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Walden Dissertations and Doctoral Studies

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Perceptions Of Instructional Accommodations Among Nursing Students With Information Processing Disorder, Imaobong Aliyu Apr 2026

Perceptions Of Instructional Accommodations Among Nursing Students With Information Processing Disorder, Imaobong Aliyu

Walden Dissertations and Doctoral Studies

Instructional accommodations in nursing education often emphasize testing adjustments, while classroom-based instructional support for students with information processing challenges remains underexamined. This descriptive qualitative study explored pre-licensure nursing students’ perceptions of instructional accommodations for students with information processing disorders in Southern California. Guided by humanistic learning theory, the study addressed the research question: What are the perceptions of instructional accommodations in the classroom setting among pre-licensure nursing students with information processing disorders? Seven pre-licensure nursing students participated in semistructured Zoom interviews. Data were analyzed using an inductive process consistent with Saldaña’s analytic approach. Analysis revealed one overarching theme- Instructional accommodations …


Optimizing The Charge Nurse Role To Improve Workflow And Communication In A Community Living Center, Ndidi Kalu Ibe Apr 2026

Optimizing The Charge Nurse Role To Improve Workflow And Communication In A Community Living Center, Ndidi Kalu Ibe

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project evaluated the impact of optimizing the charge nurse role on workflow efficiency and communication within a Community Living Center. Identified practice gaps included role ambiguity, inconsistent delegation, and communication breakdowns, which contributed to delays in care and decreased staff satisfaction. An evidence-based approach was used to standardize charge nurse responsibilities, strengthen leadership practices, and introduce structured communication processes. The project demonstrated that improving role clarity and leadership consistency supports more effective delegation, enhances team communication, and improves care coordination. Outcome included increased staff engagement, improved workflow efficiency, and enhanced patient safety. This initiative …


The Correlation Of Beer, Wine, And Liquor Excise Tax With Alcohol-Impaired Traffic-Related Deaths In All 50 U.S. States, Paul R. Amigh Ii Apr 2026

The Correlation Of Beer, Wine, And Liquor Excise Tax With Alcohol-Impaired Traffic-Related Deaths In All 50 U.S. States, Paul R. Amigh Ii

Walden Dissertations and Doctoral Studies

Alcohol-impaired driving remains a persistent public health and safety problem in the United States, resulting in thousands of preventable deaths each year and substantial societal costs. Policymakers frequently rely on alcohol excise taxes as a deterrence strategy; however, evidence regarding the effectiveness of taxation alone in reducing alcohol-impaired traffic fatalities remains mixed. The purpose of this quantitative, correlational study, grounded in economic deterrence theory, was to assess relationships between state-level beer, wine, and liquor excise tax rates and alcohol-impaired traffic fatality rates per 100,000 population in 2019. A cross-sectional design used secondary data from all 50 U.S. states and the …


Staff Education On Structured Phq-9 Administration To Enhance Depression Screening In Outpatient Mental Health Care, Zekarias F. Abessa Apr 2026

Staff Education On Structured Phq-9 Administration To Enhance Depression Screening In Outpatient Mental Health Care, Zekarias F. Abessa

Walden Dissertations and Doctoral Studies

In outpatient mental health settings, inconsistent use of the Patient Health Questionnaire-9 (PHQ-9) due to gaps in knowledge and lack of standardized training can lead to missed opportunities for early identification of depression and delayed treatment. Mental health nurses play a key role in screening and early intervention, underscoring the criticality of this role in practice. The Doctor of Nursing Practice (DNP) project explored whether a structured PHQ-9 staff education program could improve staff knowledge compared to baseline practice. The project involved using an intervention-based quality improvement design to enhance staff knowledge of administering and interpreting the PHQ-9 screening tool. …


Staff Education On The Implementation Of Walking Interventions, Cynthia Ononobi Apr 2026

Staff Education On The Implementation Of Walking Interventions, Cynthia Ononobi

Walden Dissertations and Doctoral Studies

The doctoral project was a staff education project aimed at improving the knowledge of psychiatric nurses on the use of structured walking interventions to manage depression. The practice problem was related to the lack of consistency in the application of walking as a treatment for depression. This gap was significant to address because psychiatric nurses are in the center of behavioral activation, and insufficient knowledge may deny patients the right to potentially valuable, affordable, and nonpharmacological treatment. The practice-based question was: Among psychiatric nursing staff does education on structured walking intervention, compared to standard care, improve staff knowledge and skills …


Telehealth Workflow Optimization, Taku Ajongakoh Stella Apr 2026

Telehealth Workflow Optimization, Taku Ajongakoh Stella

Walden Dissertations and Doctoral Studies

This evidence-based quality improvement (EBQI) project addresses the 36% telehealth no-show rate at an outpatient behavioral health clinic in Maryland. High attrition rates currently compromise continuity of care and result in a projected annual revenue loss of $124,000. The present project proposed a standardized workflow redesign in the current Integrated Care Approach (ICA) notes Electronic Health Record (EHR) system to address the manual outreach inconsistency. Significant interventions involved the activation of automated multimodal reminders at 72-hour, 24-hour, and 1-hour intervals, and the obligatory 24-hour technical pre-verification connection. Moreover, the project introduced a systematic 48-hour follow-up procedure of missed visits to …


Empowering Nurses To Save Lives: Suicide Prevention Education And Training For Outpatient Nurses In Prince George’S County, Maryland, Oludoyin O. Ajala Apr 2026

Empowering Nurses To Save Lives: Suicide Prevention Education And Training For Outpatient Nurses In Prince George’S County, Maryland, Oludoyin O. Ajala

Walden Dissertations and Doctoral Studies

Suicide remains a significant public health concern, with increasing prevalence across diverse populations. Outpatient nurses frequently encounter individuals at risk for suicide; however, many report limited confidence and inconsistent use of evidence-based assessment tools, contributing to missed opportunities for early intervention. The purpose of this Doctor of Nursing Practice staff education project was to implement a structured suicide prevention education program to improve nurses’ knowledge, confidence, and ability to identify and manage suicide risk. The practice-focused question examined whether implementing a structured suicide prevention education program for outpatient nurses would increase knowledge and confidence in identifying and intervening with patients …


The Association Between Racial Discrimination And Pregnancy-Related Hypertension Among Department Of Health And Human Services Regions Between 2016 And 2022, Emily Chew Apr 2026

The Association Between Racial Discrimination And Pregnancy-Related Hypertension Among Department Of Health And Human Services Regions Between 2016 And 2022, Emily Chew

Walden Dissertations and Doctoral Studies

This quantitative study examined the association between racial discrimination and pregnancy-related hypertension among women age 18–40 in the United States, and how this relationship is modified by age and the Department of Health and Human Services (HHS) regions (states). Guided by the social ecological model, this research measured whether race, place, and lived experiences of discrimination contributed to disparities in maternal health outcomes. The study utilized the Centers for Disease Control and Prevention’s Pregnancy Risk Assessment Monitoring System data set (2016–2022) which represented 81% of United States live births (n=249,970). The independent variable was self-reported racial discrimination during pregnancy, delivery, …


Executive Summary: Executive Leadership System Improvement Improving Depression Screening And Follow Up Processes, Rebecca Geneiveve Hidalgo Salomon Apr 2026

Executive Summary: Executive Leadership System Improvement Improving Depression Screening And Follow Up Processes, Rebecca Geneiveve Hidalgo Salomon

Walden Dissertations and Doctoral Studies

Depression remains a significant public health burden in the United States, contributing to disability, healthcare utilization, and economic cost. Internal 2024 audits at the project site identified variability in Patient Health Questionnaire 9 PHQ 9 screening and follow up processes, with 68% of screenings completed, 55% of follow ups timely, and disparities among patients with limited English proficiency. These findings indicate a systems level reliability and equity gap. This executive leadership system improvement project focused on developing a standardized, nurse led, electronic health record supported workflow to improve PHQ 9 completion and timely follow up. The practice focused question asked …


Prenatal Care Access And Pregnancy Outcomes Among Black Women Ages 15–44 In Cook County, Illinois, Deandrea Heggins Apr 2026

Prenatal Care Access And Pregnancy Outcomes Among Black Women Ages 15–44 In Cook County, Illinois, Deandrea Heggins

Walden Dissertations and Doctoral Studies

Maternal health disparities affecting Black women in the United States remain a persistent public health concern due to inequities in prenatal care access and adverse birth outcomes. Prior research has shown that socioeconomic conditions, insurance coverage, and systemic barriers influence prenatal care utilization and maternal outcomes; however, limited research has examined how Medicaid coverage, household income, preterm birth, and birth weight are collectively associated with prenatal care access among Black women in Cook County, Illinois. The purpose of this quantitative correlational study was to examine the relationships among these factors and access to prenatal care among Black women ages 15–44 …


Staff Education To Improve Knowledge Of Evidence-Based Engagement Strategies To Reduce No-Show Rates, Jerrica Luster Apr 2026

Staff Education To Improve Knowledge Of Evidence-Based Engagement Strategies To Reduce No-Show Rates, Jerrica Luster

Walden Dissertations and Doctoral Studies

High no-show rates in outpatient mental health settings remain a persistent barrier to effective care delivery, negatively affecting continuity of care, patient outcomes, and access to services. In the identified practice setting, inconsistent use of evidence-based engagement strategies beyond standard reminder practices contributed to missed appointments. The purpose of this Doctor of Nursing Practice project was to evaluate whether a structured staff education intervention on evidence-based engagement strategies would improve staff knowledge as a foundation for enhancing appointment adherence. A quantitative pre- and posttest design was used to evaluate knowledge change following the intervention. Participants included outpatient mental health clinic …


Nurse Education On Nonpharmacological Management Of Knee Osteoarthritis, Toyin Mary Ajayi Apr 2026

Nurse Education On Nonpharmacological Management Of Knee Osteoarthritis, Toyin Mary Ajayi

Walden Dissertations and Doctoral Studies

The Doctor of Nursing Practice (DNP) project aims to fill the gaps in the management of knee osteoarthritis (OA) in adults aged 40 to 75 years in a primary care practice. Knee OA is a common chronic disease that significantly impacts pain, mobility, and quality of life. Although there is empirical evidence that nonpharmacological interventions, including exercise, weight control, and self-management education, are effective, these methods are not consistently used in clinical practice, and pharmacologic treatment continues to be used. The project was designed to inform healthcare personnel about evidence-based nonpharmacological strategies to improve patient outcomes and reduce reliance on …


Staff Education On Early Sepsis Recognition For Medical-Surgical Nurses In The Acute Care Setting, Nadine Nzenga Udom Apr 2026

Staff Education On Early Sepsis Recognition For Medical-Surgical Nurses In The Acute Care Setting, Nadine Nzenga Udom

Walden Dissertations and Doctoral Studies

In this staff education project, I targeted early sepsis recognition and response among medical-surgical nurses. The practice gap at the site was nurses’ limited knowledge of sepsis indicators and screening tools, which contributed to delayed escalation of care. The practice-focused question guiding the project was “Does educating medical-surgical nurses on early sepsis recognition and response improve knowledge of early sepsis recognition and response?” I applied the analysis, design, development, implementation, and evaluation (ADDIE) and Johns Hopkins Evidence-Based Practice (JHEBP) models to design a structured sepsis education program for nursing staff. I searched for peer-reviewed literature via databases accessed through the …


Staff Education To Nurses To Increase Nursing Staff Knowledge On Qsofa, Pamela Robert Apr 2026

Staff Education To Nurses To Increase Nursing Staff Knowledge On Qsofa, Pamela Robert

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project evaluated the effectiveness of a structured staff education program aimed at improving nurses’ knowledge and confidence in early sepsis recognition and management using the quick Sequential Organ Failure Assessment (qSOFA) tool. Despite the availability of evidence-based screening methods, inconsistent application and limited nurse confidence were identified as key practice gaps. Guided by the Johns Hopkins Evidence-Based Practice model and the ADDIE instructional design framework, an educational intervention was developed and delivered to hospital-based nurses, focusing on qSOFA criteria, early identification of sepsis, and nurse-driven escalation pathways aligned with current clinical guidelines. A pre- …


Staff Education To Integrate Evidence-Based Practice Of Music Therapy As An Adjunct To Cognitive Behavioral Therapy For Anxiety And The Use Of Anxiety Screening Tool In An Outpatient Clinic, Virginia Bahena Apr 2026

Staff Education To Integrate Evidence-Based Practice Of Music Therapy As An Adjunct To Cognitive Behavioral Therapy For Anxiety And The Use Of Anxiety Screening Tool In An Outpatient Clinic, Virginia Bahena

Walden Dissertations and Doctoral Studies

Evidence-based practice (EBP) is essential for improving quality, safety, and outcomes in healthcare; however, gaps in staff knowledge and readiness continue to limit consistent implementation in outpatient settings. This Doctor of Nursing Practice project was a practice-focused quality improvement initiative designed to evaluate the impact of a targeted staff education intervention on EBP knowledge and readiness. The practice-focused question guiding the project was: Does a targeted staff education intervention improve knowledge and readiness to integrate brief music therapy as an adjunct to cognitive behavioral therapy (CBT) and appropriately utilize the Generalized Anxiety Disorder-7 (GAD-7) screening tool in an outpatient setting? …


Staff Education To Improve Knowledge On Discharge Planning And Transitions Of Care For Chronically Ill Patients, Cynthia Adebisi Kadiri Apr 2026

Staff Education To Improve Knowledge On Discharge Planning And Transitions Of Care For Chronically Ill Patients, Cynthia Adebisi Kadiri

Walden Dissertations and Doctoral Studies

Patients with chronic conditions have the tendency to return to the hospital. Staff education to address high-rate re-hospitalization among patients with chronic conditions is the focus of my Doctor of Nursing Practice project. This is a significant practice problem, since patient outcomes and increased healthcare costs is compromised. Regarding re-hospitalization prevention and ultimate aid in reducing readmissions among people with chronic conditions, the project was used to enhance the knowledge of the nursing staff and competence in transitions of care and discharge planning. The project included 10 nurses who are regularly involved in discharging patients in the medical outpatient clinic. …


Using Geospatial Environmental And Income Variables As Predictors Of Diabetes In Appalachia, John Kunicki Huth Apr 2026

Using Geospatial Environmental And Income Variables As Predictors Of Diabetes In Appalachia, John Kunicki Huth

Walden Dissertations and Doctoral Studies

Diabetes remains disproportionately prevalent in Appalachia, and macroenvironmental contributors remain poorly understood. Guided by spatial epidemiology, this quantitative, cross-sectional ecological study examined whether county-level environmental factors including distance to mine, distance to landfill, distance to water, mean annual precipitation, mean annual temperature, forest classification, distance to impervious surface, and median income were independently and collectively associated with diabetes cases per capita in West Virginia, used as a surrogate for Appalachia. Research questions addressed environmental predictors of diabetes cases per capita with and without controlling for median income. Publicly available county-level data from 53 West Virginia counties representing adults aged 20 …


Cervical Cancer Screening Among Women Across The United States, Srivathsan Vijaya Raghavan Apr 2026

Cervical Cancer Screening Among Women Across The United States, Srivathsan Vijaya Raghavan

Walden Dissertations and Doctoral Studies

While cervical cancer is not among the most frequently diagnosed cancers in the United States, it remains a significant concern due to its preventability through regular Pap smears and Human Papillomavirus (HPV) vaccination. However, incidence rates are rising as screening participation among U.S. women declines. This quantitative study (N = 15714) explored cervical cancer screening behaviors by analyzing levels of community involvement and social functioning, guided by the socioecological model (SEM). The dependent variable was cervical cancer screening, while the independent variables were community involvement and social functioning. The study controlled for health insurance status, age, race, ethnicity, employment, education, …


Enhancing Post‑Discharge Outcomes: A Quality Improvement Project To Reduce 30‑Day Readmission Rates For Patients With Schizoaffective Disorder, Samson Laryea Norteye Apr 2026

Enhancing Post‑Discharge Outcomes: A Quality Improvement Project To Reduce 30‑Day Readmission Rates For Patients With Schizoaffective Disorder, Samson Laryea Norteye

Walden Dissertations and Doctoral Studies

This DNP quality improvement project aimed to reduce 30-day readmission rates for patients with schizoaffective disorder (SAD) by enhancing discharge planning interventions. Using pre- and post-intervention methods, the project compared readmission rates before and after implementing interventions and gathered feedback from patients and staff to identify barriers and facilitators. The intervention bundle included patient education, participation in psychotherapy or support groups, medication reconciliation, and the use of long-acting injectables (LAIs) during hospitalization and prior to discharge. Evaluation of postintervention data revealed that none of the 10 patients in the intervention group were readmitted within 30 days, indicating a significant reduction …


An Educational Intervention To Increase Nurses’ Knowledge And Confidence Of Patient Mobility, Debbie Ann Pytak Apr 2026

An Educational Intervention To Increase Nurses’ Knowledge And Confidence Of Patient Mobility, Debbie Ann Pytak

Walden Dissertations and Doctoral Studies

Immobility is a significant concern given that nearly half of all hospitalized adults are immobile during their hospitalization, placing them at increased risk for adverse outcomes. As a result, it is critical for nurses to implement strategies that promote safe, structured patient mobility. Thus, the purpose of this Doctor of Nursing Practice (DNP) project was to determine if an educational intervention focused on patient mobility and standardized mobility tool utilization increased knowledge and confidence among nursing staff in an acute care setting. Ten participants volunteered to attend the educational intervention. The average age of the participants was 44.30 years (SD …


Dementia De-Escalation Staff Education Program, Gretchan Edwards Apr 2026

Dementia De-Escalation Staff Education Program, Gretchan Edwards

Walden Dissertations and Doctoral Studies

Behavioral and psychological symptoms of dementia (BPSD), including agitation and aggression, present significant challenges in acute care settings and contribute to increased staff injury risk and inconsistent patient care. The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate the impact of a structured dementia de-escalation education program on staff knowledge, confidence, and perceived ability to manage dementia-related behaviors. The guiding PICOT question asked: In acute care staff, how does participation in a structured de-escalation training program that incorporates environmental modifications and organizational support, compared with no formal de-escalation training, affect staff knowledge, confidence, and perceived impact …


Experiences Of Maternal Care In The Gypsy, Roma, And Traveller Population In The United Kingdom: A Cultural Care Model, Sarah Englebert Crowson Apr 2026

Experiences Of Maternal Care In The Gypsy, Roma, And Traveller Population In The United Kingdom: A Cultural Care Model, Sarah Englebert Crowson

Walden Dissertations and Doctoral Studies

Gypsy, Roma, and Traveller women (GRT) in the United Kingdom face persistent maternal health disparities and show poor engagement with healthcare services. Exclusion, discrimination, and a lack of cultural competence from healthcare professionals contribute to poor health outcomes including preterm births; and GRT women have more babies born with congenital anomalies than non-GRT women in the United Kingdom. The purpose of this focused ethnographic qualitative study was to explore how self-identified GRT women living in the United Kingdom experienced maternal care and how cultural identity and social structures influenced their interactions with healthcare providers based on Madeleine Leininger’s cultural care …


A Multilevel Analysis Of Prescriber-Reported Buprenorphine Induction Challenges In Fentanyl-Endemic Settings, Alyssa Vawn Long Apr 2026

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 Apr 2026

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 …


Staff Education To Improve Nursing Knowledge Of Catheter-Associated Urinary Tract Infection Prevention Practices, Maylin Fernandez Apr 2026

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 Apr 2026

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 Apr 2026

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 Apr 2026

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 …


Relationship Between Hepatitis B Virus Screening, Vaccination, And Spread In Sierra Leone, Muhammed Sarmodu Mansaray Apr 2026

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 …


The Association Between Advanced Technology Use And Quality Of Life Among Those With A Disability, Sarah Antus Apr 2026

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