesitant Adults Over Age 50 In Riverside County, California, Michelle Beatrice Loomis
Walden Dissertations and Doctoral Studies
Shingles (herpes zoster) causes substantial morbidity, especially among adults over age 50 in the United States. There is a need to better understand the reasons behind low vaccination rates among adults over age 50 given the associated risks for infection and adverse health outcomes that can reduce their quality of life. This qualitative interpretative phenomenological study explored how individuals’ perceptions of the benefits, barriers, susceptibility, and severity of shingles influence vaccine intentions and identified what factors influence vaccine uptake. The health belief model was used to guide the study. Data were collected from one-on-one semistructured virtual interviews with eight adults …
Evaluating The Relationship Between Vitamin D Supplementation, Lifestyle, Social Determinants Of Health, Asthma, And Respiratory Tract Infections, Yun O'Donnell
Walden Dissertations and Doctoral Studies
Hypovitaminosis D is a significant public health concern in the United States associated with inadequate sunlight exposure and insufficient dietary intake. Asthma is a chronic respiratory condition that progressively worsens over time. While asthma is typically managed through individual-level treatment approaches, population-level strategies such as vitamin D supplementation and food fortification policies have not been implemented. A five-tier Public Health Impact Pyramid theoretical foundation guided this nonexperimental quantitative cross-sectional study. Data from 2013-2014 and 2017-2018 NHANES (n = 1,456) was evaluated for relationships between vitamin D supplementation, duration of sunlight exposure, and food security index, with asthma, asthma exacerbation severity, …
Educating Staff Nurses On Pain Reassessment, Katie Louise Pemberton
Educating Staff Nurses On Pain Reassessment, Katie Louise Pemberton
Walden Dissertations and Doctoral Studies
Pain is one of the most common reasons that patients seek medical care, and chronic pain is a major health problem. The goal of this project was to address a lack of current, evidence-based knowledge of nurses regarding pain reassessment. The context for this project was a medical-surgical area in a rural hospital. The Doctor of Nursing Practice project attempted to answer the practice focus question on whether education improved knowledge related to improving pain reassessment. The project framework utilized in the doctoral project was the analysis, design, development, implementation, and evaluation model. An education program was designed with the …
Staff Education To Improve Mental Health Staff Knowledge On Mobile Health Applications For Medication Adherence, Chipasha Chingwengwezi
Staff Education To Improve Mental Health Staff Knowledge On Mobile Health Applications For Medication Adherence, Chipasha Chingwengwezi
Walden Dissertations and Doctoral Studies
Despite rising evidence supporting the efficacy of mobile health (mHealth) applications to enhance medication adherence among individuals with mental health conditions, there is little utilization of these applications within mental health facilities. This project aimed to address the issue of implementing an interactive education program to enhance the knowledge of mental health staff and skills in the application of mHealth apps to enhance medication adherence. The main objective of this project was to fill the gap between conducting research and implementing its outcomes by providing staff with the knowledge and skills to incorporate mHealth applications into their daily practice. The …
Nursing Students’ Attitudes About Correcting Health Misinformation On Social Media, Heather Ann Hill
Nursing Students’ Attitudes About Correcting Health Misinformation On Social Media, Heather Ann Hill
Walden Dissertations and Doctoral Studies
Health misinformation on social media is a global public health concern. Research has shown that health misinformation causes significant harm in communities, especially for vulnerable populations with existing health disparities. Nurses have been urged to play a more significant role in combating health misinformation. Existing research has shown that nurses are hesitant to correct health misinformation on social media, but attitudes among current nursing students have not been examined. The purpose of this qualitative descriptive study was to explore nursing students' attitudes about correcting health misinformation on social media. Guided by Ajzen’s theory of planned behavior and Paterson and Zderad’s …
Education To Improve Knowledge On Effective Communication Among Health Care Staff, Afolake Olajumoke Benson
Education To Improve Knowledge On Effective Communication Among Health Care Staff, Afolake Olajumoke Benson
Walden Dissertations and Doctoral Studies
This doctoral project was conducted at a family practice clinic to assess the impact of staff education on the clinic staff knowledge of the use of situation, background, assessment, recommendation (SBAR) as a communication tool. Miscommunication among healthcare staff is a practice problem at the clinic caused by unstructured sharing of information, which often results in delay in patient care, occurrence of medical errors, and decrease in patient safety, thus the need to address this problem. The purpose of the project was to use staff education on SBAR to increase the clinic staff knowledge on the use of SBAR as …
Examining Predictors For Surgical Site Infection Following Abdominal Hysterectomy Among Women In New York, Nicole Henry
Examining Predictors For Surgical Site Infection Following Abdominal Hysterectomy Among Women In New York, Nicole Henry
Walden Dissertations and Doctoral Studies
Surgical site infections (SSIs) remain one of the most frequent and preventable complications following abdominal hysterectomy. Existing literature has focused on clinical and procedural risk factors, while less is known about how social conditions shape surgical outcomes. This gap is especially concerning for women in New York State (NYS) where differences in income, marital status, primary payer, rurality, and county-level food insecurity may influence postoperative outcomes and subsequent care. The socioecological model provided the foundation for this retrospective cohort study by examining how social drivers of health (SDoH) are associated with SSI incidence following abdominal hysterectomy, and whether food insecurity …
U.S. Pharmacists’ Perceptions Of Getting The Covid-19 Vaccine And How That Affects Their Interactions With The Public, Megan Boals
U.S. Pharmacists’ Perceptions Of Getting The Covid-19 Vaccine And How That Affects Their Interactions With The Public, Megan Boals
Walden Dissertations and Doctoral Studies
Pharmacists play a pivotal role in public health, particularly in promoting vaccination. However, vaccine hesitancy among pharmacists significantly undermines their willingness to provide effective patient counseling and to advocate for vaccination, potentially eroding public trust in vaccines. This descriptive-phenomenological study sought to understand the factors contributing to pharmacists’ COVID-19 vaccine hesitancy and how this hesitancy affected their willingness to recommend vaccines to patients. Twenty practicing pharmacists were interviewed via Zoom between September 23 and October 14, 2025. The health belief model helped interpret the study findings. Thematic analysis, as described by Braun and Clarke, was conducted to identify and interpret …
Implementing An Acuity-Based Staffing Model To Improve Staffing Equity And Patient Safety In An Inpatient Mental Health Unit, Vivian Emuobe
Implementing An Acuity-Based Staffing Model To Improve Staffing Equity And Patient Safety In An Inpatient Mental Health Unit, Vivian Emuobe
Walden Dissertations and Doctoral Studies
Understaffing during the weekends has been related to issues in patient safety, delayed responses, and increased nurse fatigue and turnover in a majority of inpatient mental health units. This practice improvement Doctor of Nursing Practice (DNP) project aimed to address disparities in nurse staffing ratios between weekdays and weekends within inpatient mental health units. The purpose of the project was to design and test an evidence-based acuity-based staffing model, supported by structured staff education and compliance monitoring, to promote equitable workload distribution and improve patient and organizational outcomes. The guiding practice question asked: How does the implementation of an acuity-based …
Falls In Inpatient Hospital Settings, Merlina Constantine
Falls In Inpatient Hospital Settings, Merlina Constantine
Walden Dissertations and Doctoral Studies
Inpatient falls are a common and preventable problem that affects health care costs, patient safety, and clinical quality. Inpatient falls occur within hospitals, cause harm, extend hospitalization, and require additional healthcare funding. Falls harm a patient’s physical health and cause emotional trauma, decrease patient satisfaction, and undermine confidence in the hospital care systems. Falls are therefore a significant concern in the nursing practice environment because nurses form the first component of prevention, monitoring, and intervention. This doctoral project aimed to re-educate and reinforce staff understanding of clinical guidelines to prevent inpatient falls through evidence-based interventions targeting environmental, behavioral, and organizational …
Enhancing Staff Education For Remote Blood Pressure Monitoring In Rural Clinics, Judi Brown Brown
Enhancing Staff Education For Remote Blood Pressure Monitoring In Rural Clinics, Judi Brown Brown
Walden Dissertations and Doctoral Studies
This is an educational intervention project targeted was developed to fill a knowledge gap in the treatment of hypertension in a rural primary care clinic. The project focused on enhancing staff education for Remote Blood Pressure Monitoring (RBPM) to enhance the desired patient outcomes regarding continuous monitoring and early interventional actions. The practice problem focuses on the lack of effective methods in managing hypertension that can facilitate the identification of hypertensive crisis and in rural areas. This project's primary research question is: "How can staff education on RBPM enhance knowledge and skills about hypertension management in rural clinics?" The project …
Assessing Type 2 Diabetes Mellitus, Christine A. Mccaulay
Assessing Type 2 Diabetes Mellitus, Christine A. Mccaulay
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice capstone project presents the development and evaluation of a clinical practice guideline (CPG) for the assessment and management of Type 2 Diabetes Mellitus in adults. The project addresses the ongoing challenge of diabetes-related complications and hospitalizations, highlighting the critical role of personalized patient education and the integration of smartphone technology for home monitoring. Central to this initiative was the question of whether an expert panel would endorse an evidence-based guideline for diabetes monitoring using innovative technology, as evaluated by the AGREE II tool. A robust review of the literature supported the guideline’s development, with high-quality …
Reducing Social Isolation In Elderly Hospice Patients Through Structured Social Interventions, Ashley Babayan
Reducing Social Isolation In Elderly Hospice Patients Through Structured Social Interventions, Ashley Babayan
Walden Dissertations and Doctoral Studies
This doctoral project was conducted as a quality improvement organizational change initiative aimed at reducing social isolation among elderly hospice patients through structured social interventions. Social isolation is a significant psychosocial concern in hospice populations and is associated with increased emotional distress, depression, and decreased quality of life. Despite hospice care’s holistic philosophy, structured and standardized social engagement interventions are inconsistently implemented across settings, creating a gap in practice. The practice-focused question guiding this project was: In elderly hospice patients experiencing social isolation, how do structured social interventions (regular visits, group activities, and emotional support systems), compared to standard hospice …
Evaluation Of Nurses' Leadership Self-Efficacy In Belize, Ruth Rosalee Reina Jones
Evaluation Of Nurses' Leadership Self-Efficacy In Belize, Ruth Rosalee Reina Jones
Walden Dissertations and Doctoral Studies
Nursing leadership in Belize is lacking but crucial to the well-being of patients, families, and the healthcare team. The purpose of this non-experimental, descriptive, comparative study was to a) determine the difference in leadership self-efficacy for current nurse leaders with three years or less of leadership experience compared to current nurse leaders with more than three years of leadership experience in Belize, and b) examine the differences in leadership self-efficacy between nurses in a leadership position and nurses not in a leadership position in Belize. The theories supporting the study were Burns’ transformational leadership theory and leadership self-efficacy, based on …
Anxiety, Cognitive Load, And Simulation Effectiveness In Pre-Licensure Bsn Students, Brittany Behrens
Anxiety, Cognitive Load, And Simulation Effectiveness In Pre-Licensure Bsn Students, Brittany Behrens
Walden Dissertations and Doctoral Studies
High-fidelity simulation experiences are an integral component of pre-licensure nursing curricula, providing students with realistic, controlled environments to develop clinical judgement skills. While these simulations enhance learning, they can increase anxiety and cognitive load, potentially impairing students’ ability to process information and derive meaningful outcomes. The purpose of this quantitative, correlational study was to examine the relationships among pre-simulation anxiety, cognitive load, and perceived simulation effectiveness in pre-licensure BSN students. Data were collected from 90 participants using the shortened Spielberger State-Trait Anxiety Inventory (STAI), the Cognitive Load Measurement–Naïve Rating Questionnaire, and the Simulation Effectiveness Tool–Modified (SET-M). Pearson correlation analyses indicated …
Improving Depression Screening For African American Adolescents Through Staff Education On The Phq-A, Yvonne Anutatu Nkeze
Improving Depression Screening For African American Adolescents Through Staff Education On The Phq-A, Yvonne Anutatu Nkeze
Walden Dissertations and Doctoral Studies
Improving Depression Screening for African American Adolescents Through Staff Education on the PHQ-A
Implementing Staff Education To Improve Depression Detection In Primary Care Using Patient Health Questionnaire (Phq-9), Ukamaka Okeke
Implementing Staff Education To Improve Depression Detection In Primary Care Using Patient Health Questionnaire (Phq-9), Ukamaka Okeke
Walden Dissertations and Doctoral Studies
This staff education project focuses on improving depression detection in a primary care settings using Patient Health Questionnaire (PHQ-9) screening tool. Depression is a leading cause of disability worldwide, requiring reliable and adaptable screening tools. The diagnosis of depression is one of the most common mental health disorders in primary care but is poorly identified and frequently missed. The lack of consistent screening for depression among patients often results in delayed identification of symptoms, which postpones early treatment, increasing the risk of complications associated with untreated depression. The practice site identified that depression screening was frequently missed during patient intake, …
Food Insecurity’S Influence On Obesity, Hypertension, And Diabetes In Rural Vermont And Adirondack New York, Lindsay Morse
Food Insecurity’S Influence On Obesity, Hypertension, And Diabetes In Rural Vermont And Adirondack New York, Lindsay Morse
Walden Dissertations and Doctoral Studies
Food insecurity (FI) is a persistent public health challenge in the United States and disproportionately affects rural communities. Guided by syndemic theory, this quantitative cross-sectional study examined associations between FI and chronic disease outcomes among rural residents of Vermont and the Adirondack region of New York. Social determinants of health screenings and electronic medical records from 35 rural primary care sites were analyzed. Secondary data from n = 72,505 adults were used to evaluate these relationships. Binary logistic regression models assessed obesity, hypertension (HTN), and diabetes (DM), and a multinomial logistic regression model evaluated the combined presence of obesity and …