Public Health Commons^™

Understanding Parents' Disease-Managing Strategies For Children With Sickle Cell Disease, Michelle Noble Mackey

Walden Dissertations and Doctoral Studies

Sickle cell disease (SCD) is one of the most difficult and stressful chronic diseases for parents of afflicted children to manage. Managing SCD can be traumatic for parents particularly if they have no specific coping strategies for managing the disease or ensuring the child visits the doctor as scheduled. The use of certain coping strategies may affect the parents' and patients' perceptions of the illness and influence their decisions regarding treatment, which can have a lasting impact on their lives. Effective parental strategies such as positive thinking can aid in disease management, but there is limited research on the coping …

Health And Nitrate-Contaminated Drinking Water In The Lower Yakima River Valley, Michael David Mcnickle

Walden Dissertations and Doctoral Studies

In the United States, many private wells are used as the only source of potable water. These wells, under current federal and state regulations, are neither monitored nor checked for water purity. The purpose of qualitative case study was to gain an understanding about how the documented nitrate contamination problem in the Lower Yakima Valley River Valley is perceived by members of the community and to measure their willingness to engage in collective action for social change. Purposive samples of 6 participants were interviewed using 10 questions derived from the drinking water disparities framework by Balazs and Ray. Additional historical …

Adult Clients' Experience Of Walk-And-Talk Therapy, Denice Crowe Clark

Walden Dissertations and Doctoral Studies

Standards of healthcare exist to promote beneficent treatment; however, treatment approaches are sometimes not supported by research, creating potential ethical issues for clinicians expected to use evidence-based practices. For example, walk-and-talk therapy, where therapy sessions incorporate physical activity in an outdoor setting, is being offered at increasing rates, but research regarding the practice is sparse and primarily reflects the therapists' experiences. Thus, the purpose of this interpretative phenomenological analytic study was to explore the clients' experience of the altered frame of walk-and-talk therapy through the conceptual lenses of therapeutic frame and the biopsychosocial model of well-being. Data were collected through …

Hiv Prevalence And Donor Funding In Ethiopia, Walelign Meheretu Kassahun

Walden Dissertations and Doctoral Studies

Many researchers have documented the trend of decreasing financial support from donors for human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) responses in Ethiopia. Less information is available regarding the correlation between trends of HIV prevalence and external funding and ways to address the impact that funding scarcity could cause. The purpose of this study was to examine the trend of HIV prevalence and donor funding levels, analyzing how the 2 are correlated, and opportunities to improve responses. Using the proximate determinant framework, the research questions examined the changes in HIV prevalence in Ethiopia during the past 10 years; the association …

Promoting Early Mobility Of Patients In The Intensive Care Unit, Sheryl L. Gilson

Walden Dissertations and Doctoral Studies

Deconditioning occurs in critically ill patients as early as 4 days after entering the intensive care unit (ICU) resulting in a loss of up to 25% peripheral muscle tone and 18% body weight by the time the patient is discharged. Early mobility (EM) has been shown to reduce complications such as neuromuscular weakness, muscle wasting, pneumonia, and the effects of prolonged periods of time on the ventilator. No formal education on EM had been provided to nurses at the clinical site. The purpose of this project was to develop an educational program on EM to promote early ambulation of critically …

Staff Education Program To Promote Breast Cancer Prevention Among African American Women, Vanessa Marie Palmer

Walden Dissertations and Doctoral Studies

African American women living in rural Ohio have a history of low mammogram

screening rates and a high incidence of breast cancer identification in the late stage of the

disease, leading to mortality rates exceeding those of Caucasian women. The purpose of

this doctoral project was to establish a breast health educational program for health

providers in a local mammography center that did not provide such a program

specifically targeted for African American women. Three theoretical frameworks, the

health belief model, Knowles's learning theory, and the PEN-3 model, guided the

development of a staff education program based on cultural appropriateness. …

Barriers To Male Faculty In Nursing Education, Troy Jeffrey Palmer

Walden Dissertations and Doctoral Studies

Men are underrepresented among nursing faculty, providing few role models for male students who might benefit from interaction with male faculty. Male nursing faculty may face barriers similar to those faced by women in male-dominated professions. Diehl and Dzubinski's model of gender-based barriers served as the framework for this quantitative study conducted to identify disparities between male and female nursing faculty that may prevent men from entering, continuing, and advancing in nursing education. The association between the percentage of male nursing faculty with geographic region; institution type (i.e., public, private secular, or private religious); and 4 career variables (i.e., education …

Coping Methods Of Caregivers Dealing With Patients Suffering From Geriatric Dementia, Blessing Baridakara Deemua

Walden Dissertations and Doctoral Studies

Dementia is a neurological disorder primarily diagnosed in the geriatric population. A problem for paid caregivers of patients diagnosed with stage-4 dementia is that they may experience caregiving stress while rendering care. However, there was no research that described the lived experiences of paid caregivers. Caregiving stress can be accompanied by behaviors or comorbid conditions and specific symptoms of stress can have a differential wellness impact. This phenomenological study explored the lived experiences of paid caregivers of patients with dementia through Vroom's expectancy theory. Data were gathered through interpretative interviews from a sample of 10 to 15 purposefully selected nursing …

Effect Of Health Information On Food Addiction Among Obese And Overweight Women, Kirsten Elyse Grant

Walden Dissertations and Doctoral Studies

Research on obesity, weight loss, and food addiction (FA) suggested a strong relationship between use of food additives and the brain's addictive response to food. Previous researchers have examined (FA) and have identified certain food additives such as monosodium glutamate (MSG) and high fructose corn syrup (HFCS) as contributors to food addiction and overeating. Social cognitive theory (SCT) has also been effective in addressing addictive behaviors such as drug addiction, alcohol addiction, and smoking cessation (Bricker et al., 2010). However, researchers had not examined food addiction, social cognitive theory, and obesity in the same study. The purpose of this quantitative, …

Optimizing A Disease Severity Scale For Evaluating Travelers' Diarrhea In Adults, Nicole Maier

Walden Dissertations and Doctoral Studies

Primary efficacy endpoints for interventional products targeting travelers’ diarrhea (TD) prevention have been predominately based on stool frequency. However, reliance on stool-based endpoints alone may obscure potentially meaningful differences in illness profiles. A single, standardized scoring system optimized for use in adult travelers is needed to accurately measure TD severity and enable more robust estimates of treatment or intervention effectiveness. The purpose of this quantitative secondary data analysis was to describe the variability in TD signs and symptoms across traditional severity metrics such as stool output, identify which symptoms were significantly associated with a negative impact on activity, and determine …

Care Intervention And Reduction Of Emergency Department Utilization In Medicaid Populations, Eno J. Rouse

Walden Dissertations and Doctoral Studies

Expansion of Medicaid and private health insurance coverage through passage of the Affordable Care Act of 2010 was expected to increase primary care access and reduce emergency department (ED) use by reducing financial burden and improving affordability of care. The aim of this study was to examine the differences in utilization patterns that exist among the Medicaid population that participated in an optimal level of care (OLC) intervention inclusive of appointments scheduled to primary care providers. Using the integrated behavior model as a theoretical framework, the key research question focused on determining if there was a difference in ED use …

The Relationship Between Parents' And Caregivers' Demographics And Their Knowledge About Congenital Heart Disease, Adeola Barakat Animasahun

Walden Dissertations and Doctoral Studies

The lack of knowledge regarding congenital heart disease (CHD) among the Lagos populace is leading to late presentation, late diagnosis and poor outcomes. The purpose of the research was to document the level of knowledge of parents and caregivers regarding CHD using the Leuven questionnaire for assessing knowledge of parents on CHD (LKQCHD). A quantitative correlational cross-sectional study, with purposeful convenience sampling strategy, was used. Health belief model was the theoretical framework used. Primary data of demographic information such as gender, age, the level of education, and the number of years of accessing care were obtained using a survey. The …

Evaluating The Frequencies Of Self-Reported Mental Health Conditions In Affluent Youth, Philip Bondurant

Walden Dissertations and Doctoral Studies

American youth are facing a mental health crisis. Rates of depression and suicide continue to rise among all children ages 12-17. While there is considerable research on the mental health of underserved children, much less is known about the mental health status of youth from affluent communities. The purpose of this study was to evaluate the effectiveness of community health assessment (CHA)-driven mental health interventions on the youth of affluent communities. Using a pre and post evaluation model, this study compared the frequencies of self-reported depression and suicide ideation for students in Grades 8, 10, and 12, and geographic location …

Cancer Treatment Decision Making In Aging Minorities, Patrice Kemp

Walden Dissertations and Doctoral Studies

Cancer incidence is high for aging minority and underserved populations, yet research is limited about patient-provider communications with aging racial and ethnic minority populations. Achieving high-quality cancer care is crucial to reducing health disparities for this population. However, potential shortages in professional health personnel, the cost to treat cancer, a strained health care system, and large aging populations contribute to the problem. The purpose of this qualitative study was to understand the personal experiences of aging minorities during cancer treatment decision making when communicating with their cancer care providers. Purposive sampling methods were used to recruit 10 minority women and …

Smoking And Surgical Site Infection In Orthopedic Patients' Lower Extremity Arthroplasty, Alicia Y. Mingo

Walden Dissertations and Doctoral Studies

Cigarette smoking has been a public health concern for many years, and the possible impact of smoking on surgical site infection (SSI) has been studied broadly. However, a gap in understanding has persisted concerning whether there is an association between smoking tobacco and the development of SSI among patients who undergo lower extremity surgery, specifically total knee arthroplasty (TKA). The purpose of this study was to examine the association between smoking and lower extremity SSI. Andersen's behavioral model (BM) was used to understand the risk factors relevant to the interaction between smoking and SSI. Application of the BM categories of …

Unmet Support Needs Of Informal Caregivers Of Older Adults, Julie Ann Smith Hinders

Walden Dissertations and Doctoral Studies

Due to projected growth of the 65-and-older population and concerns of an impending care gap, reliance on informal caregivers is expected to increase. Improving support for informal caregivers is viewed as a national priority, yet research related to the unmet support needs of informal caregivers is limited. The purpose of this cross-sectional correlational study was to examine predictive relationships between contextual factors (caregiving relationship and type of illness) and environmental factors (rurality) and the unmet support needs (classes, service access, support groups, counseling, and respite) of informal caregivers of older adults. The theoretical framework was Bronfenbrenner's ecological systems theory. Archival …

Interprofessional Intentional Empathy Centered Care (Ip-Iecc) In Healthcare Practice, Deepy Sur

Walden Dissertations and Doctoral Studies

Training interprofessional healthcare teams continues to advance practice for patient-centered care. Empathy research is also advancing and has been explored in social work, psychology, and other healthcare areas. In the absence of understanding empathy in an interprofessional setting, educators are limited in preparing teams to develop empathy as part of core competencies This grounded theory study explored for a theory of how interprofessional healthcare teams conceptualize and operationalize empathy in their practice. Azjen's theory of planned behavior and Barrett-Lennard's cyclical model of empathy framed the study. Data were collected using 6 focus groups and 24 semistructured interviews of varied healthcare …

Determinants Of Cervical Cancer Screening In Hiv-Positive Young Women In Swaziland, Marianne Calnan

Walden Dissertations and Doctoral Studies

In Swaziland, cases of cervical cancer among Human Immunodeficiency Virus (HIV)-positive adolescent girls and young women (AGYW) are increasing, but there is low uptake of cervical cancer screening. This study was conducted using the systems thinking theory to explore the relationships between the uptake of cervical cancer screening among HIV-positive AGYW in Swaziland and the availability of trained health providers, cervical screening services, and the provision of referrals for cervical screening. The study also investigated any differences in uptake of cervical screening based on age group. For this quantitative cross-sectional study, secondary HIV program data that were collected routinely between …

Advisory Committee On Immunization Practices Recommendations, Socioeconomics, Demographics, And Influenza Vaccine Uptake, Jennifer Gadarowski

Walden Dissertations and Doctoral Studies

Seasonal influenza outbreaks are associated with morbidity and mortality in the United States. Though children are the most susceptible to influenza infection and are most likely to transmit the illness to others, many children are not vaccinated. The purpose of this study was to examine the relationship between seasonal influenza vaccination Advisory Committee on Immunization Practices (ACIP) recommendations, demographic characteristics, socioeconomic factors, and vaccine type among children over 3 consecutive flu seasons. This quantitative cross-sectional study was guided by the social ecology of health model. Secondary data from 3 consecutive flu seasons (2014-2015, 2015-2016, and 2016-2017) provided by the National …

Public Health Implications Of Retailer Resale Of Returned Textile Clothing Merchandise, Antonette M. A. Francis-Shearer

Walden Dissertations and Doctoral Studies

Historically, 18th century anecdotal accounts of the decimation of several tribes of U.S. of the Native American population by trading of infected textile blankets alludes to the role of retail in the transmission of infectious disease. This study explores implications of the modern day retail organization practice of reselling returned clothing textiles from a public health infectious disease perspective. A qualitative multi-case study, utilized responses from 20 open-ended, unstructured interviews of retail employees assigned to the returns process. Additionally, several informal observations of select U.S.based, top-ranked clothing retail organizations, identified by the National Retail Federation were completed. Select federal, state, …

Exploring Education Needs For Heart Failure Patients' Transition Of Care To Home, Michelle D. Williams

Walden Dissertations and Doctoral Studies

Transitions of care is a model designed to ensure that patients have resources needed to assist them to care for themselves at home after hospital discharge, which helps to decrease preventable adverse events. For people with heart failure (HF) to transition home from the hospital successfully, specific education is needed that is individualized to the disease process, but most patients' educational needs after discharge are unmet. The purpose of this qualitative study, guided by the Meleis middle range theory of transition, was to explore the perspectives of people with HF about their educational needs in order to gather data that …

Hiv Testing And Black Men Who Have Sex With Men, Stephaun Elite Wallace

Walden Dissertations and Doctoral Studies

HIV incidence among Black men who have sex with men (BMSM) is extremely high in contrast to their estimated population size and compared to other racial groups. Researchers have established that a significant proportion of these new cases annually originate from HIV transmission by BMSM who are unaware of their HIV status. The purpose of the study was to assess the relationship between age, sexual behavior, social support, substance use, internalized homophobia, depression, and HIV test history in BMSM. Guided by the social ecological model (SEM) as the conceptual framework, a quantitative cross-sectional study was designed to analyze secondary data …

Obesity Epidemic In The Military: Implications For Veterans, Tracy Lewis

Walden Dissertations and Doctoral Studies

The purpose of this study was to examine the impact of overweight and obesity on veterans' careers. Obesity, once thought unproblematic for the military, is being recognized as a health concern that has expansive implications for the health and readiness of service men and women, as well as for veterans. There is an abundance of information on obesity within the general population, but research on the impact of obesity on military careers is limited. This quantitative, cross-sectional research study investigated how obesity is a challenge throughout a veteran's career, from enlistment to retirement, using an online survey to gather data …

Socioeconomic Determinants Of Physical Activity Among Adult Arab Immigrants In Edmonton, Alberta, Samer Kobrosly

Walden Dissertations and Doctoral Studies

Little is known about leisure-time physical activity (LTPA) habits of Arab immigrants in Canada. Leisure-time physical activity has been linked to decreased risks for cancer, cardiovascular disease, and all causes mortality and increased life expectancy. Socioeconomic status has been recognized as a significant factor affecting health and wellbeing due to its impact on individuals’ attitudes, experiences, and exposure to several risk factors. The purpose of this cross-sectional descriptive study was to explore the levels of participation in LTPA among adult Arab immigrants in central Alberta, Canada, to examine the socioeconomic determinants of LTPA, and to investigate which individual, social, and …

Fruit And Vegetable Consumption, Physical Activity, And Colorectal Cancer Among African Americans, Stella Francoise Nanga Ndzana

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is a deadly and costly cancer, especially among African Americans. The purpose of this quantitative, retrospective, cross-sectional study was to examine African Americans' health behaviors that may have an association with CRC. The Health Belief Model was used to guide this study. The study addressed whether there is a statistical association between fruit intake, vegetable intake, and physical activity, and the occurrence of CRC while controlling for confounders, such as body mass index, smoking status, and income level. After conducting an overall analysis, the final research question examined if the association varied by race. In this study, …

Program Evaluation Of The Employee Health And Wellbeing Program, Alicia Carmen Marlena Perez

Walden Dissertations and Doctoral Studies

Health promotion and disease prevention are a focus of population health management. Without ongoing and rigorous evaluation, these programs may be in jeopardy of continuing. The purpose of this project was to conduct a descriptive population health- focused evaluation of a large-scale health system's employee health and wellbeing program. Guided by the Center for Disease Control and Prevention (CDC) framework for program evaluation in public health and National Center for Organization Development guidelines, a nurse-led evaluation was conducted using 5 specific data sets emphasizing organizational structure, employee health offerings, employee surveys, Pathway to Excellence survey, and program contributions. A descriptive …

Accessibility Of Innovative Services In Radiation Oncology, Patricia Sansourekidou

Walden Dissertations and Doctoral Studies

The field of radiation oncology (RO) involves the use of highly advanced techniques to treat cancer and safely spare healthy organs. The discipline has experienced rapid growth in the past 25 years, with technological advancement as the driving force. Available data and an instrument to effectively measure the accessibility of innovation in the field were lacking. The purpose of this study was to investigate the accessibility of innovative services in RO in the United States and assess possible diffusion patterns. Two hundred and forty medical physicists practicing in RO in the United States completed a custom Internet-based survey. The diffusion …

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 …

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 …