Public Health Commons^™

Doubly Burdened: Race-Ethnic Disparities In The Effects Of Covid-19 And Covid-19 Mitigation Strategies, Ashley Fox, Yongjin Choi

Understanding and eliminating minority health disparities in a 21st-century pandemic: A White Paper Collection

Black and Hispanic populations across New York State and around the United States have been disproportionately impacted by COVID-19 both in terms of COVID-19 associated morbidity and mortality but also bearing a larger burden of the economic impacts. Race-ethnic minorities also experience more longstanding and justified distrust of the medical community, which could serve to prolong the pandemic effects in the most vulnerable communities by contributing to reduced vaccine uptake. This paper reports the results of a survey fielded in November 2020 with an oversampling of Non-Hispanic Black and Hispanic respondents across New York State concerning the impacts of the …

Trust In Media, Institutions, And Health Information In Metropolitan Nebraska: 2021 Nebraska Metro Poll Results, Rebecca J. Vogt, Heather Akin, Cheryl A. Burkhart-Kriesel, Bradley Lubben, L. J. Mcelravy, Timothy Meyer, Steven A. Schulz

Rural Futures Institute: Publications

Overall, most metropolitan Nebraskans have confidence in their local institutions (public safety agencies in their community, public schools in their community, and voting and election systems in their county). However, many have very little confidence in many national institutions (the U.S. Senate, the U.S. House of Representatives and the Presidency) as well as the Governor.

Metropolitan Nebraskans most trust information received from friends/family/ acquaintances, local news sources (TV and newspapers), public sources (PBS and public radio) and state newspapers. They least trust information from social networking sites, Internet blogs, and Fox News.

Most metropolitan Nebraskans trust local health professionals for …

Addressing Hidden Barriers To Follow Up Healthcare: A Community Referral Pilot Project, Amber Williams

Doctor of Nursing Practice Projects

Objective: The project was aimed to reduce the number of participants lost to primary care follow-up following a mobile health unit screening event.

Design: A pilot study program screening tool implementation was utilized to address the hidden barriers of the Social Determinants of Health (SDoH) during a Winter 2021 event.

Sample: A group of 12 participants were screened during a mobile health unit event. Eight of the participants opted to be a part of the pilot study.

Measurements: A comparison ratio of Primary Care follow up was compared from the Winter of 2020 with Winter of 2021, where the screening …

Impact Of Social Barrier Removal On Primary Care Use By Managed Care Enrollees, Pamme Lyons-Taylor

Walden Dissertations and Doctoral Studies

Personal health represents a complex relationship among social, physical, and emotional factors that can be influenced by health-seeking behaviors. Prior research indicates that greater use of preventive services leads to longer life and lower healthcare costs. For some populations, evidence suggests that social barriers hinder access to preventive services. To better understand the relationship between social factors and the other personal-health factors, de-identified healthcare claims and social service encounter data for 4,480 low-income individuals enrolled in Medicare Advantage or Managed Medicaid at one national health insurance were examined using a retrospective, quasi-experimental design for services rendered between October 1, 2014 …

The Use Of Technology For Seeking Health Information In Persons With Cancer, Jasvir Zonobi

Walden Dissertations and Doctoral Studies

Cancer is a growing public health concern. The U.S. cancer prevalence nearly doubled from 8.1 million in 1996 to 15.5 million in 2016 and is expected to rise by an additional 68% from 2016 to 2040. Many cancer survivors use technology (e.g., smartphones) for health information seeking (HIS) for health-related self-efficacy (HRSE) to self-manage the health issues (e.g., physical impairment, chronic disease) they face. However, limited research exists regarding cancer survivors' use of HIS technology for HRSE. The self-efficacy theoretical framework, multiple logistic regression analyses, and the data from 2019 Health Information National Trends Survey were used in the current …

Exploring Barriers To Care: Provider Efforts To Improve Retention In Urban-Rural Clusters, Kenyata M. Fletcher

Walden Dissertations and Doctoral Studies

AbstractOver the years, the infection rates for HIV in the United States has changed partly due to lack of engagement and medication adherence which can lead to substantial declines in individual health. Factors that contribute to the individual’s adherence can include transportation cost, childcare, and lack of finances to name a few. These barriers can often be decreased with the help of supportive service providers and improvement in the patient-provider relationship. Currently, there is limited research that explores how to reduce patient barriers to care, specifically in rural areas. This qualitative study examines how Illinois health care providers help HIV-positive …

Risk Factors Associated With Childhood Vaccination Coverage In Afghanistan, Iqbal Mawani

Walden Dissertations and Doctoral Studies

Globally, vaccination is among the most successful and cost-effective public health practices in the prevention of infectious diseases. The purpose of this study was to examine the child, parental, and geographical risk factors that influence childhood vaccination coverage in Afghanistan. The health belief model and socio-ecological model was used in this study as the theoretical framework to examine the effects of these risk factors on vaccination coverage among children in Afghanistan. Univariate, bivariate, and multivariate tests were conducted within the secondary data analysis of the 2015 Afghanistan national Demographic and Health Survey dataset. Of the 32,420 children aged 0 to …

Challenges To Successful Health Care Transition Among Hiv Positive Youth With Perinatal Acquisition, Tyler Andrew Termeer

Walden Dissertations and Doctoral Studies

To ensure stability in the continuum of health care for HIV-positive youth with perinatal acquisition, there is a need for a successful transition from pediatric to adult primary care. However, there are a growing number of perinatally infected HIV-positive young persons remaining in pediatric care beyond the age of 21. Using Mohr’s program theory and a phenomenological approach, the lived experiences of Ohio HIV clinicians were examined to determine why many perinatally infected HIV-positive youths are remaining in pediatric care beyond the age of 21. Audio recorded video interviews via SKYPE were conducted with 12 participants, transcribed, underwent thematic analysis, …

Health Care Provider Program On The Management Of Obesity, Erlinda P. Bhat

Walden Dissertations and Doctoral Studies

Research has shown that educational programs have led to developing the professional skills and behaviors of front-line health care providers who care for overweight or at-risk obese patients. The purpose of this project was to provide an educational program on best practices for weight management to health care providers at a large military clinic. The project question was developed to assess whether the educational program increased the knowledge and confidence of health care providers in the management of obesity. Utilizing Pender's health promotion model, a quasi-experimental study was conducted in which 15 health care providers, including licensed and unlicensed personnel …

A Phenomenological Exploration Of How Nursing Experience Shapes The Transitional Performance Of Primary Care Nurse Practitioners, Helen Okeke

Walden Dissertations and Doctoral Studies

AbstractPoor access to healthcare and a shortage of primary care providers in underserved communities paved the way for reliance on advanced practice registered nurses (APRNs). This increased reliance on APRNs as primary care providers necessitates expanded public policy on APRN practice; however, information on APRN transitional experiences remains inadequate to inform policymakers effectively. Illinois’ Nurse Practice Act requires APRNs to incorporate the scope of practice of registered nurses into their practice but does not describe what that experience should be. Using Kanter’s theory of organizational structural empowerment and Benner’s novice to expert nursing model as theoretical lenses to ground the …

Human Immunodeficiency Virus And Homelessness Among U.S.-Born And Foreign-Born Tuberculosis Cases In Georgia, Semra Ramosevac

Walden Dissertations and Doctoral Studies

According to the Centers for Disease Control and Prevention, tuberculosis (TB) is an infectious disease caused by bacteria and can easily spread in the U.S. and worldwide. TB infections in the U.S. have been much lower compared to other countries around the world in the last 40 years, but with the recent increase in an immigrant foreign-born population, there is a serious risk of the spread of TB. The goal of the study was to look into U.S.-born vs. foreign-born populations among TB/HIV/homeless cases in the state of GA from 2014 to 2018. The quantitative study was performed using secondary …

Psychosocial Support During Pregnancy: A Narrative Inquiry Of Low-Income Unmarried Women In Iowa, Summer D. Parrott

Walden Dissertations and Doctoral Studies

Pregnant women who experience high levels of stress and who lack support are at higher risk for negative birth outcomes for themselves and their offspring including preterm labor, low birthweights, and a myriad of other short- and long-term health and behavioral consequences across the lifespan of the child. Unmarried or socioeconomically disadvantaged women lack the most common resources used to protect against the negative effects of stress during pregnancy. A research gap existed regarding the specific types of psychosocial support perceived by low-income unmarried women to be most beneficial at buffering their perceived prenatal stress. The ecological model and the …

Primary Care Providers’ Perceptions Of Adolescent Friendly Health Services In Relationship To Adolescent Pregnancy, Jill Marie Ensminger

Walden Dissertations and Doctoral Studies

According to recent research, adolescent health continues to be a public health concern. The purpose of this qualitative research was to identify the perceptions of primary care providers regarding adolescent friendly health services and the relationship to adolescent pregnancy. The theoretical and conceptual framework used for this research included the social ecological model and the recommendations of the World Health Organization (WHO) for providing adolescent friendly health services. Using a phenomenological qualitative research approach, interviews were conducted over the telephone. Data analysis included hand coding with emerging themes and subthemes in relationship to each research question. The results of the …

Examining Clinicians' Perspectives Screening For Depression In Patients With Type 2 Diabetes Mellitus, Vickie Lavette Bland

Walden Dissertations and Doctoral Studies

The United States has a significant diabetes problem. This chronic disease affects the body physically and mentally. One of the emotional effects of diabetes is depression. Depression is often present in individuals with diabetes, chiefly in those with type 2 diabetes mellitus (T2DM). While depression is common in T2DM and can interfere with treatment adherence, clinician screening for depression in T2DM patients is low. The purpose of this study was to examine clinicians' attitudes, behaviors, and perceptions concerning screening patients with T2DM for depression. Through a qualitative case study approach centered on reasoned action theory, 3 physicians and 5 nurse …

The Association Of Demographic Characteristics And Social Vulnerability With Covid-19 Outcomes, Gloria D. Boone

College of Graduate Studies: Theses & Dissertations

The Association of Demographic Characteristics and Social Vulnerability With COVID-19 Outcomes

by

Gloria Boone

(Under the Direction of Gulzar Shah)

ABSTRACT

This research explored 102 Illinois counties' COVID-19 data to determine whether demographic characteristics and social vulnerability are associated with increased vulnerability to COVID-19 infections and deaths. COVID-19 is disproportionately impacting vulnerable groups and has been deadlier for African American and Hispanic people. The findings of this research will contribute to the knowledge base regarding social vulnerability and assist public health officials in targeting resources and designing interventions. This study used a retrospective cross-sectional design to assess demographic characteristics of …

Effects Of Trained Providers And Naloxone Distribution On Prescription Opioid Use Disorder, Samuel Sarpong

Walden Dissertations and Doctoral Studies

AbstractOpioid abuse and overdose are associated with substantial morbidity and mortality rates, as well as social and economic costs. The purpose of this study was to evaluate the independent and interactive effects of state-sponsored prescription drug monitoring program (PDMP) trained healthcare providers and community-based naloxone distribution program related factors in the states of Florida and Georgia for the prevention and reduction of prescription opioid use disorder, overdose, and deaths. The research theory adopted was the socio-ecological model with an emphasis on risk factors such as age. The study used secondary data from 2014 to 2018 from the Florida and Georgia …

Social Determinants Of Health And Type 2 Diabetes Among Enrollees Of California Children’S Services Program In Fresno County, California, Daniela Marie Aghadjanian

Walden Dissertations and Doctoral Studies

Despite extensive study in adults, Type 2 diabetes (T2D) has been the subject of little research concerning young adults or children. Doctors believed T2D to develop only in a person’s later years until health care providers found younger individuals developing this disease. The purpose of this cross-sectional quantitative analysis was to determine correlations between T2D and social determinants of health in Fresno County, California, based on children and adolescents. The 2017-19 data came from the Fresno County Department of Public Health. The theoretical foundation for the study was the socio-ecological framework focusing on individuals’ traits having a bidirectional impact on …

Understanding How Religious Practices Influence Self-Care In Black Churchgoers Diagnosed With Hypertension, Taquina C. Davis

Walden Dissertations and Doctoral Studies

Religion plays an essential role in managing health; however, there is limited research on religious practices among Black churchgoers diagnosed with hypertension. This research aims to understand how religious practices influence self-care in Black churchgoers diagnosed with hypertension. The sample consisted of 21 Black men and women, ages 29 to 70 years, with a clinical diagnosis of hypertension. Participants were recruited from two local, predominately Black churches in South Carolina and administered semistructured interviews to participants. A grounded theory design was used, and the data analysis consisted of constant comparison. Two core concepts were identified. One core concept identified was …

The Influence Of Community-Based Interventions On Behaviors Of Hiv+ Persons In Congo-Kinshasa, Max Ebengho Bokelo

Walden Dissertations and Doctoral Studies

AbstractSub-Saharan African communities bear the highest burden of HIV/AIDS in the world. Because of identifiable cultural links and local beliefs, people are more likely to engage in sexual mores that could negatively impact their lives. Starting in early 2000, Congolese HIV+ patients have undergone a variety of inputs designed to decrease HIV risk behaviors among people. The purpose of this inquiry was to understand the impact of those actions within the community. Data grounded on the socioecological model were collected regarding any changes in (1) behavioral rejection of condoms, (2) Kintwidi phenomenon, (3) levirate and (4) sororate marriage, (5) sexual …

Developing A Clinical Practice Guideline For Colorectal Cancer Screening In Primary Care, Michelle Janise Berkley-Brown

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States for both men and women combined. CRC screening is an effective way to reduce mortality and morbidity related to the disease. Practitioners within primary care practices can play an essential role in encouraging people to be screened. Yet, CRC screening rates remain low in primary care practices. Evidence-based strategies are available to help practitioners improve CRC screening activities and improve screening rates. The lack of a clinical practice guideline (CPG) with strategies to help improve CRC screening interventions was identified as a practice gap for …

Patient Perceptions Of Access To Chronic Pain Medications, Lauren Amy Durham

Walden Dissertations and Doctoral Studies

AbstractThe 2014 Drug Enforcement Administration’s reclassification of hydrocodone combination products caused significant unintentional consequences to patients with chronic pain. Although a few researchers have looked at the problems that resulted immediately following the reclassification, none have as yet repeated their studies, creating a knowledge gap. Additionally, previous researchers have shown that most of the current opioid restricting policies in place today were not created using a strong evidence-based or ethically inclusive approach. The purpose of this study was to assess whether common factors identified as issues impacting care for these patients immediately following the reclassification continue to affect care standards. …

Perceived Health And Preventative Care In The Transgender Population, Gregory Page Carpenter

Walden Dissertations and Doctoral Studies

Historically, the transgender community has been treated and studied myopically, using the lens of psychological illness. As treatment and research efforts have expanded in the past decade, the transgender population is becoming better understood. The purpose of the study was to examine the relationship between perceived health and preventative care in the transgender community. The health belief model was the theoretical framework for this cross-sectional study, which included data from the 2014–2018 Behavioral Risk Factor Surveillance System Survey. Chi-square tests and binomial logistic regressions were performed to investigate associations between perceived health and preventative care in the transgender community. The …

Comparison Of The Therapeutic Efficacy Of Rheumatoid Arthritis Treatments, Kacy Smith Davis

Walden Dissertations and Doctoral Studies

Rheumatoid arthritis (RA) is an autoimmune condition that causes chronic joint pain and destruction. The current standard regimen of monotherapy disease modifying anti-rheumatic drug (DMARD) treatments may not be as effective as that of combination therapy of a DMARD and a biologic agent in treating RA. The purpose of this study was to answer the question, is there a difference in the therapeutic efficacy of combination DMARD treatments with a biologic, compared to monotherapy DMARDs without a biologic, in U.S. Caucasian women between the ages of 30 and 60 that have been diagnosed with RA? Guided by the theoretical framework …

Chronic Obstructive Pulmonary Disease Readmissions And Mortality In Veterans Administration Hospitals, Carolyne S. Davis

Walden Dissertations and Doctoral Studies

AbstractRates for chronic obstructive pulmonary disease (COPD) have continued to increase, resulting in readmission tracking by the Centers for Medicare and Medicaid for community hospitals and Veterans Health Administration (VHA) hospitals. By using the Andersen healthcare utilization model as the theoretical framework, the purpose of this quantitative correlational research was to examine differences in 4,879 COPD readmission and mortality rates in VHA hospitals for the four Veteran Administration (VA) regional districts—Northeast, Southeast, Continental, and Pacific—as well as and between rural and urban VA hospitals. Secondary data was acquired from an open website through the Centers for Medicare & Medicaid Services. …

Association Between Modifiable Risk Factors And Stroke Among Hispanics, Shanice Williams

Walden Dissertations and Doctoral Studies

Stroke is a significant public health issue that impacts the health of Hispanic adults. Understanding the multiple risk factors of stroke is an essential strategy to control the disease among this population. The purpose of this study was to examine the association between modifiable risk factors and stroke among Hispanics. The public health prevention framework guided this study. The research questions were designed to determine whether an association exists between modifiable risk factors for stroke among Hispanics. A quantitative, cross-sectional research design was used to conduct secondary analysis of the pooled 2017–2019 Behavioral Risk Factor Surveillance System annual surveys. The …

The Determinants Of Endometrial Cancer Survival Disparities In The United States, Evelyn Anegbe

Walden Dissertations and Doctoral Studies

Endometrial cancer is the most common gynecologic cancer in the United States with recent trends showing a continued increase in incidence and mortality. Prognosis is influenced by cancer stage at diagnosis and differs by race/ethnicity. Researchers have documented poorer survival among Blacks than Whites diagnosed with endometrial cancer. The 5-year survival rates for women with endometrial cancer is 81%; while survival for White and Black women are 84% and 62%, respectively. There is a gap in literature examining the widening disparity in incidence and survival of women diagnosed with advanced stage disease among population subgroups across the United States. The …

Sociodemographic And Psychosocial Factors And Wellbeing Among Adults 65 And Older In England, Dainelle Clark

Walden Dissertations and Doctoral Studies

The increased number of older adults living longer parallels with the growth of public health concerns regarding the impact of sociodemographic and psychosocial factors (e.g., loneliness and social isolation) on older adults' wellbeing. The purpose of this quantitative study was to examine the association between loneliness, social isolation, the combined model of loneliness, and social isolation on wellbeing among older adults when accounting for age, gender, ethnicity, and social support. The socioecological model (SEM) was used to evaluate the multiple levels of environmental determinants for loneliness, social isolation, and wellbeing. The target population included older adults 65 years and older …

Perceptions Of Caregivers Of Parkinson's Patients Regarding Using Advance Directives, Meghan Morgan

Walden Dissertations and Doctoral Studies

The increasing focus on end-of-life (EOL) care is influencing the role of advance directive (AD) documents. Difficult conversations among family caregivers and their loved ones are becoming more and more critical. Considering the value of communicating EOL wishes, family caregivers’ perceptions about ADs for their loved ones with Parkinson’s disease (PD) must be examined. Using the theory of planned behavior (TPB) as a foundation, the purpose of this generic qualitative study was to understand family caregivers of PD patients and their perceptions and experiences relating to AD documents. This study involved using purposeful sampling and semi-structured interviews with 11 family …

Relationship Between Trust, Race, And Health Care Information Sources Among African American Men, Uzochukwu Onukogu

Walden Dissertations and Doctoral Studies

AbstractAfrican American men have not been sufficiently at the center of research studies, especially when it comes to health. Most researchers have explored African Americans as a whole, and few have looked at African American men specifically, especially when it comes to their perceptions and ability to trust sources of health information. The purpose of this quantitative cross-sectional study was to examine the relationship between race and trust in health information sources, including the relationship between prostate cancer health outreach done through the internet and the acceptance of such information outreach among African American men. The theory of planned behavior …

Knowledge And Perceptions Of Antibiotic Resistance Stewardship Among Prehealth And Agriculture Students, Claudia Maria Da Silva Carvalho

Walden Dissertations and Doctoral Studies

The global threat of antibiotic resistant infection has resulted in health organizations to compile an antibiotic stewardship program, in which the education of current/future medical prescribers and farmers is central for the preservation of current and future antimicrobial treatments. The purpose of this study was to assess and compare the knowledge and perceived threat of antibiotic and antibiotic resistance, as well as the perceived benefit of antibiotic stewardship, among undergraduate students in biology and agriculture at a state university in Kansas. Framed by the health belief model, a cross-sectional study was conducted using a structured online survey of 136 undergraduate …