Medicine and Health Sciences Commons^™

Impact Of Free Maternal And Child Health Services On Health Care Utilization In Jigawa State, Nigeria, Nura Ibrahim Kazaure

Walden Dissertations and Doctoral Studies

In spite of a decrease globally, the maternal mortality rate (MMR) in Nigeria and its

Jigawa State has remained persistently high. Few efforts to address the MMR in Nigeria have been undertaken. The purpose of this study was to investigate the impact of Jigawa State's Free Maternal and Child Health Program (JSFMCHP), education, employment, and parity of pregnant women on health care utilization (the outcome variable), as measured by antenatal care (ANC) visits. Anderson's behavioral model served as the study's theoretical framework. The sample size included 400 antenatal records of pregnant women who were randomly selected from the state's Health …

Parental Influence On Hiv Vertical Transmission In Kenya, Hussein Abdi Nunow

Walden Dissertations and Doctoral Studies

Mother-to-infant vertical transmission of HIV usually occurs during pregnancy, labor, delivery or breastfeeding. It is the third leading cause of transmission of HIV after sexual intercourse and blood transfusions. In 2008, 12 million women aged 15 years and above were anticipated to be living with HIV in countries within Sub-Saharan Africa. In this study, the association between parental HIV knowledge, attitudes and risk reduction practices, and HIV vertical transmission in Kenya were explored. The health belief model was used to help understand and interpret the findings. For this quantitative study, data were collected via surveys from 212 participants in 3 …

A Limited Rational Choice Theory In Local Public Health Decision Making, Lona Bryan

Walden Dissertations and Doctoral Studies

The threat and occurrence of terrorist attacks have increased in the United States since September 2011, heightening concerns for weaponized anthrax, other biological pathogens, and epidemics and pandemics. Early decisions and funding levels in local public health agencies can be the first line of defense or first point of failure; yet little is understood about how decisions are made when there are budget cuts before a biological event happens. Using Lindblom's conceptualization of limited rational choice theory, the purpose of this single case study was to understand how a local public health official made decisions after budget cuts in a …

Determinants Of Low Birth Weight In A Population-Based Sample Of Zimbabwe, Paul Nesara

Walden Dissertations and Doctoral Studies

Low birth weight (LBW) is a major public health concern globally. Despite its negative social and economic impact on the family and community at large, it has remained relatively unexplored at population level in Zimbabwe. The purpose of the study was to establish determinants of LBW using data from the 2015 Zimbabwe Demographic and Health Survey. The socioecological model was the conceptual framework for the study. A secondary analysis was conducted on 4,227 mother-infant dyads. Independent variables were duration of pregnancy, number of births within the past 5-year period, exposure to mass media, type of fuel used for cooking in …

Waterborne Disease Reduction Using Evidence-Based Microbiology Verification In Lower Nyakach, Kenya, Richard R. Blodgett

Walden Dissertations and Doctoral Studies

Waterborne diseases continue to plague the poorest people in low-income countries and are estimated to cause 4,600,000 acute incidents of diarrhea resulting in over 2,000 deaths daily. A major challenge is performing microbiology tests to monitor drinking water quality. Friends of the Old (FOTO) implemented a novel strategy using evidence-based microbiology to educate communities about the relationship between contaminated water and disease. Two commercially available tests for E.coli, adapted for fieldwork, provided easily interpreted results of contamination that correlate with WHO's disease risk categories. Simple and effective household water treatment options 'solar pasteurization and/or chlorination' were provided to all 14,400 …

Women's Perceptions Of Malaria In The Western Rural Areas Of Sierra Leone, Marcella Davies

Walden Dissertations and Doctoral Studies

Malaria is one of the leading causes of death for children and women in Sierra Leone. The purpose of this qualitative study was to explore and understand the lived experiences of women from the rural areas of Sierra Leone regarding malaria. A purposive sample of Krio women from the western rural area, aged 21-55 years, spoke English, and had taken care of someone with malaria described their perceptions and lived experiences with the disease in face-to-face interviews. The research questions were based on the health belief model and focused on knowledge, beliefs, and perceptions about malaria prevention and treatment. Interpretative …

Human Immunodeficiency Virus Disparity In Black Men Who Have Sex With Men, Valencia L. Beckley Hildreth

Walden Dissertations and Doctoral Studies

The HIV/AIDS epidemic continues to be a challenge in the men who have sex with men (MSM) population. Initiatives to decrease rates of new HIV infections have proven less than optimal. Despite evidence-based interventions to curtail the prevalence and incidence rates of HIV infection, Black MSM have been most impacted with increased HIV incidence. The purpose of this quantitative correlational study was to explore the relationship, if any, between age, online and physical venues attended by participants within the last thirty days, neighborhood's perceived social environment, and HIV incidence in the non-Hispanic Black MSM population in a metropolitan statistical area …

Illegal Drug Use, Suicidal Ideation, And Attempted Suicide Among New York Adolescents, Jacqueline Taylor

Walden Dissertations and Doctoral Studies

Suicide, ranked as one of the top five causes of death among adolescents, aged 15 to 19, claims numerous lives within the state of New York. Driven by the social cognitive theory, the objective of this quantitative cross-sectional study was to investigate the association among being offered, sold, or given illegal drugs, illegal drug use, being bullied, age, gender, ethnicity, suicidal ideation, and attempted suicide among adolescents in New York. The Centers for Disease Control 2015 Youth Risk Behavior Surveillance data for 89,068 New York adolescents, Grades 9-12, were utilized in this study. There was increased risk of suicide ideation …

Using Social Cognitive Theory To Predict Obesity Behaviors In Hispanic American Children, Augustina Anyikwa

Walden Dissertations and Doctoral Studies

Childhood obesity is a growing challenge in the U.S. Hispanic American population. There is a need for evidence-based approaches to combat this problem. Social Cognitive Theory (SCT) is one such approach. The purpose of this study was to examine the extent to which selected constructs of SCT (expectations, self-efficacy, self-efficacy in overcoming barriers and self-control) could predict five childhood obesity prevention behaviors, namely time spent on television watching, time spent on physical activities, water consumption, consumption of fruits and vegetables, and meal portion size among Hispanic American children. A quantitative cross-sectional research design was employed for this study. Data were …

Special Educators' Perceptions On Effective Preparation And Practice For Student Success, Anne Brackney Liese

Walden Dissertations and Doctoral Studies

Alternative school settings are success prospects for students at risk of school failure. However, research on the daily experiences of the special educators in alternate school settings tasked with educating the at-risk population, is limited. The purpose of this phenomenological study was (a) to recognize the perceptions of special educators concerning their preparation to advance the success of SEN students who are at risk of school failure; (b) to determine how to improve special educator preparation programs in alternative school settings. Deci and Ryan's self-determination theory, focused on student success provided the study's framework. Twelve semistructured interviews were conducted to …

Computational Model For Behavior Shaping As An Adaptive Health Intervention Strategy, Vincent Berardi, Ricardo Carretero-González, Neil E. Klepeis, Sahar Ghanipoor Machiani, Arash Jahangiri, John Bellettiere, Melbourne Hovell

Psychology Faculty Articles and Research

Adaptive behavioral interventions that automatically adjust in real-time to participants’ changing behavior, environmental contexts, and individual history are becoming more feasible as the use of real-time sensing technology expands. This development is expected to improve shortcomings associated with traditional behavioral interventions, such as the reliance on imprecise intervention procedures and limited/short-lived effects. JITAI adaptation strategies often lack a theoretical foundation. Increasing the theoretical fidelity of a trial has been shown to increase effectiveness. This research explores the use of shaping, a well-known process from behavioral theory for engendering or maintaining a target behavior, as a JITAI adaptation strategy. A computational …

Perceptions Of Stress: Employee Participation In A Yoga Class, Rosemarie Lee

Walden Dissertations and Doctoral Studies

Abstract

Employees experience workplace stress that can affect their health resulting in chronic diseases such as diabetes, stress, hypertension, and cardiovascular diseases. Stress also contributes to staff presentism, absenteeism, and high turnover rate. The employee wellness program (EWP) yoga class at a metropolitan teaching hospital has not been evaluated for its effectiveness in employee stress reduction and improvement in employee health. The practice focus question for this project explored employees' perception of the impact of a metropolitan teaching hospital's EWP yoga class on their stress reduction and health promotion activities. The theoretical framework for this project is Lazarus' transactional model …

Postpartum Hemorrhage Evidenced-Based Registered Nurse Staff Education Project, Jessica Powell

Walden Dissertations and Doctoral Studies

Despite medical technology and research advances postpartum hemorrhages (PPH) continue to be a leading cause of morbidity and mortality for pregnant women, even in developed countries. One possible explanation for PPHs continuing to be a leading cause of maternal death is inconsistent recognition and timely treatment of women experiencing a PPH. This doctor of nursing practice project attempts to improve labor and delivery nurse knowledge through an educational intervention which will contribute to rapid identification and treatment of PPH. Knowledge change was demonstrated though change in pretest and posttest scores. The educational information and process was guided by adult learning …

Implementing A Smoking Cessation Educational Module For Clinical Staff Members Who Care For Mentally Ill Outpatients, Anthonia Okeani

Walden Dissertations and Doctoral Studies

In the United States, cigarette smoking is the main contributor to preventable death in all populations; and, among the mentally ill, the prevalence of smoking is a clinical practice concern. Nearly half of all smokers also have a diagnosis of mental illness compared with 23% of the general population. In an effort to reduce the problem of tobacco use within mentally ill populations, this project sought to create an educational module on smoking cessation for staff in a mental health clinic. The theory of planned behavior was used to guide the project that focused on implementation of a behavior change …

Hand Expression With Lactation Support: Effect On Self-Efficacy And Breastfeeding Duration, Florence Omekara

Walden Dissertations and Doctoral Studies

Breastfeeding is the best infant feeding method, and breastmilk has many immunological and anti-inflammatory properties that protect babies against illnesses and diseases. It protects the health of the mother and saves society substantial economic costs, as demonstrated in many studies. Studies show that if 90% of U.S mothers breastfed for 6 months, up to $13 billion in healthcare costs could be saved. Despite the health and economic benefits of breastfeeding, most women stop breastfeeding before 6 months postpartum, which falls short of the recommendations of the World Health Organization, U.S. Surgeon General, and American Academy of Pediatrics. This study explored …

A Story To Tell Among Minority Alzheimer's Patient Caregivers: A Phenomenological Study, Albertina Lashonda Walker

Walden Dissertations and Doctoral Studies

The level of burden experienced by caregivers of patients diagnosed with Alzheimer's disease is high. Studies that examine this burden by taking into account cultural and spiritual differences are limited, particularly with regard to minority populations. The purpose of this study was to investigate the burden and challenges faced by minority caregivers providing in-home care to Alzheimer's patients. Guided by social support theory, a phenomenological study design was used with semi-structured interviews of 12 caregivers to examine their perspectives on the burden and challenges they face, including their lived experiences, cultural and spiritual values, and interaction with health professionals. Thematic …

Assessing Condom Use Among Navajo Men In The Southwest, Terra E. Yabeny

Walden Dissertations and Doctoral Studies

The Navajo tribe reports extraordinarily high number of cases of sexually transmitted diseases (STDs), such as gonorrhea, chlamydia, and human immunodeficiency virus (HIV) among men who have sex with men (MSM) and heterosexual populations. The purpose of this qualitative study was to explore the cultural value of adil' idli (self-respect) and how this cultural practice might influence health behaviors in sexual activity, condoms use, and acquiring of STDs among Navajo men. The Health Belief Model (HBM) was the theoretical foundation for providing a deeper understanding of the social, environmental, and cultural factors of condom use among Navajo men. Research questions …

Mindfulness Meditation: A Self-Awareness Approach To Weight Management, Michelle Brown

Walden Dissertations and Doctoral Studies

Obesity is a crucial health care issue that has a global effect on the health care industry. Not only does obesity decrease the patients' quality of life, it also places an astronomical burden on health care delivery systems. The purpose of this quality improvement project was to establish a weight management program derived from evidence-based research. The research question is can the utilization of mindfulness meditations and practices with traditional weight loss methodologies produce sustainable weight loss? Pender's health belief model was the conceptual framework utilized to guide and provides structure for this project. The health belief model has been …

Public Health Providers' Perceptions Of Electronic Health Records In A Disaster, Sherhonda Yvette Harper

Walden Dissertations and Doctoral Studies

The introduction of federal initiatives and incentives regarding health information technology fostered a movement towards the adoption of electronic health records (EHR). Implementation of EHRs sparked discussions among healthcare providers, patients, and others about the benefits or challenges of the move from the traditional paper method to the electronic version in healthcare settings. A knowledge gap in research involving the usefulness of EHRs and their impact to the delivery of care in other settings exists. The purpose of this qualitative study was to explore public health providers' perceptions of the meaningful use of EHRs in a disaster setting. Study participants …

Maternal Socioeconomic Status And Human Papilloma Virus Vaccine Uptake, Shawn Lockett

Walden Dissertations and Doctoral Studies

There are more than 79 million people in the U.S. currently infected with human papillomavirus (HPV), with an estimated 14 million new infections annually. There is a lack of knowledge about the maternal socioeconomic influences and uptake of the HPV vaccine series. Infection with HPV can cause cervical cancer in women, and there are over 11,000 cervical cancer diagnoses in the U.S. responsible for 4000 deaths annually. Vaccination coverage to prevent HPV infection does not meet the Healthy People 2020 goals of an 80% vaccination rate in the U.S. In this study, associations were tested between maternal SES variables and …

Diabetes Management Protocol In The Rehabilitation Setting, Hannah Mottel

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a growing healthcare problem in the United States. Diabetes affects 1.4 million Americans yearly, impacting the lives of individuals of all ages. One of the most challenging aspects about diabetes is that many individuals are not aware of the impact of the disease on multiple organs until the progression of the disease has reached latter stages. Prevention and early detection of diabetes is a key component of lifesaving interventions including proper nutrition counseling, exercise regimens, management, and patient compliance with a treatment plan. The purpose of this doctoral project was to create a standardized diabetes management protocol …

A Chronic Obstructive Pulmonary Disease Self-Management Packet To Reduce 30-Day Readmissions, Josette Askratni

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) signifies a significant public health challenge that is both avoidable and treatable. There was no standardized education offered to the COPD population at the practice location. The scope of the project encompassed standardizing education by developing a self-management packet for the COPD patients. The goal of this project was to examine how the development of a standardized COPD self-management packet enhances the quality of care and strategizes reducing 30-day readmissions compared to nonstandardized delivery of education. Orem's self-care theory and Bandura's self-efficacy concept were used to explain the principle of self-management, while Rosswurm and Larrabee's …

Factors Associated With Adherence To Diabetes Medication Among Individuals With Type 2 Diabetes In Cambridge, Ontario, Canada., Benedict Osamuimen Atekha

Walden Dissertations and Doctoral Studies

Although it is known that the prevalence of type 2 diabetes is on the rise in Canada, more information is needed on how well type 2 diabetes patients living in Cambridge, Ontario self-manage their diabetes and what factors influence their adherence to diabetes medication regimens. The objective of this cross-sectional study based on the theory of planned behavior was to determine if there are predictors of adherence to diabetes medications among patients living with type 2 diabetes in Cambridge. The World Health Organization STEPwise Approach to Surveillance was used to collect demographic data. Adherence and diabetes knowledge were assessed with …

Awareness And Attitudes Of Young Nigerian Immigrants In The United States To Sickle Cell Screening And Premarital Genetic Testing, Timothy Atolagbe

Walden Dissertations and Doctoral Studies

The carrier frequency for sickle cell anemia among Nigerians, who account for a high percentage of African immigrants in the United States, is high, according to the World Health Organization. Even though sickle cell disease contributes $2.4 billion annually to U.S. health care expenditures, ascertaining the number of affected individuals in the U.S. is difficult because sickle cell is not a reportable genetic disease. However, according to the Census Bureau, the number of African immigrants continues to grow at a steady pace among the foreign-born immigrant population in the U.S. There is a lack of research on the contribution of …

Exploring The Role Of Religious Leaders In Preventing Sickle Cell Disease In Nigeria, Grace Awe

Walden Dissertations and Doctoral Studies

Nigeria has high rates of sickle cell disease (SCD), which is attributed to the lack of awareness of the disease among the reproductive age in the country. The purpose of this cross-sectional study was to explore the role of religious leaders in contributing to awareness and prevention of SCD in Nigeria. Religious leaders' knowledge, attitude, and prevention and awareness practices of SCD, and how they translated to the prevention of SCD through improved counseling of premarital couples, were explored. A stratified random sampling was employed in selecting a sample of 150 religious leaders from different religious affiliations. Data were collected …

Head Start Parent Perspectives On Child Exposure To Secondhand Smoke At Home, Christiana Abani Bekie

Walden Dissertations and Doctoral Studies

Children exposed to secondhand smoke (SHS) are at risk of developing ear infections, asthma, wheezing, bronchitis, as well as retarded lung growth. Indoor smoking is the main source of children's exposure to SHS. Despite a downward trend in smoking, children from low income families, especially African American and Hispanic children, continue to be exposed to SHS at a higher rate than their wealthier counterparts. This multiple case study explored the perceptions of 15 parents of 3- to 5-year-old children currently enrolled in Head Start regarding children's exposure to SHS. This study relied on the social ecological model, the theory of …

A Nurse-Led Evidence-Based Quality Improvement Program On Childhood Obesity Prevention, Ana Flor Rasonabe Ciocson

Walden Dissertations and Doctoral Studies

The increased prevalence rate of childhood obesity in Saudi Arabia is a nationwide health issue. The doctoral project was instituted in the pediatric out-patient clinic (POPC) of a tertiary university hospital in Riyadh, Saudi Arabia. Child obesity clinic and clinical practice guideline (CPG) for primary prevention were not available in the pediatric outpatient clinic with a high incidence of newly diagnose obese children. The focus of this doctoral project was to improve the clinical nursing practice of POPC nurses through the adoption of CPG on primary prevention of childhood obesity. The knowledge translation into action framework provided a summary of …

Systematic Review Of Sedation Management In The Pediatric Critical Care Unit, Myrlene Madelon

Walden Dissertations and Doctoral Studies

Nurse-driven guidelines existed for the management of sedation in adult population; however, there is a lack of guidelines for the critically ill children. Nurses play significant roles in the management of sedation for mechanically ventilated patients in the Pediatric Intensive Care Unit (PICU), nonetheless, comprehensive guidelines for the management of sedation does not exist. The purpose of this systematic literature review was to evaluate and synthesize evidence-based research that can be used to adapt a pediatric clinical guideline for sedation management. The ACE star model and the evidence-based practice model were used as a framework to guide this review. The …

Rational Design Of Peptides Binding Towards Human Pd-L1 Using Knob-Socket Model, Xingchen Zha

University of the Pacific Theses and Dissertations

Programmed death-ligand 1 (PD-L1) is a type 1 transmembrane protein that has been reported to play a vital role in mediating suppressed immunity. The interaction between PD-L1 and PD-1 delivers a negative signal that reduces the proliferation of these T cells and induces apoptosis at the same time. Antibodies that can block the Programmed death-ligand 1 (PD-L1) on tumor cells have been shown to alleviate cancer-induced immunosuppression. While antibodies have a great potential in various therapeutic uses, many drawbacks such as the high cost of production, huge molecular size, and poor permeability impose restrictions on the extensive use of full-length …

Case Study On Inclusive Design And Operations At One Campus Recreation Center, Kelly Cartner

University of the Pacific Theses and Dissertations

The case study highlights the evaluation of one campus recreation center in terms of its inclusive design and operation on the basis of physical disability inclusion. Because of the plethora of barriers in campus recreation centers, those with physical disabilities are limited in their recreation choices and do not take part in recreation as their able-bodied counterparts. This study measures, observers, and evaluates one campus recreation center to determine its level of inclusiveness for those with physical disabilities. The AIMFREE survey was conducted along with observations and extensive interviews with staff that run the campus recreation center and those with …