Public Health Commons^™

Oromo Ethiopians Perceptions Of The Prevalence, Causes, Treatment And Prevention Of Trachoma, Linda L. Gross

Walden Dissertations and Doctoral Studies

In Ethiopia, one of the primary contributors to blindness is trachoma, which is an infectious ocular disease. There is no record of any prevention programs in rural Ethiopian villages of Oromia, where the prevalence of trachoma is high. The original purpose of this phenomenological study was to explore the perceptions of rural Oromo villagers in Ethiopia on the causes, treatment, and prevention of trachoma, using the health belief model and the social-ecological model as a theoretical framework. Due to a security situation in Ethiopia, final interviews were conducted with immigrant Ethiopians in the US, all of them from the trachoma-endemic …

Parental Perception Of Physician Cultural Sensitivity And Adherence To Asthma Treatment, Narue Jaynelle Wright-Jegede

Walden Dissertations and Doctoral Studies

In the United States, asthma remains a major cause of frequent urgent care visits, hospitalizations, and preventable deaths among children. Nationwide, the chronic disease continues to fall disproportionately on minorities, mostly residing in urban localities. When a child is diagnosed with asthma, the parents are typically tasked with managing the child's condition. Establishing a collaborative partnership between parents and their child's primary physician is significant for improving asthma self-management among youth. Using the theory of reasoned action as a theoretical framework, this mixed-methods study examined whether a relationship exists between parental perceptions of physician cultural sensitivity and parental care in …

Sexual Behaviours Of Adolescents In Creek Town, Cross River State, Nigeria, Kabiru K. Salami, Rowland E. Edet

Department of Sociology: Faculty Publications

Risky sexual behaviors of adolescents in Creek Town have not been fully profiled. This study investigated the sexual behaviors of adolescents and their various dimensions in Creek Town, in Cross River State, Nigeria. This cross-sectional survey design adopted multi-stage sampling procedure to administer a 112-items questionnaire to 422 adolescents, to elicit information on their sexual behaviors and practices. Four focus group discussion sessions were also conducted with in-school and out-of-school adolescents. The mean age of adolescents was 17 years. Majority (65.4%) of the adolescents were sexually active. The mean age at sexual debut was 15 years for both male and …

Implementation Of A Transcultural Nursing Education Program To Improve Nurses' Cultural Competence, Ann Marie Elizabeth Edwards

Walden Dissertations and Doctoral Studies

The exponential growth of culturally diverse populations in the United States has led to a multicultural patient population while the nursing workforce remains predominantly White. At the project site, managers identified that staff nurses struggled to deliver culturally competent care. The purpose of this project was to improve the cultural competence of registered nurses (RNs) through a transcultural nursing education program. Leininger's transcultural nursing theory guided the project. Sources of evidence used to develop a face-to-face educational program included peer-reviewed journals, credible websites, and the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-R tool. Aggregate pretest and …

Lived Experiences With Social Networking Technology To Improve Physical Activity, Paula Nobles Eubanks

Walden Dissertations and Doctoral Studies

Research suggests that Black women living in the United States are not engaging in sufficient physical activity, which is a major factor negatively impacting their health outcomes. Black Girls Run (BGR) is a targeted national health movement using the capacity of social networking technology as a tool to interact with and inspire Black women to live healthy through running. Literature lacked the voice and perspective of Black women who were embracing the innovation of technology to positively improve their health behaviors. The purpose of this qualitative phenomenological study was to gain a better understanding of the composite experiences of women …

Beliefs And Opinions Of Low-Income Residents Living In A Food Desert In A Gulf Coast State, Kimberly Lakeidra Willis

Walden Dissertations and Doctoral Studies

This study was an investigation of the access problem to fresh and affordable fruits and vegetables and how limited access influenced the beliefs and opinions of residents of a food desert as designated by United States Department of Agriculture. Many researchers have documented that price, availability, and transportation are barriers to fruit and vegetable consumption, particularly among low-income individuals. Researchers in other studies have concluded that these barriers are further exacerbated by an individual's distance from a supermarket or grocery store. However, much less information is available regarding the beliefs and opinions about life in a food desert and how …

Preventing Obesity And Type 2 Diabetes In Immigrant Populations, Maxwell K. Chikuta

Walden Dissertations and Doctoral Studies

Obesity-related diseases have been increasing in African immigrants throughout the United States. Although research has been done to identify risk factors associated with many ethnic groups in the United States, only a few studies exist that explore obesity and type 2 diabetes diseases among Central African immigrants. The conceptual framework for this qualitative case study was social constructivism and the health belief model. The primary research question addressed the potential underlying causes for an increase in obesity and type 2 diabetes among Central African Immigrants. The secondary research questions explored how culture, illiteracy, and religion contribute to the problem of …

Globalization Of Clinical Research And Assessment Of Global Access To Treatments Approved Between 2006-2015, Rafael Duncan Escandon

Walden Dissertations and Doctoral Studies

Globalization in clinical research and development has increased since the 1990s. Products approved in the United States (U.S.) and European Union (EU) include increasing numbers of research participants from low- and middle-income countries. The purposes of this quantitative correlational study were to investigate the lag time, or drug lag, between U.S. approval and the approval of selected drugs in all countries that hosted their pivotal clinical trials. The study population was limited to products approved first in the U.S. between 2006 and 2015. The health capability model and research for health justice framework were the theoretical frameworks for the study. …

Connecticut Primary Care Physicians And Chronic Lyme Disease, Yvette P. Ghannam

Walden Dissertations and Doctoral Studies

The prevalence of chronic Lyme disease (CLD) remains relatively unknown in Connecticut because there is not an agreement on what CLD is and how it should be diagnosed in addition to which pathological agent causes CLD. The aim of this quantitative study was to assess whether there were significant differences between two groups of primary care physicians (PCP) working in Connecticut from two different points in time regarding their knowledge in the diagnosis, treatment, and management of CLD. A knowledge, attitude, and practice model was used as the underlying theoretical framework for this study. A random cross-sectional survey was mailed …

Parental Perception Of Physician Cultural Sensitivity And Adherence To Asthma Treatment, Narue Jaynelle Wright-Jegede

Walden Dissertations and Doctoral Studies

In the United States, asthma remains a major cause of frequent urgent care visits, hospitalizations, and preventable deaths among children. Nationwide, the chronic disease continues to fall disproportionately on minorities, mostly residing in urban localities. When a child is diagnosed with asthma, the parents are typically tasked with managing the child's condition. Establishing a collaborative partnership between parents and their child's primary physician is significant for improving asthma self-management among youth. Using the theory of reasoned action as a theoretical framework, this mixed-methods study examined whether a relationship exists between parental perceptions of physician cultural sensitivity and parental care in …

Directory Of Services And Resources To Support Breastfeeding Initiation, Exclusivity, And Longevity In The El Paso Texas Region, Tiffany Nichelle Butler

Open Access Theses & Dissertations

Human milk is recognized as the ideal food for infants; however, in order for human milk to get to the infants, breastfeeding requires the support of the healthcare system. Among infants born in 2015 in United States, 4 out of 5 started to breastfeed and despite of this high rate, only 22% of mothers exclusively breastfed for 6 months. The decisions to breastfeed are influenced by multiple factors including breastfeeding education and support, hospital practices, and participating in tailored education programs. The Office of the Surgeon General has identified the need for healthcare systems to "guarantee continuity of skilled support …

Exploring The Association Between Post-Traumatic Stress Disorder And Social Connectedness With Quality Of Life Among High-Risk Hispanic Women Living In The U.S.-Mexico Border: A Mixed Methods Approach, Tamanna Ferdous

Open Access Theses & Dissertations

Quality of life (QOL) is an emerging significant public health concern. The QOL among the women living in the U.S.-MX border region is different than that of other parts of the United States. The unique characteristics of U.S.-MX border include lower socioeconomic status, immigration and acculturation challenges. These along with social, structural, and regional norms place individuals, particularly women, living in this region at high-risk for post-traumatic stress disorder (PTSD), substance use disorder (SUD), weakened social connectedness, and domestic violence, which in turn affect their QOL. The purpose of this study is to examine the effects of PTSD and social …

Psychologically Satisfying: Exploring Client Experiences With Dynamics Of Shared Decision-Making In Care From Prescribing Psychologists, Ashley Graboski-Bauer

Open Access Theses & Dissertations

The purpose of this study was to explore the field of prescribing psychology as it is practiced by providers and experienced by clients in New Mexico. Prescribing psychology is an emerging field of hybrid mental healthcare in which psychologists with special post-doctoral training can obtain prescriptive authority in certain jurisdictions. The study sought to take a client-centered approach to investigating the type and quality of care provided to clients by prescribing psychologists (RxPs). This study included a provider survey of knowledge, attitudes, and practices regarding health literacy and shared decision-making, and a client survey of satisfaction and experiences with care …

Association Between Education And Health Outcomes Among Adults With Disabilities: Evidence From Shanghai, China, Tong Ge, Qi Zhang, Jun Lu, Gang Chen, Mei Sun, Xiaohong Li

Community & Environmental Health Faculty Publications

Background

Adults with disabilities often have worse health outcomes than do their peers without disabilities. While education is a key determinant of health, there is little research available on the health disparities across education levels among adults with disabilities in developing countries. We therefore examined the association between health outcomes and education among adults with disabilities in Shanghai, China.

Methods

We used the health examination records of 42,715 adults with disabilities in Shanghai in 2014. Five health outcomes, including two diseases (fatty liver and hemorrhoids) and three risk factors (overweight [body mass index ≥ 24]), high blood glucose, and high …

Improving Access To Clean Water In Rural Ecuador: The Connection Between Willingness To Pay And Population Health, Micalea Leaska

Capstone Collection

Climate change is affecting social and environmental determinants of health through access to safe drinking water, safely managed sanitation systems, and access to health care services and the ability for individuals to break free from unsuitable circumstances. Ecological disturbances such as those caused by climate change can cause a shift in host vectors or a change in habitat that results in a greater likelihood of the pathogen coming in contact with humans. Water, sanitation, and hygiene (WASH) services and their accessibility to populations can directly impact a community’s vulnerability to diseases and limiting factors to increase economic growth. If rural …

What Influences Our Decision To Vaccinate? The Social Amplification Of Risk Framework And Vaccination, Laura B. Carper

International Crisis and Risk Communication Conference

The current study applies the social amplification risk framework to the anti-vaccination movement, specifically to the social factors that influence the likelihood to vaccinate. A total of 264 participants were recruited using Amazon’s Mechanical Turk engine and students from a large southern university. Participants responded to questions about their personal, friend, and family experiences with vaccines, their discussion about vaccines, and trust in vaccine literature (CDC, Facebook, family, etc.). Lastly, participants responded to a modified Duke’s social support scale. Results indicated that the likelihood to vaccinate is impacted by several social factors and that those factors can be amplified based …

Tweeting To Prepare: An Examination Of Government And Organizational Messages During National Preparedness Month, Jenna L. Currie-Mueller

International Crisis and Risk Communication Conference

Each year, disasters have devastating consequences in the United States. Consequences are long term and extend beyond the disaster’s immediate impact area. Establishing a culture of preparedness is necessary for the U.S. A prepared populace responds more effectively to disasters and is less stressful on community infrastructure and resources during the response phase. One of the ways government organizations and non-government organizations can encourage preparedness actions is via social media. This study examined preparedness messages existing independently of an emerging event disseminated on Twitter by government and non-government organizations. A total of 6,374 tweets were analyzed from data collected during …

Quality Improvement Initiative To Improve Patient Attendance In Diabetes Self-Management Education Classes, Charon Denise Randel

Walden Dissertations and Doctoral Studies

Diabetes self-management education (DSME) is a key resource in the battle against diabetes and its secondary effects. This quality improvement project was conducted to address the decreased attendance rates of DSME classes in a community health center in the southern United States. The practice question for this project explored process-related strategies to increase patient attendance in DSME classes. Based on review of patient reports of reasons for nonattendance and an evaluation of peer reviewed literature on improving attendance in DSME, the following strategies were implemented: (a) alternative solutions such as providing patients with the dates for a year of initial …

Cardiovascular Exercise Participation And Obstructive Sleep Apnea Among Adults Over Normal Weight In The United States, Marytherese Agwara

Walden Dissertations and Doctoral Studies

Obstructive sleep apnea (OSA) is a type of sleep apnea that is common, complicated, and a major contributor to cardiovascular diseases, neurocognitive impairment, and mortality. This disease has additional negative impacts on patients' lives by contributing to daytime sleepiness and low productivity at work as well as absenteeism and work-related injuries. Several studies have been conducted to assess the relationship between cardiovascular exercises and OSA; however, a definite conclusion is lacking. The purpose of this quantitative cross-sectional study was to assess the relationship between cardiovascular exercise participation and OSA by examining the relationship between total cardiovascular exercise participation per week …

Characteristics Of Young People Seen In The Emergency Department For Assault-Related Injuries, Robyn Coons

Walden Dissertations and Doctoral Studies

Violence is among the most serious threats to the health and safety of young people between the ages of 10 and 24 in the United States. The purpose of this cross-sectional quantitative study using secondary data from the CDC's 2015 National Hospital Ambulatory Medical Care Survey (NHAMCS) data set was to examine the characteristics (age, sex, race and ethnicity, insurance or payer source, and housing status) of young people between the ages of 10 and 24 who seek medical care for assault-related injuries through the emergency department (ED). The social ecological model was used to examine the complex interplay between …

Evaluation By Geospatial And Spatiotemporal Distribution Of Tularemia Cases In Arkansas, Toni Kathleen Beavers

Walden Dissertations and Doctoral Studies

Tularemia is a vector-borne disease of global concern with diverse regional foci. Arkansas is an endemic state with differences in case distribution and land suitability supporting host and vector sustainment. The aim of this study was to conduct a geospatial and spatiotemporal assessment of factors associated with case distribution and timeliness and completeness of public reporting. Guided with direction from spatial epidemiology and nidality, referring to the association of ecology, climate, and proximity of disease, analysis included secondary data collected from the Arkansas Department of Health between 1995 and 2018. Using Poisson-based software, 2 clusters were found: a high-risk cluster …

Factors Contributing To High Readmissions For Congestive Heart Failure Among African Americans, Shavonda Caprice Devereaux

Walden Dissertations and Doctoral Studies

Abstract

African Americans are disproportionately affected by heart failure, with prevention and treatment of heart failure being a public health concern in the United States. The purpose of this retrospective quantitative study was to examine the primary variable race, specifically African Americans, and how this variable relates to 30-day readmission post discharge when controlled with geographic location (urban vs. rural), gender, and insurance status. The expanded chronic care model was used as a framework to shape health promotion, prevention efforts, and social determinants of health and to enhance community involvement related to chronic disease issues. The research questions were focused …

Staff Education Program On Diabetes Using Self-Care Behaviors, Ruth Adhiambo Ogot

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus affects patients' health across the globe and is costly to manage. The chronic high blood sugar of diabetes is linked to cardiovascular and kidney damage, impaired functional status, and multiple organ failure. To lessen the complications associated with diabetes and promote self-care in those with the disease, health care professionals must be vigilant in offering diabetes education to patients with each clinic or primary care visit. Lack of diabetic educators in the clinic that provided the setting for this study indicated a need to increase clinical staff competency in teaching self-care and diabetes management to patients. …

The Relationship Between Limited Partner Availability, Masculine Ideologies, And Condom Use, Diakima Y. Thomas

Walden Dissertations and Doctoral Studies

One in every 4 people living with the Human Immunodeficiency Virus (HIV) are women. The leading cause of infection is heterosexual contact. The purpose of this quantitative, correlational study was to examine the relationship between gender ratio perception and masculine ideology and a woman's decision to use condoms during her sexual activity. The theory of gender and power and the theory of planned behavior served as the theoretical frameworks for this study. The perceptions of gender ratios, as measured by the Gender Ratio Imbalance Beliefs and Behaviors Scale (GRIBBS) subscale, GRIBeliefs, and masculine ideologies, as measured by the Gender Role …

Factors Affecting Breastfeeding In Preterm Infants, Evangeline Starks Glover

Walden Dissertations and Doctoral Studies

Even though initiation of breastfeeding among term and preterm infants has increased, the incidence and duration among preterm infants continues to lag because of the unique challenges of breastfeeding preterm infants. African American mothers have the lowest rates of breastfeeding initiation and duration, and their preterm infants are less likely to receive breast milk while in the neonatal intensive care unit. The objective of this cross-€sectional quantitative study was to evaluate the relationship between breastfeeding and maternal sociodemographic factors as well as medical and obstetrical conditions for infants born between 32-€37 weeks gestational age in South Carolina from 2009 to …

Psychosocial Consequences Of Parental Wrongful Conviction On Children, St.Jean Jeudy

Walden Dissertations and Doctoral Studies

This qualitative multiple-case study sought to provide an in-depth understanding of how children living in broken families-due to the wrongful conviction of parent(s)-developed psychosocial issues. The theoretical frameworks applied to this study were the social learning theory, the social control theory, the role-modeling theory, and the general theory of crime. A purposeful sample of 13 adults who were children at the time of their parents’ wrongful incarceration were drawn for phone and in-person interviews. The data were transcribed and analyzed to code, sort, and organize; to analyze connections in the information, and to compare and contrast cases. The multiple-case study …

Strategies For Patient Engagement In A Self-Management Program For Adults With Diabetes, Carolinee Jokotola Ogungbayi

Walden Dissertations and Doctoral Studies

Patients' lack of adherence to diabetes self-management education and support (DSMES) recommendations is a challenge for healthcare. One approach to addressing patient noncompliance with DSMES is through education of staff on current guidelines. In an outpatient facility in South Texas, staff training on current DSMES guidelines was recommended as one of the solutions to the problem of Type 2 diabetes mellitus (T2DM) complications observed among clinic patients. An educational module was created to increase staff knowledge on T2DM and to assist staff members in teaching patients to self-manage T2DM. The module was built on the self-management and health promotion models, …

Predicting Outcomes Of American Youths' Shift Toward E-Cigarette Use, D J. Resendez

Walden Dissertations and Doctoral Studies

There has been a shift toward e-cigarette use and away from tobacco smoking among American youth. Despite effects of ongoing public health campaigns that bring attention to the harmful effects of tobacco and nicotine use generally, youths might not perceive e-cigarette use to be unhealthful in terms of psychological functioning. This study was an investigation of the impact of the method of tobacco use (cigarette or e-cigarette), past cessation attempts, cravings or needs to use tobacco, and serious cognitive difficulties, upon youths' intentions concerning future tobacco usage. The conceptual framework was based upon the self-medication hypothesis, biopsychosocial model, and social …

Cultural Factors Affecting African Americans Of Caribbean Descent With Type Ii Diabetes, Ruth Runette Aguy-Paulsaint

Walden Dissertations and Doctoral Studies

Type II diabetes is a significant problem in the United States that had affected almost 10% of the American population and over 13% of African Americans. Although culturally competent diabetes education and treatment programs have been significantly more successful, little is known about the cultural factors affecting type II diabetes in African Americans of Caribbean descent (AACD). The purpose of this qualitative, phenomenological study was to explore the cultural factors relevant to the treatment and prevention of type II diabetes among AACD. The theoretical framework for the study consisted of cultural adaptation theory and the transtheoretical model. Data collection consisted …

Perceptions Of Access To Healthcare In Cameroon By Women Of Childbearing Age, Wenceslaw Chap Chapnkem

Walden Dissertations and Doctoral Studies

Increased poverty and unemployment rates, minimal investment in social amenities, a shortage of healthcare professionals, poor infrastructure, inadequate social services, and poor institutional and political leadership have weakened the healthcare status of Cameroon's women who have reached the age of childbearing. The World Health Organization expressed increased urgency for healthcare providers and patients to develop new healthcare policies to eliminate health-related disparities. The aim of this phenomenological study was to examine the perceptions of women of childbearing age living in Mamfe rural community in regard to Cameroon's healthcare system and its impact on their lives. The theoretical foundation of the …