Public Health and Community Nursing Commons^™

Nurses Leading In Bridging The Culture Gap: Communicating With The Deaf Community, Veronica C. Leftridge

Electronic Theses and Dissertations

Nurses provide patient care in clinics, hospitals, homes, churches, schools, communities, and military, as well as on emergency medical helicopters. When a nurse is assigned to care for a patient, the patient expects the nurse to be culturally competent, communicate effectively, and provide safe quality care. However, cultural incompetence is observed when nurses provide care for Deaf patients, but they are unfamiliar with Deaf culture. In addition, communication is a fundamental skill nurses learn in nursing school, but course content in nursing programs rarely touches on how to communicate effectively with Deaf patients. Of the approximately 325 million people in …

Understanding How To Promote Healthy Dietary Habits Among Parents Of Adolescents, Jazmine D. Collins

Electronic Theses and Dissertations

Adolescents in the United States today have record-high prevalence rates for childhood obesity and overweight, which are conditions that have lifelong negative health consequences for individuals, and also carry high financial and social costs for the entire nation. The disproportionate burden of obesity and associated health conditions falls on adolescents of racial and ethnic minority group identities and from lower-income households. The increased risk that adolescents have for developing conditions like childhood obesity is closely associated with youth having diets that are unhealthier than in the past. Parents have a large influence on the eating habits and preferences of their …

Addressing The Psychosocial State Of High-Risk Individuals Undergoing Hereditary Cancer Screening By Advanced Practice Registered Nurses (Aprns) In The Community Oncology Setting, Aquilina Kerubo Thompson

Electronic Theses and Dissertations

Abstract

Neoteric advances in genetics make it possible to define genetic risk in cancer, and there should be methods in place to provide comprehensive genomic care with oncology advanced practice registered nurses bridging this gap. The current scope of nursing practice stipulates genetic and genomic literacy; however, there remains a deficit among advanced practice registered nurses in identifying and addressing psychosocial distress during the genetic cancer risk assessment process. Oncology advanced practice registered nurses must be equipped with the knowledge that the genetic cancer risk assessment also involves protecting patients from the psychosocial repercussions of carrying a hereditary cancer gene …

Decreasing Unintentional Pregnancies For Tennesseans, Paula M. Todd

Electronic Theses and Dissertations

In 2018, 49% of all pregnancies in the United States were unintended, with women with a lower- income status being five times more likely to experience an unplanned pregnancy. Tennessee has a high rate of unintended pregnancies, particularly among the uninsured, low-income, and rural teen populations; some 22% of these unintended pregnancies end in abortion. Oral or transdermal contraceptives that are affordable and accessible for women of childbearing age can reduce unintentional pregnancies. The addressed gap in clinical practice was that contraceptives are not currently available over the counter in Tennessee pharmacies without a prescription, which necessitates a costly medical …

Food Addiction And Obesity, Lisa Ling

Electronic Theses and Dissertations

The obesity rate in the U.S. adult population has increased to epidemic levels despite attempts to decrease obesity through evidence-based knowledge, clinical practice guidelines, medical interventions, and individual efforts. For certain individuals, food addiction behaviors such as food cravings, loss of control, and binge eating contribute to obesity and require a different approach to care. Little work has been done on adding the possibility of food addiction to obesity screening and treatment. This study utilized a quasi-experimental quantitative pre- and postsurvey research design based on Lewin’s change theory. Nurse practitioners were surveyed regarding the provider’s perceptions, attitudes, and beliefs about …

Developing Outpatient, Clinic-Based Education For Patients With Diabetes And Prediabetes, Ruth Ann Slayton

Electronic Theses and Dissertations

Abstract Education and support provided to the newly diagnosed prediabetic or Type 2 Diabetic are inadequate in the outpatient arena. In rural areas, instruction for diabetes is minimal to nonexistent, and patients are paying for this with their health and lives many times. The financial burden of diabetes in the United States is astronomical. The loss of life and life quality is significantly high as well. A systems-based approach to education in the rural health clinic would be of great benefit and has proven to be enough to reverse or avoid the progression of the disease. A clinic or field-based …

Advance Care Planning Protocols And Hospitalization, Rehospitalization, And Emergency Department Use In Home Health, Sharon Bigger

Electronic Theses and Dissertations

Aim. The aim of this study was to examine the relationship of advance care planning protocols with hospitalization, rehospitalization, and emergency department use rates in U. S. home health agencies (HHA).

Background. Since 2003, CMS has required HHAs to report on quality outcomes such as hospitalization, rehospitalization, and emergency department use rates, made publicly available online. Advance care planning (ACP) is a conversation about beliefs, goals, values, future treatment choices, and designation of a surrogate decision-maker, that someone has in advance of a health crisis. Most existing studies on ACP have taken place outside of HHAs among populations with serious …

A Faith-Based Approach To Promote African American Healthy Heart Behaviors, Gwendolyn Gaston

Electronic Theses and Dissertations

More than 100 million American people have some form of cardiovascular disease. African American life expectancy is 3.4 years shorter than that of Caucasians, with an estimated 32% difference in cardiovascular disease mortality between Caucasian and African American men and a 43% difference between Caucasian and African American women. The purpose of this project was to utilize a faith-based approach in developing a heart-healthy program for addressing health disparities in an African American Baptist Church. The program focused on improving cardiovascular health literacy and addressing modifiable risk factors. The results of this project revealed that African Americans need interventions to …

The Effect Of Breastfeeding Education In African American Women On Initiation And Duration Of Breastfeeding, Shalawn F. Harris

Electronic Theses and Dissertations

Abstract

This Doctor of Nursing Practice scholarly project aimed to evaluate the effectiveness of breastfeeding education in African American women on the initiation and duration of breastfeeding. Studies demonstrated that breastfeeding education by providers and a breastfeeding support network positively influenced breastfeeding initiation and continuation in African American women. Breastfeeding education containing information on the decreased risk of breast cancer in African American women may be an even greater motivator for breastfeeding. Participants for this project were African American women, ages 18–50, in their last trimester of pregnancy. The project was approved to be implemented at an urban clinic in …

Perceptions Of Migrant And Seasonal Head Start Parents About Childhood Vision Care Utilization, Felicia R. Thomas

Electronic Theses and Dissertations

The benefits of pediatric vision screening for very young children is not a new concept. However, not all children receive this valuable preventative intervention, or they do not receive an evaluation or examination to rule out or treat common visual refractive errors. This Doctor of Nursing Project sought to identify factors that impact a parent’s failure to follow up on recommendations for further evaluation or treatment following their child’s failed vision screening. The project utilized a phenomenological study to assess Migrant and Seasonal Head Start parents’ perceptions about their perceptions of the need for preventative vision screening and care. Three …

The Impact Of A Digital Intervention On Perceived Stress, Resiliency, Social Support, And Intention To Leave Among Newly Licensed Nurses: A Randomized Controlled Trial, Lisa Concilio

Electronic Theses and Dissertations

The nursing shortage has been deemed a public health crisis with the turnover rate of newly licensed nurses (NLNs) growing (Robert Wood Johnson Foundation, 2014). One out of five NLNs are leaving the profession due to work dissatisfaction and feelings of inadequacy (National Academy of Medicine, 2017). NLN attrition during the first year of hire has been associated with feelings of overwhelming stress and decreased sense of support which negatively impact patient safety (Spence Laschinger et al., 2016). As seasoned nurses are attempting to retire amidst a nursing shortage (American Association of Colleges of Nursing, 2018), NLNs require more support …

Assessing Nurse Practitioners' Knowledge And Clinical Practice With Regard To The Oral-Systemic Link, Angela Haynes

Electronic Theses and Dissertations

Nurse Practitioners (NPs) comprise a significant portion of the U.S. primary care workforce and play an essential role in patients' health awareness, prevention strategies, disease management, and in providing appropriate provider referrals. Nurse Practitioners receive education on the oral-systemic connection, yet there have been limited studies on the clinical practice of NPs assessing the oral cavity to evaluate the condition of the teeth and the oral tissues. The purpose of this study was to explore the nurse practitioners’ knowledge and practice habits of assessing the oral cavity for diseases or abnormalities in the mouth that can, in turn, affect overall …

Determining The Effectiveness Of A Peer Support Person In Individuals With Depression Symptoms, Donna K. Reeves

Electronic Theses and Dissertations

Abstract

This study’s aim was to evaluate the effectiveness of an existing peer support program as an adjunct treatment for patients with depression. This retrospective evaluation analyzed the total scores of 110 patients with depression on the PHQ-9 questionnaire at the initial assessment (Time 1), at 6-weeks (Time 2), and then at 12-weeks (Time 3). The participants were divided into two groups, those who enrolled in a peer support program (n = 55) and those without peer support (n = 55). PHQ-9 total scores for each time interval were compared for the two groups utilizing independent sample t-tests …

A School-Based Sexual Health Education Program, Tracy L. Kendall

Electronic Theses and Dissertations

A small rural community has high incidence rates of chlamydia (4,751 per 100,000) and gonorrhea (970 per 100,000) in females 15–24 years old. Data obtained from Texas Health and Human Services showed that incidence rates of chlamydia and gonorrhea in females 15–24 years old were higher in Navarro County, Texas, than the state of Texas. Texas schools do not mandate sex health education. There is a gap in school-based sexual health education available to 18- and 19-year-old females residing in this rural community in Texas. The purpose of this research study was to evaluate the impact of school-based sexual health …

Exploring The Relationship Between Dietary Self-Monitoring With A Mobile App And Weight Change, Jason Payne

Electronic Theses and Dissertations

Background: Approximately 70% of the adult population in the United States has overweight or obesity and increased risk for developing chronic diseases. Dietary self-monitoring adherence using a paper diary is associated with weight loss; however, few studies have examined this association with dietary self-monitoring apps. Objectives: 1) explore if an association exists between app-based dietary self-monitoring and weight change among adults with overweight or obesity and 2) explore the relationships between the frequency, consistency, and completeness of self-monitoring and weight change. Methods: Participants self-monitored dietary intake for 8 weeks using the app Calorie Counter by FatSecret. Participants were assigned …

Increasing Healthy Lifestyle Behaviors In Cargo Drivers, Ronda L. Bell

Electronic Theses and Dissertations

The purpose of this project was to examine the extent to which lifestyle behaviors of transportation drivers in North Texas can be improved with health education. This research study was conducted to examine the health behaviors of transportation drivers as a result of an educational partnership between nursing and the transportation industry. The goal was to improve healthy lifestyles through education to decrease chronic illness and comorbid conditions of a significantly at-risk occupational population. The impact of this education was immediate and verified with quantitative measurement and statistical analysis. Results demonstrated that after nurse-led health education, transportation drivers reported significant …

Addressing The Problem Of Sterile Drug Injecting Supply Acquisition For People Who Inject Drugs., Barbra Ann Cave

Electronic Theses and Dissertations

This dissertation contains five chapters, including three manuscripts, covering harm reduction and some of the challenges people who inject drugs (PWID) face in their effort to reduce the risk of injection drug-related harms through sterile injecting supply acquisition and use. Chapter One discusses some background related to PWID and provides an overview of the issues addressed in this dissertation. Chapter Two includes a literature review covering the harm reduction concept, important aspects of syringe exchange programs as a harm reduction tool, and the social determinants of health model as a potential tool for future research. Chapter Three is a two-phase …

The Impact Of Direct Nursing On Patient Engagement To Improve Medication Adherence, Shelley Moore

Electronic Theses and Dissertations

This study examined the impact of direct nursing care on patient engagement and medication adherence within the practice setting of specialty pharmacy. It investigated the problem statement, “Among patients with specialty pharmacy dispensed medications, will direct interaction with nurses impact patient engagement and improve medication adherence?” Patient engagement in healthcare is a growing area of knowledge for the effectiveness of care. The research uncovered patient engagement as a predictor of improved medication adherence through effective direct nursing involvement. Methods to measure engagement were the utilization of the ACE™ Altarum Consumer Engagement (ACE) Measure™. By using a proven, researched tool to …

Examining Opportunities To Increase Flu Vaccine Uptake On College Campuses Through Pharmacy Partnerships, Kristi Hargrave

Electronic Theses and Dissertations

The purpose of this project was to examine a university health clinic’s influenza vaccination program in a suburban city in a western U.S. state, and to explore the effects of partnering with a local pharmacy to overcome billing issues. A program evaluation was conducted to identify the potential barrier of cost for students. The health clinic was not set up to bill private health insurance for students; therefore, if students wanted to get a flu shot, they had to pay out of pocket for it. A pilot program was created in conjunction with the program director, partnering with the local …

Std Education Among African American Women: An Educational Improvement Initiative, Marqueta V. Abraham

Electronic Theses and Dissertations

Research reveals there is a knowledge gap facing African American women regarding sexual health education, specifically sexually transmitted diseases. The Sexually Transmitted Disease Knowledge Questionnaire (STD-KQ) was used to assess participants’ knowledge and attitudes regarding sexually transmitted diseases. The STD-KQ self-assessment was administered to African American women and utilized to develop a 45-minute education seminar to bridge the knowledge gap. After an education seminar was held, a posttest was administered to test the women’s knowledge and to determine their level of awareness. Using a paired-samples t test, the researcher found an overall increase in awareness of the types of sexually …

Cultural Aspects Of End Of Life Advance Care Planning For African Americans: An Ethnonursing Study, John Collins

Electronic Theses and Dissertations

Introduction: Advance directive completion rates among the general population are low. Studies report even lower completion rates among African Americans are impacted by demographic variables, cultural distinctives related to patient autonomy, mistrust of the healthcare system, low health literacy, strong spiritual beliefs, desire for aggressive interventions, importance of family-communal decision making, and presence of comorbidities. End of Life (EOL) advance care planning (ACP) promotes patient and family centered care. The purpose of this study was to identify culturally based meanings, expressions, and traditions of EOL ACP and decision making among African Americans, to better understand and provide culturally congruent nursing …

Exploring Maternal Factors Linked To Weight Status In Salvadorian Infants, Carmen M. Kiraly, Melanie Turk, Melissa Kalarchian, Cheryl Shaffer

Electronic Theses and Dissertations

Background: Obesity rates in the US have risen dramatically, especially among Hispanic adults and children. Because of the high prevalence of overweight and obesity in Latino children by preschool age, it is prudent to examine maternal factors potentially linked to weight status during an infant’s first year of life. The literature on risk factors of child obesity has focused primarily on children of Mexican descent, and little research exists for other Latino populations, such as Salvadorans. Objective: To investigate maternal physiologic and infant feeding factors associated with infant overweight and/or obesity in a sample of Salvadoran mother-infant dyads. Methods: A …

An Exploration Of Barriers To Health Care Access Among Uninsured Patients: Using The Moderating Effect Of Patients’ Enablement, Enedelia L. Jessup

Electronic Theses and Dissertations

ABSTRACT On March 23, 2010, Congress passed the Patient Protection and Affordable Care Act (ACA) to increase value of care, improve clinical outcomes, decrease health care costs, and increase affordability in health care access. The purpose of the study attempts to examine the moderating effects of patient enablement impacting barriers, low socio economic status, and unmet basic needs, toward health care access in uninsured populations post ACA. Only certain aspects of patient enablement in self-management of an individual’s health care goals have been conducted with uninsured populations with barriers toward health care access. The research design was a quantitative, exploratory, …

Self-Management As A Mediator Of The Relationship Between Social Support And Health Outcomes Of African American Adults With Type 2 Diabetes., Tariq N. Al-Dwaikat

Electronic Theses and Dissertations

Type 2 diabetes (T2D) is often associated with serious complications. African American adults have higher rates of diabetes-related complications than other ethnicities. Diabetes self-management reduces the risk of developing biological and psychological symptoms. Social support promotes positive behavior change and self-management that leads to improved biobehavioral and psychosocial outcomes. Few studies explored the relationship between social support dimensions and self-management behaviors, diabetes biomarkers, and psychosocial outcomes of African American adults with T2D. The purpose of this dissertation was to examine the relationships of various dimensions of social support with self-management behaviors and diabetes biomarkers and psychosocial outcomes of African American …

Mammography Utilization In African American Women, April D. Kidd

Electronic Theses and Dissertations

Purpose: Breast cancer presents differently among women causing breast cancer health disparities with women of color disproportionally shouldering later-stage screening, incidence, and treatment, and greater mortality. This study assessed 10 predictors and rates of recent and long-term mammography utilization for women 43-79 years of age to better understand differences among age strata and races. This was the first study to use both the calculated Gail Risk scores (calculates absolute breast cancer risk over time intervals) from the 2010 National Health Interview Survey (NHIS) and a temporary homelessness variable in predicting mammography utilization using national-level data.

Theoretical Framework: A modified Behavioral …

Positive Deviance, Contraceptive Self-Efficacy And Social Desirability In Sexually Active Adolescent Females : A Mixed Methods Approach., Ashley D. Miller

Electronic Theses and Dissertations

Unintended pregnancy is an issue that impacts women of all ages, ethnicities, and socioeconomic statuses. It also impacts the child that results and the society in which they live. In the United States, adolescents experience unintended pregnancy more than adolescents in other countries. The purpose of this dissertation was to explore the factors that contribute to successful contraceptive use among adolescent females (ages 13-18) seeking reproductive health services at a local family planning clinic. The theoretical framework of contraceptive self-efficacy (CSE) was used to frame this understanding. The exploration was conducted in three ways: a critical review of the literature …

The Influence Of Time Perspective On Physical Activity Intentions And Behaviors Among Adolescents Residing In Central Appalachia., Tauna Gulley

Electronic Theses and Dissertations

Obesity and inactivity are prevalent among central Appalachian adolescents. Appalachian residents have been labeled "fatalistic," a time perspective unsupportive of health-promoting behaviors such as regular participation in physical activity. The theory of planned behavior has been used extensively to explain the physical activity behaviors of adolescents. Constructs within the theory of planned behavior include attitudes toward the behavior, subjective norms, perceived behavioral control, and intention to perform the behavior. The purpose of this study was to determine the time perspective of central Appalachian adolescents and examine the relationship between time perspective and the constructs within the theory of planned behavior. …

Primary Care Nurse Attitudes, Beliefs And Confidence Levels Regarding Alcohol Abuse And Its Treatment: Impact Of Educational Intervention., Raja Sekhar Vadlamudi

Electronic Theses and Dissertations

Alcohol abuse has been a major burden on the society. In the fight against it a key issue the education of the primary care nurses has been ignored. This study evaluates the effect of education program on the attitudes, beliefs, and confidence levels of primary care nurses regarding alcohol abuse and its treatment. Data from the Project Mainstream educational intervention were used with permission from the investigators. Two hundred one students and faculty of nursing at Vanderbilt University participated in the intervention, which was designed to train primary care providers in the Brief Negotiated Intervention technique for early detection and …