Medicine and Health Sciences Commons^™

Mental Health Outpatient Services And Hospital Readmissions Among Adolescent Patients In Louisiana, Whitney Walker

Walden Dissertations and Doctoral Studies

Hospital admissions and readmissions among Medicaid patients significantly impact increased healthcare costs for the state of Louisiana and are associated with poor quality of care. The specific research problem under study was the relationships, if any, between mental health outpatient services in Louisiana, either individual therapy or home and community-based services post-hospital discharge, gender of the patient, and age of the adolescent patient with the number of hospital readmissions over 1 year. Secondary quantitative data analysis was performed using the Island Peer Review Organization Annual External Quality Review Technical Report and data from the managed care organization in Louisiana. No …

Relationship Between Screentime And Depressive Symptoms And Associated Mediators For African American Adolescents In The United States, Brittney Jones

Walden Dissertations and Doctoral Studies

The prevalence of adolescent depression in the United States is increasing as adolescents’ use of electronic screen devices increases. Some studies have found associations between screentime and adolescent depression, and other researchers have posited that screentime is not intrinsically harmful. High screentime in African American adolescents may place them at risk for worse depressive symptom outcomes, but the relationship between screentime and depressive symptoms for this population is unknown. The three research questions of this study addressed whether there is a relationship between screentime and depressive symptoms in African American adolescents, and whether sleep duration and the frequency of physical …

Associations Between Substance Use And Obesity Among Native American Adolescents, Joseph Jude Janosky

Walden Dissertations and Doctoral Studies

Obesity and substance use are two significant public health issues among Native American adolescents. Despite much evidence linking obesity and substance use during adolescence to several long-term health conditions and increased morbidity and mortality, evidence describing the relationship between current substance use and obesity among Native American adolescents is lacking. The purpose of this quantitative study was to investigate associations between current substance use – specifically alcohol, marijuana, and tobacco products – and obesity among Native American high school students, when adjusted for sex, soda consumption, and physical activity. Rosenstock’s health belief model served as the theoretical foundation for this …

Associations Between Substance Use And Obesity Among Native American Adolescents, Joseph Jude Janosky

Walden Dissertations and Doctoral Studies

Obesity and substance use are two significant public health issues among Native American adolescents. Despite much evidence linking obesity and substance use during adolescence to several long-term health conditions and increased morbidity and mortality, evidence describing the relationship between current substance use and obesity among Native American adolescents is lacking. The purpose of this quantitative study was to investigate associations between current substance use – specifically alcohol, marijuana, and tobacco products – and obesity among Native American high school students, when adjusted for sex, soda consumption, and physical activity. Rosenstock’s health belief model served as the theoretical foundation for this …

Relationship Between Screentime And Depressive Symptoms And Associated Mediators For African American Adolescents In The United States, Brittney Jones

Walden Dissertations and Doctoral Studies

The prevalence of adolescent depression in the United States is increasing as adolescents’ use of electronic screen devices increases. Some studies have found associations between screentime and adolescent depression, and other researchers have posited that screentime is not intrinsically harmful. High screentime in African American adolescents may place them at risk for worse depressive symptom outcomes, but the relationship between screentime and depressive symptoms for this population is unknown. The three research questions of this study addressed whether there is a relationship between screentime and depressive symptoms in African American adolescents, and whether sleep duration and the frequency of physical …

Providers’ Perspectives On Barriers Associated With Repeat Teen Pregnancies In Rural Southeastern United States, Vanessa Iheoma Iheanachor

Walden Dissertations and Doctoral Studies

Teen (or adolescent) pregnancy remains a significant public health problem in the United States. Rapid repeat pregnancy, defined as any pregnancy that occurs within 24 months of a previous birth, has been linked to adverse maternal and neonatal outcomes. The purpose of this quantitative, cross-sectional study was to understand the perceptions of health care providers (HCPs) regarding barriers that influence repeat pregnancies among adolescents in rural southeastern United States. The theoretical framework that guided this study was Urie Bronfenbrenner’s social ecological model. A survey instrument was developed and disseminated to HCPs using Qualtrics, an online survey platform. Data (n=32) were …

The Experience And Perception Of Contraceptive Use Among Teenage Girls Living In Lagos, Nigeria, Kikelomo Omotoso

Walden Dissertations and Doctoral Studies

AbstractThere is a low level of contraceptive use among Nigerian teenagers, leading to unwanted pregnancies and subsequently unsafe abortions. Sexual activities among teenagers in Lagos, Nigeria, are a major public health problem. The principal factors leading to this health problem are poverty, peer pressure among university students leading to involvement in the sex trade, and early marriage in some cultures. There are myths and perceptions about the use of contraception in society, especially concerning the use of condoms, which Nigerian teenagers believe do not make intercourse interesting or satisfying; these ideas can lead to unwanted pregnancies, sexually transmitted infections (STIs), …

Predictors Of Health Literacy Scores In The Adolescent Oncologic Population, Amber N. Jenkins

Walden Dissertations and Doctoral Studies

Recent research showed a relationship between low health literacy in adult oncology patients, poor communication with providers, misconceptions about disease and treatment options, and the inability to adhere to treatment plans. Comparative literature addressing adolescent health literacy contained insufficient evidence of these relationships. The purpose of this exploratory cross-sectional quantitative study, based on the health literacy skills framework, was to assess the health literacy of adolescents treated in the oncology department at an academic children’s hospital in Missouri to determine whether there was a significant relationship between individual health literacy scores of this population based on age, sex, number of …

Parental Education As A Potential Predictor Of Adolescent Substance Use Status, Haruna Bida Aliyu

Walden Dissertations and Doctoral Studies

AbstractAdolescents in the United States commence substance use as early as 12 to 14 years old and as late as 15 to 17 years old. Several factors influence adolescent substance use/abuse status, including environment, boredom, friends, teachers, and parental influence. The influence of parental communication with adolescents about the danger of substance use/abuse (SUA) required further study. The purpose of this quantitative cross-sectional study was to understand the influence of parental knowledge and communication with adolescents as potential predictors of substance use/abuse status. The social cognitive theory and social determinants of adolescent risky behavior provided the theoretical framework of this …

Cell Phone Use And Adolescent Weight Problems, Florence Kenkor Njang

Walden Dissertations and Doctoral Studies

AbstractOverweightinadolescenceincreasestheriskofobesityandmanyadversehealthoutcomeslaterinlife.The purpose of this quantitative cross-sectionalstudy was to investigatetheassociationbetweencell phoneuseandweightstatusinadolescents,ages14 17yearsold,livingintheUnitedStates.Thesocio-ecologicalmodel(SEM)wasusedtoexplainthelinkbetweencellphoneuseandoverweightamongadolescents.Threeresearchquestionswere used to explore(a)therelationshipbetweencellphoneuseandadolescentweightstatusaftercontrollingforage,gender,andrace;(b)the effectofcellphoneuseonoverweightandnormalweightstatusesamongadolescentsaged 14 17yearsaftercontrollingforage,gender,andphysicalactivity;and(c)themodifyingeffectofraceontherelationshipbetweencellphoneuseandadolescentoverweightaftercontrollingforageandgender.Secondary data from the2017YouthRiskBehavioralSurveillanceSystemwere analyzed usingbinarylogisticregressiontoanswer theresearchquestions.Highcellphoneusesignificantlyandpositivelypredictedoverweightinadolescentsaftercontrollingforage,gender,andrace(p<0.001).Afteraccountingforage,gender,andphysicalactivity,highcellphoneusewasasignificantpredictorofoverweight(p<0.001).Similarly,racehadasignificantmodifyingeffectonthepositiveassociationbetweenhighcelluseandoverweightamongadolescents(p<0.001).Thekeypositivesocialchange implication of this studyis the potentialtointegratehealthycellphoneusewithexistingobesitypublichealthinterventionsthatcanreduceoverweightandpositivelyimpactindividuals,families,andcommunities.

Moderate-Intensity Risk Reduction Counseling And Acquisition Of Sexually Transmitted Infection, Cindy M. Farina

Walden Dissertations and Doctoral Studies

Sexually transmitted infections (STIs) are a public health problem in the United States, with adolescents and young adults to age 25 bearing a disproportionate burden of infection. Risk reduction counseling (RRC) as a strategy to decrease STI incidence has been a focus of scholars. Research examining RRC efficacy has suggested that RRC is effective for 6 to 12 months after treatment. However, study samples have varied by age, ethnicity, race, gender, and geographic location. Whether RRC is effective for more than 1 year is unknown. The purpose of this post hoc chi-square study was to examine the efficacy of moderate-intensity …

Clinical Practice Guideline Development To Diagnose And Treat Adolescents With Obesity, Barbara Hunter Hudgens

Walden Dissertations and Doctoral Studies

Adolescent obesity is a worldwide multifaceted epidemic. This disease affects the medical, physical, psychosocial, and family aspects of adolescent life. Identification, diagnosis, and referrals to providers that can initiate early interventions that improve weight status have been recommended as critical steps in curtailing childhood obesity. This evidence-based clinical practice guideline (CPG) was developed for the healthcare providers at a rural clinic in Southwest Arkansas to provide consistency in the identification, diagnosis, and referral of adolescents. The health belief model (HBM) and the trans-theoretical model (TTM) were used to consider adolescents’ individual characteristics and beliefs as well as their readiness to …

Predictors Of Larc Use In High School Adolescent Females In The Unitedstates, Gloria J. Mabry

Walden Dissertations and Doctoral Studies

Teen pregnancy is a major public health problem in the United States of America. Among many contraceptive methods, long acting reversible contraception (LARC) is popular and effective. However, there was no adequate research study performed to show if minority teenagers are less likely to use LARC. The purpose of this study was to explore the relationship between adolescent sexual behavior and activity and the use of LARC in females, ages 14 to 19, in high schools across the United States. The theoretical framework used for this study was the health belief model. The study population was 1,496 White, Black/African American, …

Acknowledging And Addressing Adolescent Depression, Johnsie Burke Hughes

Walden Dissertations and Doctoral Studies

A family practice was found to inconsistently screen adolescents for depression even with the necessary Patient Health Questionnaire (PHQ) screening tools being readily available in their electronic medical record. The development of a practice guideline that offers a systematic approach to screening using the PHQ2 and the PHQ9 will potentially result in an increased guidance and provider willingness to screen for adolescent depression in the family practice setting. The purpose of this DNP project was to determine if an algorithmic practice guideline would increase provider willingness to assess for adolescent depression and identify any barriers to the use of the …

Provider Perspectives Of Equine Assisted Psychotherapy For Social Skills, Rachel Young

Walden Dissertations and Doctoral Studies

Animal assisted therapy has been used for years and has been researched primarily for autism but researchers have not focused specifically on the experiences of children with Attention Deficit Hyperactivity Disorder (ADHD) and their social skills after involvement in animal assisted therapy. Children with ADHD frequently struggle expressing their emotions and communicating effectively, primarily in social settings, which can have an extensive impact on their functioning that can extend into adulthood. The theoretical attachment framework from Ainsworth and Bowlby, when applied through the retrospective multiple case study model allowed for a greater understanding of the experiences of children involved in …

Association Between Mentoring Interventions And Drug Abuse Among African Americans Aged 10-24 Years, Anthonia Ifeyinwa Dunkwu

Walden Dissertations and Doctoral Studies

Drug abuse represents a significant public health problem worldwide, with socioeconomic consequences shaped by a cluster of behavioral, cognitive, and physiological phenomena and serious social, physical, emotional problems. The purpose of this study was to assess the association between mentoring interventions and drug abuse among African American young people. The health belief model was the theoretical framework. The secondary data analysis was done using the data set from the 2014 National Survey on Drug Use and Health. The dependent variable was drug abuse, while the independent variable was mentoring interventions. The Chi-square analysis revealed an association between participation in school-based …

The Effects Of Sexual Education On Sexual Behaviors Of Adolescents In Rural Jamaica, Deborah Simmonds

Walden Dissertations and Doctoral Studies

Adolescent pregnancy and the sexual behaviors of adolescents continue to be robust public health and social problems in Caribbean countries such as Jamaica. Numerous researchers have conducted studies on the impact of sex education on sexual behaviors and pregnancy patterns among adolescents with mixed results (i.e., a lack of knowledge) especially in rural communities. The purpose of this study was to ascertain the impact of school- or home-based sex education on sexual behavior and pregnancy patterns of adolescents aged 15 —19 years in the rural community of St. Thomas, Jamaica. The parental expansion of the theory of planned behavior and …

Opioid Abuse In Rural Communities Among Adolescents With Bipolar Disorder, Sherlina Daishernai Holland

Walden Dissertations and Doctoral Studies

Abstract

Low population density in rural areas makes it difficult to deliver services to people with mental health problems and nonmedical prescription opioid abuse remains a problem in the United States. The purpose of this cross-sectional study was to determine whether a parent's socioeconomic status affected care opportunities for children 12 to 17 years of age and whether bipolar disorder increased the likelihood of substance abuse in those children. The theory of reasoned action/planned behavior provided the framework for the study. Secondary data from the Interuniversity Consortium for Political and Social Research 36361 data system, specifically the National Survey on …

Physical Activity And Dietary Interventions For Adolescent African Americans In Mississippi, Tanga Deson Hart Robinson

Walden Dissertations and Doctoral Studies

African American (AA) adolescents have higher rates of obesity than many other ethnic groups, which increases their risk for obesity-related diseases. Culturally sensitive obesity preventive interventions have been unsuccessful, resulting in a steady increase of obesity among AA adolescents. AA adolescents in the southern region of the United States are at a higher risk for obesity and physical inactivity; knowledge and understanding of causative factors remains limited. To identify the impact of programs, a systematic review of the literature focused on structured physical activity and/or dietary education interventions in Mississippi. The ecological framework was used to guide this study. The …

A Meta-Synthesis Of Adolescent Psychological Help-Seeking, Karen Barnes

Walden Dissertations and Doctoral Studies

Although adolescents experience psychological difficulty at a rate higher than any other age group, most do not get the support they need. The purpose of this study was to explore perceptions about barriers, facilitating factors, and help-seeking preferences for psychological support among adolescents. This study involved Best, Gil-Rodriguez, Manktelow, and Taylor’s conceptual framework pathways to online help-seeking to help explain adolescents’ perceptions of factors that influence them seeking support as well as identify pathways for support. A qualitative meta-synthesis design was used to synthesize findings of individual qualitative studies into themes around the central phenomenon of adolescent help-seeking. Data were …

Relationship Between Adolescent Perception Of Harm, Electronic Cigarette Use, And Texas Antitobacco Campaigns, Candace Rasheedah Campbell

Walden Dissertations and Doctoral Studies

The increase in use of e-cigarettes in adolescents is a major public health concern that must be addressed. Research studies showed some e-cigarettes contained varying amounts of nicotine and sever cancer-causing chemicals. The purpose of this quantitative, cross-sectional study was to assess the perception of harm (dependent variable) from using e-cigarettes and being exposed to state and school-based antitobacco programs (independent variable) and to determine if the association was modified by socioeconomic status or area of residence. Attitude-social influence-self-efficacy theory was the chosen theory for research and suggests that attitude, social influence, and self-efficacy variables can be persuaded via specific …

Evaluation Of The N-O-T Program For Smoking Cessation Among High School Students, Whitney Jaye Erickson

Walden Dissertations and Doctoral Studies

Adolescents and young adults use more tobacco than all other adults, yet the percentage of this younger population eventually quitting the use of tobacco is lower. There is little evidence-based research to support adolescent smoking cessation programs. Using social learning theory (SLT) and the stages of change model, the purpose of this project was to evaluate the effectiveness of the Not-On-Tobacco (N-O-T) program, an evidence-based adolescent smoking cessation program, in reducing or preventing the number of cigarettes smoked by high school boarding students and to evaluate how best to individualize the program for this high school going forward. The DNP …

Predictors Of Binge Drinking In High School Youths In Montgomery County, Maryland, Lum M. Fube

Walden Dissertations and Doctoral Studies

Underage drinking is a major problem in the United States, leading to increased morbidity and mortality. About 43,000 deaths a year result from binge drinking in youths at a cost of $24 billion in 2010 to the U.S. economy. The purpose of this quantitative dissertation was to examine the predictors of binge drinking in high school youths in a highly racial diverse community of Montgomery County, Maryland. The social ecological model was the theoretical framework used for this study due to the presence of both personal and contextual factors that influence behavior. Using binary logistic regression to analyze data from …

Cultural Perspectives On African American Adolescent Sexual Risk Behavior In Central Mississippi, Debra Suzette Smith

Walden Dissertations and Doctoral Studies

In 2015, Mississippi had the 3rd highest adolescent birth rate in the United States, high rates of sexually transmitted diseases, and enduring racial disparities between African American and White teenagers. Few researchers have described the immediate cultural environment to determine how it may influence the sexual behaviors and attitudes of African American teens. The purpose of this qualitative ethnographic study was to describe the sociocultural environment of African American adolescents in Mississippi that influences their sexual behavior by exploring the knowledge, feelings, experiences and beliefs of African American adults. The social cognitive theory was used as a theoretical framework to …

Development Of A Staff Education Module On Adolescent Obesity, Deborah Ann Stallworth

Walden Dissertations and Doctoral Studies

Adolescent obesity is a growing health concern in the United States due to its increasing prevalence and comorbidities that can reduce longevity and increase morbidity. Advanced practice nurses (APNs) providing care in school-based health centers (SBHC) located in marginalized communities are uniquely positioned to work with adolescent students challenged with obesity. The management of adolescent obesity requires advanced skills and knowledge to promote healthy lifestyles, prevent obesity, and to directly address the many factors that contribute to the condition. The purpose of this project was to develop an education program for APNs to prepare them to work with students in …

Neighborhood And Community Influence On Adolescent Obesity, Peggie Arnzellique Harrison

Walden Dissertations and Doctoral Studies

In the United States, over two-thirds of adults are overweight or obese, and the number of children and adolescents who are overweight is increasing. Obesity is a significant issue as obesity-related chronic diseases can result in diminished quality or life, high morbidity and mortality, and substantial healthcare costs. The purpose of this study was to examine neighborhood social capital and how it relates to adolescent obesity. The socio-ecological model was used as the theoretical framework of this study to examine how the environment and social contexts influence health behaviors. Utilizing a quantitative cross-sectional research design, bivariate and multivariate analyses were …

An Ecological Approach To African American Adolescent Food Choices In Low Income Neighborhoods, Clarence E. Mcmillan

Walden Dissertations and Doctoral Studies

Childhood obesity remains prevalent among African American (AA) adolescents in low income neighborhoods with limited access to a variety of foods from stores. Guided by the ecological framework, the purpose of this study was to examine the impact of neighborhood stores on food choices, and physical activity among AA adolescents in a low income neighborhood. A quantitative research design with cross sectional primary and secondary surveys was used. Participants included 176 high school students and 42 store merchants. Data sources were the 2011 New Jersey Student Health Survey with core questions from the Youth Risk Behavior Survey and the Hmong …

High School Teachers' Perceptions Of Mental Health And Adolescent Depression, Christine Ann Breuer

Walden Dissertations and Doctoral Studies

Adolescents have a high rate of untreated mental health issues, specifically related to depression. Current literature does not indicate the impact of teachers' attitudes toward mental health on their decisions to refer students for services. This study provides understanding specifically, how teachers' beliefs about mental health, as well as their age, gender, ethnicity, years of education, and years of teaching, were analyzed to determine the impact each these characteristics had on the decision to refer a student for services. 92 high school teachers participated in this quantitative study by completing a survey measuring their attitudes of mental health, and then …

Youth Assault-Injury Variation Patterns And Their Dimensional Structure, Diana Faissal Wilkerson

Walden Dissertations and Doctoral Studies

Youth assault-injury is 1 of the 5 leading causes of adolescents' death in the United States. Despite public health efforts, the prevalence rates of youth assault-injury and almost all its risk factors have remained consistent in the past 10 years. The purpose in conducting this cross-sectional quantitative study using archival data of the Add Health Wave II in-home survey was to examine the underlying-multidimensional structure of youth assault-injury. Problem behavior theory (PBT) lens and a multidimensional model were used and a structural equation model was conducted to examine the relationships between 22 risk and protection variables, 3 unobserved latent factors, …

Adolescent And Community Adult Perceptions Of Adolescent Tobacco Use, Susan M. Franko

Walden Dissertations and Doctoral Studies

In 1964, the Surgeon General issued the first report that linked smoking cigarettes as a direct cause of emphysema, heart disease, and lung cancer. Despite this landmark publication, the primary cause of preventable deaths each year in the United States continues to be related to the use of tobacco. Regardless of decades of health education and resources available to inform society that the use of tobacco products can have deleterious effects on health, adolescents continue to experiment with them. The purpose of this study was to gain a better understanding of the influences of adolescent tobacco use. Based on the …