Public Health Commons^™

American Indians' Perceptions Of Obesity And Its Effects On Healthy Lifestyles, Morgan J. Foster

Walden Dissertations and Doctoral Studies

A disproportionate number of American Indians are overweight or obese and have a higher risk of other health concerns compared to the general United States population. Researchers conducting anthropometric studies have found that American Indians have higher body mass indices and worse health than most of the general United States population. There is, however, a gap in the literature regarding American Indians' perceptions, beliefs, opinions, and attitudes of obesity and its effects on their health. The purpose of this qualitative study was to determine whether American Indians view obesity as a major health concern. Focus groups and key-informant interviews were …

An Integrated Approach To Malaria Prevention And Control In Rural Cameroon, Naomi Chuiwo Azunie

Walden Dissertations and Doctoral Studies

Malaria is a life-threatening parasitic disease spread to humans through bites of an infected mosquito. In rural Cameroon, malaria is one of the major causes of morbidity and mortality. Several studies have examined the use of various malaria preventive tools; however, there is insufficient literature available on use of an integrated approach to prevent and control malaria in rural Cameroon. The aim of this study was to provide information necessary for bridging the gap in understanding the proper use of insecticide treated nets (ITNs) and antimalarial drugs and the roles of education and socioeconomic status in malaria prevention and control …

Culturally Competent Nutrition Counseling And Health Outcomes Of Patients On Emergency Dialysis, Edlyn Geraldine Bustamante

Walden Dissertations and Doctoral Studies

Undocumented end stage renal disease (ESRD) patients in the United States only have access to emergency dialysis. To compensate for the lack of regular dialysis these patients must follow strict renal dietary restrictions. However, nutrition counseling by a dietitian is not part of the renal management of patients on emergency dialysis. The purpose of this quantitative quasi-experimental treatment-control study was to assess how the application of nutritional counseling that is both culturally and linguistically competent affects dialysis frequency and biochemical lab values such as serum potassium, phosphorus, and vitamin D of patients in emergency dialysis. The study was grounded on …

Improving Fall Prevention Strategies In An Acute-Care Setting, Sylvia B. Boye-Doe

Walden Dissertations and Doctoral Studies

Falls with or without injuries among the elderly have become a public health concern, with falls among adults age 65 years and older increasing every year. Nurses play a role in ensuring patient safety by following fall prevention guidelines. The purpose of this evidence-based study was to implement the RE-AIM evaluation tool to determine the impact of the Safe Five program on staff compliance with the program; patients' awareness of the need for falls prevention; and falls among older adults, ages 65 years and older, admitted to an acute care nursing unit. The literature supports implementing a falls prevention program …

Impacts Of Observing Live Open Heart Surgery On Young Adults' Health Behaviors, Muhammad Musa Qarizadah

Walden Dissertations and Doctoral Studies

Having a heart healthy lifestyle at a younger age is beneficial in reducing the risk of coronary heart disease (CHD) in adulthood and various health education programs for CHD prevention exist to persuade young adults to adopt a heart healthy lifestyle. Little is known, however, about the influence of watching live open heart surgery on young adults' adoption of a heart healthy lifestyle. To address that gap in knowledge, this study was conducted at a health facility in Virginia where students came to observe live open heart surgery. The purpose of the study was to understand whether watching live open …

Evaluation Of Automated Reminders To Reduce Sepsis Mortality Rates, Maria M. Lindo

Walden Dissertations and Doctoral Studies

Sepsis is still a leading cause of death in the United States despite extensive research and modern advancement in technology. Early recognition of sepsis and timely management strategies are important for effective reduction of sepsis-related morbidity and mortality. Guided by the logic model, the purpose of this project was to evaluate the effectiveness of electronic reminders in enhancing clinical decision-making among 30 nurses in 3 medical-surgical units. The practice-focused question addressed the effectiveness of electronic reminders for early recognition and initiation of goal-directed treatment of sepsis in hospitalized patients on medical-surgical units in an effort to reduce sepsis mortality rates. …

Identifying Communication Barriers And Trust Issues Of Black Women Seeking Preventive Health Services In Houston, Texas, Melissa E. Shelton

Walden Dissertations and Doctoral Studies

Black women mortality rates are perceived to be impacted by communication barriers, trust issues, and the lack of quality preventive health services. The purpose of this phenomenological study was to explore communication barriers and trust issues perceived by Black women when seeking preventive health services. HMB was used to identify public attitudes around receiving preventive health services and to construct each question based on perceived susceptibility and perceived severity of communication barriers and trust issues. An ecological model of the communication process was used as a framework to identify fundamental relationships between the Black female patients and health care providers. …

Workers' Perceptions Of The Effect Of Three-Tier Shift Schedules On Community Functioning, Jillian Leigh Wallace

Walden Dissertations and Doctoral Studies

Shift work is commonplace in many fields that require around-the-clock employee coverage. There is ample evidence that two-tier shift work can detrimentally affect health and functioning. The purpose of this study was to understand the impact of three-tier shift schedules on physical and mental health and community functioning, a concept which refers to activities and behaviors performed by individuals or groups within a system. This study used a qualitative phenomenological design, and community functioning and recovery theory were central to the conceptual framework. In-depth interviews were used to explore the perceptions of three-tier shift workers on their functioning, relationships, mental …

The International Scientific Association For Probiotics And Prebiotics (Isapp) Consensus Statement On The Definition And Scope Of Prebiotics, Glenn R. Gibson, Robert W. Hutkins, Mary Ellen Sanders, Susan L. Prescott, Raylene A. Reimer, Seppo J. Salminen, Karen Scott, Catherine Stanton, Kelly S. Swanson, Patrice D. Cani, Kristin Verbeke, Gregor Reid

Department of Food Science and Technology: Faculty Publications

In December 2016, a panel of experts in microbiology, nutrition and clinical research was convened by the International Scientific Association for Probiotics and Prebiotics to review the definition and scope of prebiotics. Consistent with the original embodiment of prebiotics, but aware of the latest scientific and clinical developments, the panel updated the definition of a prebiotic: a substrate that is selectively utilized by host microorganisms conferring a health benefit. This definition expands the concept of prebiotics to possibly include non-carbohydrate substances, applications to body sites other than the gastrointestinal tract, and diverse categories other than food. The requirement for selective …

The 1939 Dickinson-Belskie Birth Series Sculptures: The Rise Of Modern Visions Of Pregnancy, The Roots Of Modern Pro-Life Imagery, And Dr. Dickinson’S Religious Case For Abortion, Rose Holz

Women's and Gender Studies Program: Faculty Publications

This multidisciplinary essay examines the hugely influential—yet surprisingly overlooked—Birth Series sculptures. Created in 1939 by Dr. Robert L. Dickinson (obstetrician-gynecologist and leader of the Planned Parenthood Federation of America) and sculptor Abram Belskie, they illustrate the process of human development from fertilization through delivery. First displayed at the 1939–1940 World’s Fair in New York City, they were reproduced in a variety of forms and sent out across the United States and overseas. Hardly a brief fad, their popularity persisted into the 1980s. This essay has four purposes. First, it tells the stories of Dickinson and Belskie to appreciate their contributions …

Predictors Of Obesity, Acculturation, And Perceived Stress In Meskhetian Turk (Ahiska) Immigrants In The United States, Zekeriya Temircan

Walden Dissertations and Doctoral Studies

Obesity is a risk factor for chronic diseases among the ethnic minorities for adult immigrants in the United States. There have been many research studies conducted to examine the relationship between the predictors and obesity in minority groups in the United States, that relationship was unknown in Meskhetian Turk (Ahiska) immigrant populations. Guided by social ecological model and acculturation theory, this study examined the predictors of obesity in the Meskhetian Turk (Ahiska) immigrant population in the western United States. Data were collected from 109 participants using CDC's Behavioral Risk Factor Surveillance System, Stephenson Multigroup Acculturation Scale, and Perceived Stress Scale. …

Barriers And Perceptions Of Black American Men About Prostate Cancer In Georgia, Martins M. Nnoko

Walden Dissertations and Doctoral Studies

In 2016, prostate cancer was the second leading cause of fatality in the United States. However, the population in this study 'Black American men, ages 40 and older, in selected counties in Fulton, DeKalb, Gwinnett, Clayton and Atlanta metropolitan areas' tended to underutilize prostate cancer care. The purpose of this quantitative, nonexperimental descriptive study was to determine whether socio-economic barriers and perceptions of Black American men about prostate cancer reduce their ability to access quality care in this county in Georgia. The Health Belief Model (HBM) was used to inform the predictive validity of perceptions, attitudes, and belief on individual …

Using An Apn-Led Transitional Care Program To Reduce 30-Day Hospital Readmissions, Miaozhen Li

Walden Dissertations and Doctoral Studies

Heart failure (HF) is a serious public health problem associated with high mortality rates, hospital readmissions, and health care costs. Transitional care has emerged as a disease management model used to reduce readmissions for hospital-discharged patients with HF. However, the efficacy of an advanced practice nurse (APN)-led transitional care program (TCP) in readmission reduction is under debate. The practice question for this project examined the extent to which an APN-led TCP was effective in reducing 30-day all-cause readmissions for hospital-discharged HF patients. The logic model was the framework guiding this program evaluation. An analysis of quality improvement HF data from …

Higher Education Leaders' Transformative Learning And Leadership Experiences Responding To Student Drug Abuse, James Vernon Battin

Walden Dissertations and Doctoral Studies

Today's academic and social environment creates uncertainties, new roles, frequent changes, and challenging situations for student affairs academic leaders. The purpose of this study was to explore how student affairs academic leaders described their recent challenging experiences in addressing student drug abuse in higher education. The conceptual framework was based on adult transformative learning theory and applied transformative leadership perspectives. An interview format with open-ended questions was used to explore the experiences of 8 student affairs leaders who had faced challenging situations in the context of student drug abuse. A qualitative interpretive analysis was used that involved open coding of …

Barriers To Preventive Healthcare For Immigrants In Michigan, Sondos Ghazi Al-Hachim

Walden Dissertations and Doctoral Studies

The Affordable Care Act expanded insurance coverage to the general population; however, expanding insurance coverage to immigrants might not be sufficient to improve utilization of annual physical preventive exams. This study evaluated adult Michigan immigrants' individual demographics, perceptions, and behaviors, as well as the collective cultural and system characteristics that might act as barriers to the utilization of annual physical preventive exams. Ken Wilber's integral operating system model for medicine conceptual framework was used to create a comprehensive map of factors and bring more clarity and understanding to the barriers to annual physical preventive exam. The quantitative survey was the …

Determinants Of Switching From Peritoneal To Hemodialysis In Preserving Residual Renal Function, Mohamed Katerji

Walden Dissertations and Doctoral Studies

There are more than 2 million end stage renal disease (ESRD) patients in the world. ESRD is becoming more manageable with the advent of competent therapies such as peritoneal dialysis (PD) and hemodialysis (HD). While recent evidence suggests that switching from PD to HD may preserve residual renal function longer than either PD or HD alone as an alternative approach, little is known about the optimal timing and the long-term efficacy of switching dialysis modes. The purpose of this quantitative retrospective study, based on the bio-psychosocial model, was to investigate the optimal timing and determinants of the effectiveness of switching …

Caring For Patients With Delirium In The Intensive Care Unit, Susan Archer

Walden Dissertations and Doctoral Studies

Patients in hospital intensive care units are at increased risk to develop delirium, a condition which is characterized by a disturbance of consciousness and a change in cognition. Critical care nurses must have the knowledge to assess, recognize, and manage delirium. The purpose of this project was to develop an evidence-based policy for the assessment of delirium and a comprehensive nursing education plan which included an analysis and synthesis of the literature, a curriculum plan, and a pretest/posttest. The Johns Hopkins Evidence-Based Practice Model framed the project, which used a multidisciplinary team approach. Two nursing leaders, each with a doctor …

Impact Of Hospital Closures On Families In Rural Communities, Onetha Dickerson

Walden Dissertations and Doctoral Studies

Closure of community hospitals directly impacts the health of rural populations and indirectly affects economic growth and access to medical services. The purpose of this doctoral project was to assess the causes and impacts of hospital closures on rural communities. The practice-focused question addressed the implications of hospital closures on individuals and families in rural communities. A systematic review of the literature, based on conflict theory, addressed populations that lack health care facility resources. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided the selection of 8 journal articles for review. The inclusion criteria for articles encompassed the impact …

Effect Of Physical Activity Frequency On Body Image Among Young Adult Women, Kristin Minter

Walden Dissertations and Doctoral Studies

Approximately half of all female adolescents and young adults suffer from body dissatisfaction and, in turn, body image-related health concerns. Poor body image can contribute to various negative health behaviors including low self-esteem, depression, anxiety, eating disorders, and suicide. Research indicates a positive relationship between physical activity and self-esteem, and between self-esteem and body image. However, a paucity of research examines the effect of physical activity frequency on the body image of young women with two-like body compositions, as measured by body mass index (BMI). Based on self-discrepancy theory, self-schema theory, and the health belief model, this quantitative study explored …

Understanding The Importance Of Culturally Appropriate Patient-Provider Communication In Diabetes Self-Management, Anita Mwalui

Walden Dissertations and Doctoral Studies

According to the Centers for Disease Control and Prevention, 29.1 million people in the United States have diabetes. Among those 29.1 million people, 21 million have been diagnosed, but 8.1 million have not. Changing demographics in the United States and the prevalence of diabetes are projected to be burdens on the health care system through 2050. Guided by the social cognitive theory, the purpose of this qualitative case study was to understand the importance of culturally appropriate patient-provider communication to the self-management of Type 2 diabetes by patients who are African immigrants. Culturally based health care has unique challenges when …

Contributing Factors Of Obesity Among Over-The-Road Truckers, Shari Weiss

Walden Dissertations and Doctoral Studies

Obesity among over-the-road truckers (OTRs) is an epidemic creating significant public health issues among this population. The consequences of obesity (hypertension, diabetes, heart disease) put both truckers' health and their medical clearance at significant risk. The purpose of this study was to examine the impact of gender, physical activity, diet, and sleep on obesity among OTRs. Through a socioecological lens, this study examined whether obesity is significantly impacted by gender, physical activity, nutrition, and sleep. This study also examined the impact of the trucking environment on obesity. The study used a quantitative research design and data were collected through a …

Nursing Student's Breast Cancer Knowledge And Breast- Self Examination Technique Confidence, Lydia E. Gaud

Walden Dissertations and Doctoral Studies

Breast cancer is the second leading cause of cancer death in women in the United States. Several factors have been identified that interfere with women's breast cancer screening practices, including lack of knowledge and confidence in the breast self-examination (BSE) technique, and lack of information provided by health care provider. One of the reasons nurses do not teach breast cancer detection could be the little emphasis given to breast cancer examination in nursing schools. The BSE is a measure of significant value in detecting cancer of the breast. However, less than half of the women in the United States are …

Testing A Psychological Readiness Training Intervention On Ptsd, Depression, Anxiety, & Stress In First Responders, Renee Kosor

Walden Dissertations and Doctoral Studies

Exposure to traumatic events is rare for the general public but common for first responders. However, there is little proactive emotional health care occurring inside the first responder community. No preventive treatment for depression, anxiety, stress, and PTSD exists. The purpose of this study was to determine the efficacy of a psychological readiness training intervention on 361 police officers and firefighters in a medium-size Midwestern city. A combined positive psychological capital and cognitive behavior therapy approach was used to frame the study. This study used a pretest, posttest quasi-experimental design. The participants were a convenience sample of 119 volunteers from …

A Secondary Analysis Of Survey Data Evaluating The Lifelines Suicide Prevention Program Among Middle School Students, Nicki Sullivan

DNP Projects

PURPOSE: The purpose of this study was to evaluate student feedback of the 2015 Lifelines Suicide Prevention Program at Jessie Clark Middle School. Student feedback was examined by assessing students’ knowledge of suicide, attitudes toward suicide, knowledge of when and from whom to seek help if feeling suicidal or told by a friend that they are suicidal, and impressions of the educational presentation following participation in the Lifelines Suicide Prevention Program.

METHODS: In this secondary analysis, anonymous student responses (N=269) from a 2015 middle school survey were examined by using a mixed method design with the quantitative study measures being …

Knowledge And Use Of E-Cigarettes And Risk Perception In Brazil: Results From A Country With Strict Regulatory Requirements, Tânia Maria Vavalcante, André Salem Szklo, Cristina De Abreu Perez, James Thrasher Phd, Moyses Szklo, Janine Ouimet, Shannon Gravely, Geoffrey T. Fong, Liz Maria De Almeida

Faculty Publications

Due to uncertainties about the impact of electronic cigarettes on health, Brazil adopted, in 2009, a regulation that prohibited the sale, importation and advertising of these products until manufacturers can demonstrate that they are safe and/or effective in smoking cessation. The objective of the study was to analyze among Brazilian smokers: (1) knowledge about the existence of electronic cigarettes, lifetime use, and recent use; (2) risk perception of e-cigarettes compared to conventional cigarettes; and (3) factors correlated with knowledge and perception of risk. This is a cross-sectional study among Brazilian smokers (≥ 18 years old) using a replacement sample from …

Physician Burnout Is Better Conceptualised As Depression, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Ronald Epstein and Michael Privitera reported that burnout affects more than half of practising physicians. The authors additionally warned against confusing burnout with depression. For two reasons we are concerned with the validity of these conclusions. First, there is now robust evidence that burnout is a depressive condition. Second, the published estimates of burnout’s prevalence rely on clinically groundless criteria, cobbled together without any rationale.

Your Teaching Strategy Matters: How Engagement Impacts Application In Health Information Literacy Instruction, Heather A. Johnson, Laura C. Barrett

Dartmouth Scholarship

The purpose of this study was to compare two pedagogical methods, active learning and passive instruction, to determine which is more useful in helping students to achieve the learning outcomes in a one-hour research skills instructional session.

Rural Community Health Needs Assessment Findings: Access To Care And Mental Health, Sabrina Cherry, Ayanna Robinson, Jared Jashinsky, Grace Bagwell-Adams, Michelle Elliott, Marsha Davis

Journal of Social, Behavioral, and Health Sciences

This article highlights the qualitative results from focus groups conducted as part of a Community Health Needs Assessments in two rural Georgia communities. Four 1-hr focus groups were facilitated with 32 community stakeholders. Sessions were audio recorded and transcribed verbatim. Thematic analysis identified two primary themes: mental health and barriers to accessing health care. Focus group participants discussed mental health challenges as they related to substance abuse and suicide. Participants acknowledged barriers to access, including no health insurance, cost, eligibility gaps for government-sponsored programs, the low availability of specialty care, and poverty. Addressing mental health and access to care in …

Designing Effective Messages To Promote Future Zika Vaccine Uptake, Jeanine Guidry

Theses and Dissertations

The Zika virus is associated with the devastating birth defect microcephaly, and while a vaccine was not yet available in early-2017, several were under development. It is imperative to identify effective communication strategies to promote uptake of a new vaccine, particularly among women of reproductive age. Moreover, though the Zika outbreak has received much social media attention, little is known about these conversations on Instagram. The purpose of this dissertation, therefore, was to understand current Zika-focused communication on Instagram and to inform effective communication strategies to promote future Zika vaccine uptake intent.

The study aims were: (1) explore Zika conversations …

Internet-Based Behavior Of It Professionals: Implications For Online Ergonomic Education To Prevent Work-Related Musculoskeletal Disorders, Priyadarshini Pattath

Theses and Dissertations

INTERNET-BASED BEHAVIOR OF IT PROFESSIONALS: IMPLICATIONS FOR ONLINE ERGONOMIC EDUCATION TO PREVENT WORK-RELATED MUSCULOSKELETAL DISORDERS

By Priyadarshini Pattath, Ph.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University Virginia Commonwealth University, 2017 Director: Dr. Robin Hurst, Assistant Professor of Adult Learning, Teaching and Learning,

School of Education

The purpose of this study was to explore the preferences of medium of ergonomic education and views about self-directed online training modules to prevent musculoskeletal disorders in computer professionals and understand their perspectives and experiences about online health information seeking using a …