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Walden Dissertations and Doctoral Studies

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The Effect Of Phytoestrogen Chemoprevention Of Prostate Cancer, Ruel Slyfield Michelin Jan 2011

The Effect Of Phytoestrogen Chemoprevention Of Prostate Cancer, Ruel Slyfield Michelin

Walden Dissertations and Doctoral Studies

Prostate cancer (CaP) remains the most commonly diagnosed cancer and second leading cause of cancer mortality among men in several ethnic groups in the United States. Lower CaP incidence among Asian men has been attributed to increased intake of soy derived phytoestrogens (SDPs); however, its association has not been extensively explored in U.S. men. The purpose of this study was to determine the effect size of serum prostate specific antigen (sPSA) and serum estradiol (sE2) following dietary SDP intervention. The study was based on an original conceptual model that aims to avert early prostate tissue damage through identification of critical …


Factors Affecting Cervical Cancer Screening Among African Women Living In The United States, Mosunmola Adeyemi Jan 2011

Factors Affecting Cervical Cancer Screening Among African Women Living In The United States, Mosunmola Adeyemi

Walden Dissertations and Doctoral Studies

More than half of the incidents and mortality rates from cervical cancer occur among minority groups, including immigrant women from continental Africa living in the United States. Although researchers have examined cervical cancer screening practices among minority populations, including Black women in Africa and in the United States, there are few studies on cervical cancer screening and associated risk factors, specifically among African women living in the United States. The purpose of this study was to investigate the association between selected factors and cervical cancer screening practices among African immigrant women living in the United States. Using the behavioral model …


Effect Of Education On Stigma Of Epilepsy In South Eastern Nigeria, Augustina Chinyelu Maduakor-Ugo Jan 2011

Effect Of Education On Stigma Of Epilepsy In South Eastern Nigeria, Augustina Chinyelu Maduakor-Ugo

Walden Dissertations and Doctoral Studies

There is a need for epilepsy-based health education programs to enlighten Nigerian communities and reduce the stigma associated with epilepsy. Epilepsy in Nigeria is viewed by some as a contagious and an infectious disease or a condition imposed from the gods, possessed by demons, as the work of witchcraft, or punishment from ancestral spirits, which are all related to a lack of knowledge about epilepsy leading to stigmatization of persons with epilepsy. Guided by the stigma theory, the purpose of this community-based, cross sectional study was to quantitatively examine the effect of an educational program on interpersonal, internalized, and institutional …


Perspectives Of Women In Nairobi Kenya Toward Malaria Control, Catherine Kisavi-Atatah Jan 2011

Perspectives Of Women In Nairobi Kenya Toward Malaria Control, Catherine Kisavi-Atatah

Walden Dissertations and Doctoral Studies

Malaria infection has been and continues to be a serious public health concern that has mystified many in the public health care industry. One area in Sub Saharan Africa that continues to feel the devastating effects of malaria is in Nairobi, Kenya. This qualitative research study explored the attitudes of women in Nairobi, Kenya and how they view intervention measures already introduced by public health care experts in fighting malaria. The phenomenological research approach used purposeful sampling to recruit 16 women from Nairobi, Kenya to participate in semi-structured, open-ended interviews. The ecological systems theory was used as a lens of …


A Case Study Of Primary Healthcare Services In Isu, Nigeria, Raymond Ogu. Chimezie Jan 2011

A Case Study Of Primary Healthcare Services In Isu, Nigeria, Raymond Ogu. Chimezie

Walden Dissertations and Doctoral Studies

Access to primary medical care and prevention services in Nigeria is limited, especially in rural areas, despite national and international efforts to improve health service delivery. Using a conceptual framework developed by Penchansky and Thomas, this case study explored the perceptions of community residents and healthcare providers regarding residents' access to primary healthcare services in the rural area of Isu. Using a community-based research approach, semistructured interviews and focus groups were conducted with 27 participants, including government healthcare administrators, nurses and midwives, traditional healers, and residents. Data were analyzed using Colaizzi's 7-step method for qualitative data analysis. Key findings included …


Emotional Support In Managing Cardiovascular Diseases Among Hispanic And Non- Hispanic Menopausal Women, Claudette Andrea Jan 2011

Emotional Support In Managing Cardiovascular Diseases Among Hispanic And Non- Hispanic Menopausal Women, Claudette Andrea

Walden Dissertations and Doctoral Studies

Effective recognition and proper treatment of cardiovascular diseases (CVDs) in Hispanic woman is a public health problem that needs further investigation. Guided by the stress and coping social support theory, the purpose of this cross-sectional survey study was to examine the relationship between attitudes, emotional support, and the perception of success in managing cardiovascular diseases (CVDs) in 335 Hispanic women living in Atlanta, Georgia. Correlations, independent-sample t tests, simple linear regression, and multiple linear regressions showed ethnicity as a moderating variable between the perception of success in handling CVD and emotional support, while emotional support was shown to be a …


Barriers To Healthcare Access For Members Of The Bronx Ghanaian Immigrant Muslim Community In New York City, Adam A. Musah Jan 2011

Barriers To Healthcare Access For Members Of The Bronx Ghanaian Immigrant Muslim Community In New York City, Adam A. Musah

Walden Dissertations and Doctoral Studies

Cultural beliefs on healthcare in the 21st century by the African immigrants in the United States have contributed to the severity of illnesses in their communities. The results of this research identified the healthcare barriers experienced by members of the Bronx Ghanaian Immigrant Muslim Community (BGIMC) in New York City. The purpose of this research was to investigate the influence of education, immigration status, health insurance status, and cultural beliefs on the BGIMC members' perceived access and willingness to use healthcare services for various ailments. A sample of 156 male and female members of the BGIMC completed the survey questionnaire. …


Responses Of Successful Latina Students To Academic Challenges Of Prerequisite Nursing Courses, Julie Wiggins Nadeau Jan 2011

Responses Of Successful Latina Students To Academic Challenges Of Prerequisite Nursing Courses, Julie Wiggins Nadeau

Walden Dissertations and Doctoral Studies

Nursing schools struggle to prepare enough nurses to meet the health care needs of a diverse and aging population in the United States. Many students do not complete their degrees, contributing to the problem. The purpose of this qualitative study was to explore and describe how successful Latina students experience and respond to the academic challenges of prerequisite nursing courses. The nursing shortage; healthcare needs of Hispanic patients; student outcomes; self-efficacy, achievement goal orientation, and academic help-seeking; and Hispanic cultural values framed the study. Using semistructured private interviews, the researcher explored the lived experiences of 6 successful Latina students when …


The Relationship Between Overweight And Obesity And Acculturation Of 12- To 19-Year-Old Mexican American Children, Elsa Ramirez-Brisson Jan 2011

The Relationship Between Overweight And Obesity And Acculturation Of 12- To 19-Year-Old Mexican American Children, Elsa Ramirez-Brisson

Walden Dissertations and Doctoral Studies

Mexican Americans, one of the fastest growing segments of the population, have been identified as having above-average rates of obesity. Yet, among this group, obesity rates seem to differ by immigrant status: recent immigrants, immigrants who have lived in the United States more than 15 years, and U.S.-born Mexican Americans. Guided by the acculturation phenomenon and the social ecological model, the current study assessed all 1,732 Mexican American children 12-19 years old who participated in the National Health and Nutrition Examination Survey between 2003 and 2008 to determine the association between body mass index (BMI) and language, years living in …


The Relationship Of Provider Cultural Competence And Utilization Of Prenatal Care In The Hmong Of Minnesota, Cynthia J. Larson Jan 2011

The Relationship Of Provider Cultural Competence And Utilization Of Prenatal Care In The Hmong Of Minnesota, Cynthia J. Larson

Walden Dissertations and Doctoral Studies

Experts suggest that the cultural competence of healthcare providers is a critical factor impacting healthcare services to the ethnically diverse patient populations in the U.S. and that it may play a role in improving outcomes and reducing health disparities; however, the association between cultural competence and health outcomes remains unclear. This study used a cross-sectional quantitative design grounded by cultural competency constructs and the ethnic origins theory to explore the relationships between provider cultural competence, adequacy of prenatal care, and neonatal health outcomes in Hmong women, a population whose cultural beliefs affect their use of early and adequate prenatal care. …


Evaluation Of Capacity For Best Practice Of Clinical Vaccine Research In Western Kenya, Sylvie Anne Kwedi Jan 2011

Evaluation Of Capacity For Best Practice Of Clinical Vaccine Research In Western Kenya, Sylvie Anne Kwedi

Walden Dissertations and Doctoral Studies

African institutions that perform health research need to continuously evaluate their practices in order to ensure compliance with international standards of good clinical practice (GCP). This mixed-methods study, undertaken at one clinical research site in Western Kenya, was an evaluation of GCP compliance at the site, research participants' satisfaction with research procedures, and research participants' comprehension of informed consent. The qualitative portion of the study involved audit of the site's compliance with GCP standards. The quantitative portion was an assessment of participant satisfaction and informed consent comprehension, undertaken through interviews with a sample of 297 participants. Thematic analysis of the …


Experiences And Perceptions Of Pregnant Unmarried Adolescent Girls In Nigeria, Priscilla N. Asonye Jan 2011

Experiences And Perceptions Of Pregnant Unmarried Adolescent Girls In Nigeria, Priscilla N. Asonye

Walden Dissertations and Doctoral Studies

Sexual activity among unmarried adolescents is a major public health problem in Nigeria, because unmarried pregnant girls are more likely to have multiple sex partners and are less likely to use contraceptives, putting them at greater risk for sexually transmitted diseases (STD), unplanned pregnancy, abortion, social isolation, and poverty. Teen pregnancy and STD rates are on the rise in Nigeria, yet few data exist on the experience of the adolescents themselves. This phenomenological study was designed to explore the in-depth experiences of 10 pregnant, unmarried adolescent girls aged 16-19, including the factors contributing to their sexual activity. An ecological model …


The Relationship Of Self-Care To Burnout Among Social Workers In Health Care Settings, Jennifer D. Weekes Jan 2011

The Relationship Of Self-Care To Burnout Among Social Workers In Health Care Settings, Jennifer D. Weekes

Walden Dissertations and Doctoral Studies

Self-care is critical in minimizing the symptoms of burnout among human services professionals, but specific information on the role of self-care among social workers in healthcare settings is limited. This correlational study was designed provide a fuller understanding of this relationship. Orem's theory of self-care and the theory of reasoned action and planned behavior served as the theoretical foundations of this study. The sample included 185 members of the National Association of Social Workers, who volunteered to participate in this study. Participants completed online versions of the Maslach Burnout Inventory and Self-Care Assessment Work Sheet. Correlation and analysis of variance …


A Correlational Study Of Telework Frequency, Information Communication Technology, And Job Satisfaction Of Home-Based Teleworkers, Shana P. Webster-Trotman Jan 2010

A Correlational Study Of Telework Frequency, Information Communication Technology, And Job Satisfaction Of Home-Based Teleworkers, Shana P. Webster-Trotman

Walden Dissertations and Doctoral Studies

In 2008, 33.7 million Americans teleworked from home. The Telework Enhancement Act (S. 707) and the Telework Improvements Act (H.R. 1722) of 2009 were designed to increase the number of teleworkers. The research problem addressed was the lack of understanding of factors that influence home-based teleworkers' job satisfaction. Job dissatisfaction has been found to have a significant impact on voluntary turnover. The purpose of the study was to assess the relationship among telework frequency, information communication technology (ICT), and job satisfaction. The research questions were designed to answer whether correlational relationships exist among telework frequency, ICT, and job satisfaction and …


Job Satisfaction, Job Involvement, And Perceived Organizational Support As Predictors Of Organizational Commitment, Jennifer Parker Ayers Jan 2010

Job Satisfaction, Job Involvement, And Perceived Organizational Support As Predictors Of Organizational Commitment, Jennifer Parker Ayers

Walden Dissertations and Doctoral Studies

The purpose of this study was to determine whether or not there is a significant relationship between job satisfaction, job involvement, perceived organizational support, and organizational commitment among educators. A review of the literature revealed there is limited research that examined organizational behaviors among educators. Organizational commitment has been identified as a leading factor impacting an employee's level of success in various organizations. There remains a gap in the current literature regarding specific attitudinal behaviors influencing organizational commitment across various levels of education. Organizational commitment among educators employed at the primary, secondary, and postsecondary levels was examined. The sample for …


Who Shares? Managerial Knowledge Transfer Practices In British Columbia's Ministry Of Health Services, Gwendolyn Elizabeth Lock Jan 2010

Who Shares? Managerial Knowledge Transfer Practices In British Columbia's Ministry Of Health Services, Gwendolyn Elizabeth Lock

Walden Dissertations and Doctoral Studies

The British Columbia government's Ministry of Health Services will experience significant loss of operational knowledge from an aging managerial workforce, increased staff turnover, and difficulties in recruitment. The purpose of this study is to provide the ministry's Strategic Human Resources Planning branch staff with a map and description of knowledge transfer practices used by approximately 40 managers within the ministry's Health Sector Information Management/Information Technology division and its Vital Statistics Agency. The study is a mixed-methods case study of knowledge retention and transfer practices founded on a knowledge management and social network theoretical foundation. To understand the ministry's complex nature …


Risk Factors For Development Of High Blood Pressure And Obesity Among African American Adolescents, Monique Shanta White Jan 2010

Risk Factors For Development Of High Blood Pressure And Obesity Among African American Adolescents, Monique Shanta White

Walden Dissertations and Doctoral Studies

Childhood obesity has reached epidemic proportions in the United States and has been linked to hypertension, especially among African American youth. Optimistic bias leads youth to underestimate their susceptibility to negative health outcomes. Public health officials want to reduce risk factors to result in significant long term reduction in cardiovascular disease. The purpose of this study was to explore adolescent behavior practices in a school district and prevalence of high blood pressure and obesity in that population. The health belief model guided the framework for this study. Research questions examined relationship between individual health risk practices and optimistic bias on …


The Relationship Between Leadership Styles And Performance Success In Hospitals, Beverly J. D. Hernandez Jan 2010

The Relationship Between Leadership Styles And Performance Success In Hospitals, Beverly J. D. Hernandez

Walden Dissertations and Doctoral Studies

Upheavals in the health care landscape threaten the sustainability of contemporary hospital organizations. Yet there is limited research regarding the characteristics of leaders within successful hospitals. The problem is the leadership styles needed to effectively run hospital organizations have not been identified and/or established. The purpose of this study was to develop a model of congruent leadership styles linked to the success of hospitals in one metropolitan city. The research questions sought to uncover (a) consistent leadership styles within successful hospitals, and (b) what, if any, relationship exists between leadership styles and measures of success. Examination of the literature uncovered …


National Survey On Equine Assisted Therapy: An Exploratory Study Of Current Practitioners And Programs, Patricia J. Mcconnell Jan 2010

National Survey On Equine Assisted Therapy: An Exploratory Study Of Current Practitioners And Programs, Patricia J. Mcconnell

Walden Dissertations and Doctoral Studies

Equine facilitated psychotherapy (EFP), a new field in psychology, is an alternative method of therapy that uses horses to facilitate therapeutic outcomes. There is minimal peer reviewed literature and few published studies examining efficacy. The conceptual lens of this study was grounded theory, as there is insufficient evidence of theoretical frame-works guiding equine assisted therapy. The purpose of this exploratory concurrent mixed methods study was to examine the theoretical foundation of practitioners; program make up; client populations; efficacy of program; and why the horse serves as the therapeutic catalyst of this model. A 43-item survey was sent to 800 programs, …


Immigration And Obesity In African American Adults Residing In The United States, Julius N. Ade Jan 2010

Immigration And Obesity In African American Adults Residing In The United States, Julius N. Ade

Walden Dissertations and Doctoral Studies

Obesity increases risk for heart disease, hypertension and other chronic diseases, and it affects minority ethnic groups disproportionately. However, it is unknown if African American immigrant adults, an increasing segment of the population, are at higher risk for obesity than African American non-immigrant adults residing in the United States. This study examined the association of obesity and immigrant status by comparing African American immigrant adults now residing in the United States to the general population of African American adults. The socio-ecological model provided the conceptual framework for this study. This study used a cross-sectional quantitative self-administered web-based survey to collect …


Knowledge, Attitudes, And Behaviors Of African American Women Regarding Breast Cancer Screening, Lilian Uwuseba Jan 2010

Knowledge, Attitudes, And Behaviors Of African American Women Regarding Breast Cancer Screening, Lilian Uwuseba

Walden Dissertations and Doctoral Studies

Breast cancer is one of the most widespread chronic diseases and a major cause of death among women in the United States. African American women have a higher incidence of breast cancer than their counterparts from other ethnic/racial groups. The purpose of this cross-sectional survey of 126 African American females from the western US metropolitan area was to assess knowledge, attitudes, and behavior with respect to breast cancer manifestation, detection services, and the role of mammography in breast cancer prevention and control. The health belief model guided this study. A 41-item, ethnically sensitive, self-administered, and gender-specific instrument, the Champion Revised …


Racial /Ethnic Differences In Susceptibility And Intention To Smoke On Smoking Behavior Among Adolescents, Kafilat Tolani Jimba Jan 2010

Racial /Ethnic Differences In Susceptibility And Intention To Smoke On Smoking Behavior Among Adolescents, Kafilat Tolani Jimba

Walden Dissertations and Doctoral Studies

Every year, more than 400,000 Americans die prematurely because of tobacco use, and most users began smoking during their teen years. Adolescent tobacco use remains the nation's most preventable threat to life and health. A better understanding of the relationships between susceptibility to smoking and intention to smoke on smoking behavior by ethnicity, age, and gender is useful for program planners and health educators in designing ethnic, age, and gender specific strategies for tobacco control and prevention initiatives. The purpose of this study was to test the relationships between susceptibility to smoking and intention to smoke on smoking behavior among …


The Effect Of Direct Contact On Public Attitudes Towards People Living With Human Immunodeficiency Virus (Hiv) And Acquired Immune Deficiency Syndrome (Aids) In Zimbabweans, Mavis Mashingaidze Jan 2010

The Effect Of Direct Contact On Public Attitudes Towards People Living With Human Immunodeficiency Virus (Hiv) And Acquired Immune Deficiency Syndrome (Aids) In Zimbabweans, Mavis Mashingaidze

Walden Dissertations and Doctoral Studies

Stigma surrounding HIV and AIDS poses a significant threat to the curtailing of the epidemic by acting as a barrier to HIV testing and disclosure of serostatus. Previous research in the United States found personal knowledge of someone with HIV/AIDS to be a predictor of lower levels of HIV/AIDS-related stigma. However, no study to date has examined this relationship in Zimbabweans. Allport's contact hypothesis was hypothesis was the theoretical frame used to assess the effect of direct contact on public attitudes towards people living with the human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in Zimbabweans with the …


The Mediating Role Of Psychological Distress In The Relationship Between Adverse Childhood Experiences And Adult Smoking, Tara Wynn Strine Jan 2010

The Mediating Role Of Psychological Distress In The Relationship Between Adverse Childhood Experiences And Adult Smoking, Tara Wynn Strine

Walden Dissertations and Doctoral Studies

While research has indicated that impaired mental health partially mediates the relationship between adverse childhood experiences (ACEs) and alcohol and illicit drug use, little research has examined potential mediators in the relationship between ACEs and smoking, the number one cause of preventable mortality in the United States. Accordingly, this study examined the potential mediating effect of psychological distress on the relationship between ACES and smoking using data from Wave II of the ACE Study, a cross-sectional study completed between June and October of 1997 on a sample of adult health maintenance organization members (N = 7,211). The theoretical underpinnings for …


The Use Of Human Patient Simulators To Enhance The Clinical Decision Making Of Nursing Students, Sharon Kay Powell-Laney Jan 2010

The Use Of Human Patient Simulators To Enhance The Clinical Decision Making Of Nursing Students, Sharon Kay Powell-Laney

Walden Dissertations and Doctoral Studies

One of the newest teaching modalities in nursing education is the use of human patient simulators (HPS). An HPS simulation scenario creates a software program vignette in which students interact with a manikin to practice caring for critical patients in a risk-free environment. Although used extensively in schools of nursing, there is little research that examines if these expensive simulators improve the clinical decision-making ability of nursing students. The purpose of this experimental differentiated treatment study was to assess if HPS technology leads to increased clinical decision-making ability and clinical performance more than the teaching modality of a paper and …


Using A Structured Decision Making Protocol To Stratify Caseloads In The Child Support Program, Steven J. Golightly Jan 2010

Using A Structured Decision Making Protocol To Stratify Caseloads In The Child Support Program, Steven J. Golightly

Walden Dissertations and Doctoral Studies

Although structured decision making and risk assessment protocols have successfully been used in human service programs, little research has been done on their applicability in the child support program. In this study, problems identified with child support case management were examined, along with positive and negative attributes of various risk assessment tools utilized in other arenas. The overall research problem asserted that there are no structured decision making protocols in the child support program to support case assignment by enforcement difficulty. The primary research question asked whether or not a process stratified by risk and level of enforcement difficulty could …


Manual Handling Workload And Musculoskeletal Discomfort Among Warehouse Personnel, Terrance N. Knox Jan 2010

Manual Handling Workload And Musculoskeletal Discomfort Among Warehouse Personnel, Terrance N. Knox

Walden Dissertations and Doctoral Studies

Work-related musculoskeletal disorders (WRMSD), specifically physical and muscular discomfort in the upper arm, lower arm, thigh, lower leg, wrist, shoulders, back, or neck, are among the most frequently reported workplace injuries in the United States. The dearth of knowledge about the types of workloads that may contribute to the development of WRMSD was the impetus of this research. The study aimed to identify antecedents of WRMSD among warehouse workers in order to reduce WRMSDs and increase productivity as expressed in a systems perspective on industrial health. The research questions examined the prevalence of specific WRMSDs, the relationship of high-risk tasks …


Clinical Recognition Of Obstructive Sleep Apnea In A Population-Based Sample, Mark R. Zellmer Jan 2010

Clinical Recognition Of Obstructive Sleep Apnea In A Population-Based Sample, Mark R. Zellmer

Walden Dissertations and Doctoral Studies

Obstructive sleep apnea (OSA), a disorder in which the airway intermittently collapses and obstructs during sleep, is associated with increased cardiovascular and cerebrovascular morbidity and mortality, increased risk of motor vehicle accidents, metabolic syndrome, hypertension, and depression. Treatment of OSA attenuates or reverses many of these associated risks. However, most cases of OSA are unrecognized and untreated. The two most recent studies using 1990s data found that only 6.5 - 15.4% of OSA cases, depending on severity, are clinically recognized in mixed gender populations. Based on a conceptual framework of improved physician awareness of OSA, and reduced diagnostic access bias …


Perspectives Of Executive Women: Life Choices And Balancing Career With Marriage And Children, Wendy James Jan 2010

Perspectives Of Executive Women: Life Choices And Balancing Career With Marriage And Children, Wendy James

Walden Dissertations and Doctoral Studies

This qualitative study investigated the experiences of executive women and their choices in balancing work with marriage and children. Research on women in the workplace tends to conflate categories of hourly workers, part-time employees, and middle- and upper-management careers. Yet, the literature on balancing career and family life does not adequately portray the experiences of executive women. The purpose of the study was to discover executive women's perceptions about their career, how they chose their path, and how their career choices affected their decisions about marriage and children. The research questions for this study examined: (a) The effect of executive …


A Phenomenological Inquiry Of Chronic Homeless Individuals' Challenges To Independence, Dewana Hall Jan 2010

A Phenomenological Inquiry Of Chronic Homeless Individuals' Challenges To Independence, Dewana Hall

Walden Dissertations and Doctoral Studies

Homelessness is a comprehensive social problem affecting approximately 744,000 people in the U.S. Despite consistent efforts from politicians, state and local leaders, and service providers, the number of homeless people continues to rise. Although there are some explanations in the literature to account for the increase of homelessness, the literature tends to not include the voices of the homeless themselves. The purpose of this phenomenological study, which used Maslow's hierarchy of needs as its conceptual framework, was to understand the life experiences of members of the homeless population, as perceived by four male residents of a mission in an eastern …