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Full-Text Articles in Public Health

Racial Disparities In Periconceptual Folic Acid Levels, Kelvin Gibson Jan 2020

Racial Disparities In Periconceptual Folic Acid Levels, Kelvin Gibson

Walden Dissertations and Doctoral Studies

Periconceptional folate level deficiencies are associated with birth defects of the brain and spinal cord, posing a significant public health problem. In 2009, Black and Hispanic women exhibited lower periconceptual folate levels and higher rates of folate-related birth defects compared with non-Hispanic White women, prior to enactment of the Affordable Care Act (ACA) of 2010. It is not known if improved access to prenatal care under the ACA narrowed the gap in mean periconceptual folate levels between non-Hispanic White, Black, and Hispanic women between 2009 and 2017. The purpose of this causal-comparative cross-sectional quantitative study was to determine whether there …


Socioeconomic And Health-Related Factors Affecting Congestive Heart Failure Readmissions, Jollibyrd Miguel Gusto Jan 2020

Socioeconomic And Health-Related Factors Affecting Congestive Heart Failure Readmissions, Jollibyrd Miguel Gusto

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) readmissions are frequent and costly, but preventable. These readmissions not only contribute to rising healthcare cost but also affect the quality of life of these individuals and their loved ones. Guided by the social ecology model for health for health promotion, the purpose of this study was to analyze the socioeconomic and health-related factors of CHF readmissions. The main hypothesis of this study was that there was a relationship between 30-day readmissions of individuals with CHF and their payer status, race, ethnicity, primary language spoken, living arrangement, and comorbidities in the dataset as identified in their …


Sexual Education, Sexual Initiation, And Contraceptive Use Among African American Young Women, Kineka J. Hull Jan 2020

Sexual Education, Sexual Initiation, And Contraceptive Use Among African American Young Women, Kineka J. Hull

Walden Dissertations and Doctoral Studies

Unintended pregnancy is associated with adverse social, economic, and health outcomes making it a public health concern. African American (AA) women aged 18–24 are at higher risk of unintended pregnancy due to earlier sexual initiation and non-use, inconsistent, or improper use of contraceptive methods (CM). The purpose of this study was to investigate the extent to which receipt of formal sexual health education (FSHE) impacts age of sexual initiation and contraceptive use and selection of more effective CMs (ECMs) among AA women aged 18–24 (N = 242) who have sex with men. Driven by the reasoned action approach, 2015–2017 National …


Primary Care Physicians’ Knowledge And Perception Of The Impact Of Health Literacy On Patient Care, Lutrisha S. King Jan 2020

Primary Care Physicians’ Knowledge And Perception Of The Impact Of Health Literacy On Patient Care, Lutrisha S. King

Walden Dissertations and Doctoral Studies

Until recently, many health literacy studies were completed from the patient and nurse perspective, while few focused on the physician perspective, specifically the primary care physician. The purpose of this study was to provide insight into the health literacy knowledge and education of primary care physicians and determine the association, if any, between physicians’ perceptions of patients’ limited health literacy and physicians’ use of health literacy communication techniques. The knowledge, attitudes, and practice (KAP) framework directed this study. This framework posits that knowledge informs or influences attitudes, which leads to practices. The KAP framework was employed to answer the research …


Microvascular Disease And Chronic Kidney Disease In Persons With Diabetes In Grenada, Jennifer Elizabeth Lewis Jan 2020

Microvascular Disease And Chronic Kidney Disease In Persons With Diabetes In Grenada, Jennifer Elizabeth Lewis

Walden Dissertations and Doctoral Studies

Chronic kidney disease (CKD) is a set of pathophysiological reactions that impact the functionality of the kidney. The association between microvascular disease (MVD) and CKD as it relates to diabetes is important to the evaluation of organizational effectiveness in-hospital services planning as well as improving health outcomes. The purpose of this quantitative, cross-sectional study was to determine if there is an association between MVD and CKD severity in persons with diabetes. Using the socioecological model, the association between gender, age group, cigarette smoke, cigarette smoke frequency, alcoholic drink, alcoholic drink frequency, hypertension, albumin-to-creatinine ratio (ACR) severity, cholesterol, sickling (i.e. persons …


Assessing School-Based Telehealth Utilization In Medically Underserved Communities, Danielle Wesley Jan 2020

Assessing School-Based Telehealth Utilization In Medically Underserved Communities, Danielle Wesley

Walden Dissertations and Doctoral Studies

Medically underserved communities face challenges accessing health care services, and millions of Americans have no access to primary care. In many areas of the United States, the supply of primary care providers cannot keep up with the demand for health services. Newer healthcare delivery models are needed to address the issue. Using telehealth can augment the physician workforce shortages. The purpose of this quantitative dissertation is to examine the associations of telehealth utilization using a pediatric school-based telehealth model in Health Professional Shortage Areas (HPSAs) in North Texas. Texas has many counties without a primary care provider, making them medically …


Environmental Barriers To Accessing Tertiary Prevention Among Hispanics Diagnosed With Type 2 Diabetes, Stella B. Biira Jan 2020

Environmental Barriers To Accessing Tertiary Prevention Among Hispanics Diagnosed With Type 2 Diabetes, Stella B. Biira

Walden Dissertations and Doctoral Studies

In the United States, Hispanics diagnosed with type 2 diabetes (T2DM) have not accessed tertiary level prevention, which is critical in diabetes management and the prevention of further complications. The purpose of this quantitative study was to examine the association between neighborhood crime, the absence of community health centers, the lack of culturally competent providers, the lack of public transportation, the residential setting, the distance to T2DM education classes, and access to tertiary prevention among Hispanics diagnosed with T2DM. The research was guided by the Andersen behavioral model. A sample size of N = 4,977 was used in the study, …


Family Rejection And Unprotected Sex Inlatino Gay Men, Juan Alejandro De Llano Montano Jan 2020

Family Rejection And Unprotected Sex Inlatino Gay Men, Juan Alejandro De Llano Montano

Walden Dissertations and Doctoral Studies

The present work explored the role of family rejection on the sexual behavior of Latino gay men under the guidance of the minority stress model. Family rejection was analyzed as a distal stressor, self-esteem as a proximal stressor, and unprotected sex as the outcome. The hypotheses were tested using regression, mediation, and multiple regression of secondary data from the Latino men who have sex with men (MSM) community involvement project. The results suggested that family rejection is a weak predictor of low self-esteem and engaging in receptive unprotected sex with more partners. Low self-esteem did not mediate the relationship between …


Treatment Disparities In Black And Hispanic Children With Attention-Deficit Hyperactivity Disorders, Charlotte Seiji Frey Jan 2020

Treatment Disparities In Black And Hispanic Children With Attention-Deficit Hyperactivity Disorders, Charlotte Seiji Frey

Walden Dissertations and Doctoral Studies

Disparity in diagnosis and treatment of attention deficit hyperactivity disorder (ADHD) among children has been studied; however, no known studies examining disparities based on severity of symptoms have been investigated. The purpose of this study was to assess the racial disparities in diagnosis and treatment that exist among children based on severity of symptoms. This cross-sectional quantitative analysis used data from the 2016 National Survey of Children's Health and the theoretical foundation was guided by the behavioral model of healthcare utilization and help-seeking behavior for ADHD. Binomial logistic regression analysis showed an overall association between race and the diagnosis and …


Neighborhood Factors, Depression, And Body Mass Index Among Patients With Lupus In Georgia, Aisha L. Hill Jan 2020

Neighborhood Factors, Depression, And Body Mass Index Among Patients With Lupus In Georgia, Aisha L. Hill

Walden Dissertations and Doctoral Studies

Elevated BMI (overweight and obesity) is a common health-related issue and affects more than half of the lupus population. Weight issues lead to additional health-related issues, such as heart disease and disabilities in the lupus population. To address the shortage of research focusing on this specific issue in the lupus population, one approach is a novel outlook on how neighborhood factors have the capability of determining or altering behaviors, such as physical activity, healthy eating, and healthy social relationships. Another variable to consider is depression and its capability of altering interactions, relationships, self-esteem, or even the inflammatory state of the …


Factors Associated With Flu Vaccination Status Among Older Hispanics In The United States, William Esteban Toledo Velazquez Jan 2020

Factors Associated With Flu Vaccination Status Among Older Hispanics In The United States, William Esteban Toledo Velazquez

Walden Dissertations and Doctoral Studies

AbstractOlder Hispanics in the United States are less likely to be vaccinated with the flu vaccine compared to older White Americans, despite being at higher risk of influenza-associated deaths and hospitalizations. A quantitative cross-sectional study based on the social ecological model was carried out to evaluate the influence of several sociodemographic and health factors on flu vaccination status among elderly Hispanic individuals in the United States. Logistic regression analyses were conducted using secondary data collected from 95,414 elderly Hispanic and White American 2018 Behavioral Risk Factor Surveillance System participants. Multivariate logistic regressions controlling for other variables revealed health care coverage …


Understanding Characteristics Of Chronic Obstructive Pulmonary Disease Readmissions In An Acute Care Hospital, Jordan Danyale Brautigam Jan 2020

Understanding Characteristics Of Chronic Obstructive Pulmonary Disease Readmissions In An Acute Care Hospital, Jordan Danyale Brautigam

Walden Dissertations and Doctoral Studies

Patients suffering from chronic obstructive pulmonary disease (COPD) not only face difficulties managing their disease but are also faced with a higher risk of being readmitted to a hospital after an initial visit for acute exacerbation of their condition. Despite hospitals’ many attempts to offset this burden, readmission reduction programs are not effective. The purpose of this quantitative study was to further research an organization’s specific population surrounding patient comorbidities, reasons for readmissions, and demographic characteristics that may lend insight into reasons for readmissions. The research design was a retrospective analysis of a health system’s electronic medical record with a …


Perceptions On Maternal Mortality Among The Ekpeye Community, Theresa Tenim Ogide-Alaeze Jan 2020

Perceptions On Maternal Mortality Among The Ekpeye Community, Theresa Tenim Ogide-Alaeze

Walden Dissertations and Doctoral Studies

In Africa, especially Nigeria, maternal mortality is a public health issue among women of childbearing age (WCBA). WCBA living in the Ekpeye community located in Rivers state in Nigeria are at high risk of maternal deaths during pregnancy and labor or delivery. Data were obtained through key informant interviews with 9 relatives, friends, and health workers. The purpose of the key informant interviews was to identify perceived barriers that result in high maternal deaths and facilitators seen as promoters to reduce pregnancy-related deaths. The participants identified 11 core themes as contributors to maternal death: (a) postpartum death, (b) financial insecurity, …


The Relationship Between Cervical Cancer And Women Living With Disabilities In Kentucky, Carolyn Akakpo Jan 2020

The Relationship Between Cervical Cancer And Women Living With Disabilities In Kentucky, Carolyn Akakpo

Walden Dissertations and Doctoral Studies

AbstractDespite many national interventions, cervical cancer (CC) rates persist, and in Kentucky (KY), CC incidence rates are on the rise. Additionally, women with disabilities face more barriers to secondary prevention and healthcare access, have more known risks, and experience more health disparities than women without disabilities. Given that 1 in 4 persons live with a disability, the purpose of this observational, cross-sectional, quantitative study was to explore the relationship between CC and women with disabilities as evidenced by reproductive cancer discharges from inpatient hospital (IHD) and outpatient services databases (OSD) so as to compare population-specific differences from social determinants of …


Health Systems Predictors And Trends Of Access To Vaccinations In 9 Sub-Saharan African Countries, Mirfin Mpundu Jan 2020

Health Systems Predictors And Trends Of Access To Vaccinations In 9 Sub-Saharan African Countries, Mirfin Mpundu

Walden Dissertations and Doctoral Studies

The purpose of this ecological quantitative study was to examine the predictors of health systems building blocks and their interactions in improving access and uptake of immunizations in nine sub-Saharan African countries. Immunization rates in this region remain lower than global targets leading to preventable diseases and mortality. Using the systems approach, the study examined the relationships among five independent variables: quality of service delivery, governance, vaccine supply, health financing, socioeconomic factors and the dependent variable, access to immunizations. Datasets from the WHO and UNICEF were used. Analysis included a series of descriptive statistics, logistic and linear regression, and correlations. …


Translation And Validation Of The Hplp-Ii From English To Armenian, Zoya Minasyan, Leslie C. Hussey Sep 2019

Translation And Validation Of The Hplp-Ii From English To Armenian, Zoya Minasyan, Leslie C. Hussey

Journal of Excellence in Nursing and Healthcare Practice

As the focus of healthcare shifts toward the social determinants of health, more information about health disparities between different ethnic communities is needed. The Health Promoting Lifestyle Profile II (HPLP-II) is an instrument that measures health promotion behavior across various cultural lines. This article describes the translation and validation of the HPLP-II from English to Armenian for the purpose of studying health promotion behavior among the hypertensive and normotensive Armenian American population and addressing health disparities among this community. Translating the HPLP-II required a multistep process to capture cultural linguistic adjustment. First, the researcher, a local bilingual professor, and a …


Neighborhood-Level Predictors Of Obesity Among African American Children In California, Uche Onyeka Jun 2019

Neighborhood-Level Predictors Of Obesity Among African American Children In California, Uche Onyeka

Journal of Social, Behavioral, and Health Sciences

The increased prevalence of childhood obesity is a major public health concern nationally and globally. Childhood obesity is primarily caused by the imbalance between caloric intake and caloric expenditure; however, its increase over the past decades may be due to environmental and behavioral factors. The purpose of the current study was to examine if any relationships existed between childhood obesity, level of physical activity, and neighborhood-level risk factors. This study used the California Health Interview Survey 2009–2014 data sets for African American children aged 5–11 years (n = 1,049). The dependent variable was body mass index (BMI) while the …


Social Ecological Predictors Of Risky Sexual Behavior Among Young Adults, Maureen Muchimba Feb 2019

Social Ecological Predictors Of Risky Sexual Behavior Among Young Adults, Maureen Muchimba

Journal of Social, Behavioral, and Health Sciences

Most studies on sexual behavior outcomes are restricted to adolescents. However, rates of sexually transmitted diseases (STDs) are highest among young adults. This study examined social–ecological predictors in adolescence that predict risky sexual behavior in young adulthood. Using longitudinal data, logistic regression was used to determine social–ecological factors that predict early sexual debut and a high number of lifetime sexual partners among 3,109 young adults. Risk-taking was associated with early sexual debut and a high number of lifetime sexual partners. Father–child connectedness decreased the odds of early sexual debut and a high number of lifetime sexual. School connectedness also decreased …


Experiences Of Formal Caregivers Providing Dementia Care To American Indians, Damon Grew Peter Syphers, C.J. Schumaker, Ronald P. Hudak Jan 2019

Experiences Of Formal Caregivers Providing Dementia Care To American Indians, Damon Grew Peter Syphers, C.J. Schumaker, Ronald P. Hudak

Journal of Sustainable Social Impact

Alzheimer’s disease (AD) is a significant public health concern for all elders in the United States. It is a particular concern for the American Indian (AI) population, which is one of the fastest aging populations in the United States and the smallest, most underrecognized, and most culturally diverse group in the country. A formal caregiver understanding of AD in the AI population is scarce. This phenomenological study was designed to discern what is known about AD in the AI population by exploring the cultural beliefs and experiences of formal caregivers who provide care for AI dementia patients. Specifically, this study …


Effects Of Psychiatric Hospital Closures On Local Jail Administrators, Correctional Staff, And Inmates, Mark Christian Lasko Jan 2019

Effects Of Psychiatric Hospital Closures On Local Jail Administrators, Correctional Staff, And Inmates, Mark Christian Lasko

Walden Dissertations and Doctoral Studies

A series of psychiatric hospital closures has led to a movement of care for individuals with mental illness from state-run facilities to managed care centers. Many of the individuals who no longer reside in psychiatric hospitals have become ensnared in the criminal justice system. Correctional facilities have an increased burden to care for the needs of the mentally ill, but lack the training and facilities to do so adequately. In this study, the lived experiences of correctional staff who have experienced the process of a hospital closure were examined. Psychiatric rehabilitation and gatekeeper theories served as the theoretical framework for …


Lived Experiences Of African American Females With Breast Cancer Treatment Access, Tamika Chantey Smith Jan 2019

Lived Experiences Of African American Females With Breast Cancer Treatment Access, Tamika Chantey Smith

Walden Dissertations and Doctoral Studies

Breast cancer (BC) is a significant condition that can result in devastating outcomes without treatment. The purpose of this phenomenological study was to explore barriers to health care disparities among young African American females. The findings of this study may help to address gaps in knowledge, obtain insights in treatments, and comprehend lived experiences with BC. The theoretical framework for this study was Bronfenbrenner's social ecological theory. Data were collected from face-to-face interviews with 10 African American women ages 20 to 40. Data were then transcribed and coded. The findings of the study indicated that women required treatment plans, informative …


Social-Emotional Support As A Mediator Of Household Structure And Mental Distress In Women, Trisha Jeanine Walker Jan 2019

Social-Emotional Support As A Mediator Of Household Structure And Mental Distress In Women, Trisha Jeanine Walker

Walden Dissertations and Doctoral Studies

Mental illness affects more women than men in the United States. Poor mental health in reproductive-age women has negative implications on population health. The purpose of this quantitative, correlational study was to examine the relationship between household structure and frequency of mental distress, with consideration of the mediation social-emotional support provides for reproductive-age women. The social ecological model was the theoretical framework for this research, in which frequency of mental distress related to the individual-level of the human-environment interaction construct. Household structure and social-emotional support were examined at the relationship-level. Pearson's correlation coefficient and linear regression were used to conduct …


Simulated Clinical Experience: An Investigation Of Emotion Understanding And Management, Neena White Jones Jan 2019

Simulated Clinical Experience: An Investigation Of Emotion Understanding And Management, Neena White Jones

Walden Dissertations and Doctoral Studies

Many investigators have documented that lack of emotional intelligence (EI) in professional nursing correlates with patient dissatisfaction, negative patient outcomes, and litigation. However, much less information is available to nurse educators for an effective instructional strategy to increase EI skills, specifically emotion understanding and management (the most influential branches of EI) in nursing students. Grounded in the theory of EI and the theory of simulation, the purpose of this quantitative quasi experimental study was to introduce educational technology as a useful strategy for influencing EI in a convenience sample of 88 second semester students in a baccalaureate program. Research questions …


Natural Environment Associations With Mental Health And Obesity Status, Adam Edwin London Jan 2019

Natural Environment Associations With Mental Health And Obesity Status, Adam Edwin London

Walden Dissertations and Doctoral Studies

Mental health and obesity were ranked among the health priorities of the 2014 and 2017 Community Health Needs Assessments in Kent County, Michigan. Exposure to nature is correlated to improved health outcomes across a variety of morbidities including poor mental health and obesity. This cross-sectional study set within the frameworks of attention restoration theory, environmental health, and pathways to health benefits from nature assessed county survey data including self-reported nature exposures/interactions separated into 3 domain areas: access to nature, attitudes about nature, and physical activity in nature or in nature-based activities. Binary logistic regression analyses of the 653 respondents found …


The Role Of Glucose Level On The Performance Of The Framingham Risk Score, Uohna June Thiessen Jan 2019

The Role Of Glucose Level On The Performance Of The Framingham Risk Score, Uohna June Thiessen

Walden Dissertations and Doctoral Studies

Cardiovascular diseases (CVD) are responsible for more deaths than any other disease, continue to threaten the quality of life for many, and is a major burden to the health care system. The Framingham Heart Study (FHS) identified the major CVD risk factors that became essential to effective CVD screening strategies and the Framingham Risk Score (FRS), is used to assess CVD risk. Based on the concepts of the health behavior model and CVD as a cardiometabolic disorder, multivariate logistic regression analysis was used to evaluate the association between fasting blood glucose (FBG) levels and a CHD event, and to determine …


A Geographic Study Of Lung And Bronchus Cancer Rates In Kentucky, Gabriel Njoh Dikong Jan 2019

A Geographic Study Of Lung And Bronchus Cancer Rates In Kentucky, Gabriel Njoh Dikong

Walden Dissertations and Doctoral Studies

The average age-adjusted incidence and mortality rates of lung and bronchus cancer is 55% and 56% higher in Kentucky than the national averages in the United States, respectively. Populations with low income and educational attainment, and those who live close to the mining regions across Kentucky are more affected by the high prevalence and resulting mortality rates of lung and bronchus cancer. This study was conducted because of the high incidence of lung and bronchus cancer and resulting mortality rates in the state of Kentucky that may not be caused solely by social and demographic factors. The theoretical foundation for …


Associations Between Healthcare Utilization Factors And Diabetic Retinopathy Among Adult African Americans, Olusina Adesanya Jan 2019

Associations Between Healthcare Utilization Factors And Diabetic Retinopathy Among Adult African Americans, Olusina Adesanya

Walden Dissertations and Doctoral Studies

African Americans are disproportionately affected by diabetes mellitus (DM) and complications that include diabetic retinopathy and its disease and socioeconomic burdens. This study examined the relationships between diabetic retinopathy and health care utilization factors, such as gender, DM comorbidities of hypertension and hyperlipidemia, and health care access, among sampled African Americans with DM in the United States. The Andersen health care utilization model was the framework for the study. In this correlational cross-sectional study, data from the 2011-2016 National Health and Nutrition Examination Survey datasets were analyzed. Results of complex samples logistic regression showed that there were no significant associations …


Caregiver Review Of Nonpharmacological Interventions For Behavioral Symptoms Associated With Dementia, Karla Chaney Ballew Jan 2019

Caregiver Review Of Nonpharmacological Interventions For Behavioral Symptoms Associated With Dementia, Karla Chaney Ballew

Walden Dissertations and Doctoral Studies

Alzheimer’s disease (AD) is the most common form of dementia and affects an individual’s overall cognitive function, including orientation, memory, and executive function. Most AD patients in the United States reside in residential care facilities or private homes under the care of individuals with little education on the challenges of the AD patient. Among the challenges faced by caregivers are behavioral and psychological symptoms related to dementia (BPSD). Education has been shown to improve caregivers’ treatment of BPSD in AD patients and to improve caregiver retention. The purpose of this project was to develop an evidence-based education module guided by …


Effects Of Pregnancy-Related Depression On Low Birth Weight Infants, Kimberly J. Bauer-Schaub Jan 2019

Effects Of Pregnancy-Related Depression On Low Birth Weight Infants, Kimberly J. Bauer-Schaub

Walden Dissertations and Doctoral Studies

Maternal depression during pregnancy can have a negative impact on the developing child. Numerous studies have focused on postpartum depression and the influences on infant outcomes; however, there are limited data on pregnancy-related depression. The problem addressed in this study was the inadequacy and insufficiency of depression screening during the pregnancy period and access to quality-related health services for women. The purpose of this quantitative retrospective study was to test social cognitive theory on low birth weight and prenatal care adherence to pregnancy-related depression in women residing in Colorado. This research measured an association between pregnancy-related depression and both low …


Yoga As A Women’S Population Health Intervention, Lisa Ann Clow Jan 2019

Yoga As A Women’S Population Health Intervention, Lisa Ann Clow

Walden Dissertations and Doctoral Studies

Women’s mortality rate in the United States has increased in almost every age group in the past several years. However, more women in the United States are choosing yoga as a complementary health approach to improve general well-being. Thus, research on yoga and other factors that affect women’s health in the United States may inform public health initiatives to address the health disparities in women’s mortality rates. Grounded in the health belief model, the purpose of this study was to explore whether the factors of practicing the components of yoga, doctor’s recommendation for increased physical activity, body mass index (BMI) …