Public Health Commons^™

Acculturation And Diabetes Among New York's Bangladeshi Immigrants, Renee Mehrra

Walden Dissertations and Doctoral Studies

There are more than 3.4 million South Asians in the United States. Among this subgroup, Bangladeshis in New York have a high prevalence of Type 2 diabetes ranging from 15 to 24% compared to the general population. This study examined the effect of acculturation through length of stay in the United States and understanding of the English language, and the role of gender on self-efficacy (SE) and diabetes self-management among 336 New York Bangladeshi immigrants between the ages of 21 and 75 who had been diagnosed with type 2 diabetes with A1C -‰¥ 6.5%, as verified by their medical record …

Parent Perceptions Of Biofeedback Treatment Effectiveness For Pediatric Migraine, Andrea Grando Weber

Walden Dissertations and Doctoral Studies

Gate control theory posits the idea that the brain and spinal cord have the ability to control the perception of pain sensation throughout the body. Biofeedback provides a proven way to teach a person how they may control their heart rate, breathing, and skin temperature. Through this process, individuals learn to lessen their migraine frequency and intensity. There are no studies to date that have measured the effectiveness of biofeedback in conjunction with medication for migraines in children despite established evidence of success in adults. In this study, an online format via SurveyMonkey was used to document the perceptions of …

The Influence Of Obstetrician And Gynecologists' Avoidance Behaviors On Maternal Morbidities, Nakisha Rene'e Boulware

Walden Dissertations and Doctoral Studies

The prevalence of maternal morbidities continues to increase in U.S. women of lower socioeconomic status and non-Hispanic Black women despite the efforts of health care practitioners to reduce the disparities. Two decades of research has shown that physicians avoid patients based on insurance and socioeconomic status or their malpractice history. Reducing maternal illness and complications is one of the federal government's top 10 maternal health indicators in the Healthy People 2020 initiative. The purpose of this study was to evaluate the influence of malpractice allegations on patients at high-risk for maternal morbidity. Supported by the theoretical foundation of human factor …

Late-Stage Breast Cancer Diagnosis Among Haitian Women In The United States, Marie-Hortence Prosper

Walden Dissertations and Doctoral Studies

Breast cancer is the 2nd leading cause of death among women. While a significant amount of research has been done to understand the different disparities related to this disease, there is still more to learn about the relationship between a person's nationality and the staging of breast cancer. Using the Surveillance, Epidemiology, and End Results Program as the data source, this retrospective cohort study was aimed at assessing late-stage breast cancer among Caribbean immigrants, specifically comparing Haitian women with Americans and other immigrant populations in the United States. The research questions addressed the link between nationality and the likelihood of …

Preconception Health And Preterm Birth Differences Among U.S.-Born And Foreign-Born Black Women, Sheree Holmes Keitt

Walden Dissertations and Doctoral Studies

Foreign-born Black women giving birth in the United States have superior preterm birth outcomes compared to their U.S-born Black peers. Many studies have focused on tobacco use and medical risk factors, but few have focused solely on preconception health. The purpose of this study was to examine preconception health and preterm birth differences among U.S.-born and foreign-born Black women. Three theoretical frameworks guided this study: the life course theory, healthy migrant theory/immigrant paradox, and weathering theory. Primary research questions assessed (a) if there were an association between chronic preconception risk factors, prepregnancy obesity, diabetes, and hypertension, in U.S.-born and foreign-born …

Association Of Health Facility Delivery And Risk Of Infant Mortality In Nigeria, Susan Adaku Ukwu

Walden Dissertations and Doctoral Studies

Infant mortality (IM) incidence in health facility systems during or after infant delivery is

substantially high in Nigeria. In this quantitative, cross-sectional study, the effects of skill

birth attendants (SBAs), prenatal care, and providers of prenatal care on IM in health

facility delivery centers were examined. The Mosley and Chen theoretical framework

informed this study and was used to explain the relationship between SBAs, prenatal

care, and providers of prenatal care and IM. One hundred and sixty infant deaths were

examined among mothers who used an SBA versus those who did not, mothers who had

prenatal care versus those without, …

Instrumental Role Modeling And The Sensitive Topic Of Obesity: A Grounded Theory, Tulie Blot Gay

Walden Dissertations and Doctoral Studies

The nurse practitioner (NP) role is more prominent now than ever before in primary healthcare, positioning them as providers who defend initiatives and ongoing health agendas. Obesity is among those agendas. The concept of instrumental role modeling was explained as a combination of understanding and physical presence that gives meaning and quality to inspire change. It implied that health professionals are not merely insightful clinicians but suggested their expertise is complimented by demonstrations of wellness in knowledge and practice. This topic of weight was perceived as sensitive but must be addressed. In this grounded theory study, the perspectives of NPs …

Abstract Hiv Testing And Multiple Sexual Partnerships Among Men In Nigeria, Kelvin Meyeyin-Bala

Walden Dissertations and Doctoral Studies

Low Human Immunodeficiency Virus [HIV] test uptake and multiple partnerships among men in Nigeria are contributing factors to HIV transmission. The purpose of this quantitative cross-sectional study was to examine the relationship between HIV test uptake, sociodemographic characteristics, HIV knowledge, attitude, and multiple sexual partnerships. The health belief model provided the framework for the study. Data were collected from the 2013 Nigerian National Demographic Health Survey, which surveyed 17,359 Nigerian men ages 15-49 years. Chi-square and binary logistic regression analysis showed that sociodemographic variables (age, residence, marital status, religion, wealth status, ethnicity, and educational level), HIV test uptake, HIV knowledge, …

Predictors Of Poor Pregnancy Outcomes Among Pregnant Women In Island Maternity, Nigeria, Letam Nwi-Ue

Walden Dissertations and Doctoral Studies

Pregnancy outcomes have improved tremendously in developed countries. Notwithstanding, it is still a huge challenge in developing countries, especially Sub-Saharan Africa. In 2015 in Nigeria, about 145 women died daily from pregnancy-related causes. Similarly, nearly 2,300 children under 5 years were lost in the same year. Nigeria consistently underperformed in some of the critical pregnancy indicators such as maternal and neonatal mortality, second worst only to India in the world. Studies on poor pregnancy outcomes are scarce in Nigeria. The purpose of this quantitative, retrospective cross-sectional study was to use local evidence to ascertain the risk factors that predict poor …

Maintaining Confidentiality Among Hiv Infected Couples: Physicians' Patterns Of Decision In Nigeria, Francess Uju Ayaebene

Walden Dissertations and Doctoral Studies

Policies mandating HIV status disclosure to decrease incidence create ethical challenges for physicians on whether to breach or maintain infected patients' confidentiality. In Sub-Saharan Africa where HIV incidence is high, there is a need for clear guidelines/policies on making confidentiality decisions. The purpose of this quantitative quasi experiment was to determine whether the gender, gender orientation, and sexual relationship of an infected patient and physicians' demographics predicted physicians' decisions to breach confidentiality. In Plateau State, Nigeria, 222 physicians were given vignette questionnaires containing 6 different descriptions of gender, gender orientation, and sexual relationships of a hypothetical patient. Each physician decided …

The Impacts Of Race, Residence, And Prenatal Care On Infant Mortality, Mary Christine Dorley

Walden Dissertations and Doctoral Studies

Tennessee ranks high for infant mortality (IM) in the United States. Despite public health efforts, the IM rate for Blacks is twice that of Whites mimicking what is observed nationally. Several risk factors for IM have been identified; however, it was still unclear how places of residence and prenatal care (PNC) affect IM for Tennesseans. The purpose of this study was to assess the relationship between places of residence (conceptualized by rurality and racial concentration), PNC, and IM among racial groups across Tennessee and to determine if race modified these associations. This was a cross-sectional study using data from the …

Advanced Practice Nursing In Nigerian Healthcare: Prospects And Challenges, Raymond O. Chimezie, Sally N. Ibe

Journal of Sustainable Social Impact

This study explored the prospects and challenges of introducing advanced practice nursing (APN) in the Nigerian health system. It sought to address the following: career pathways for registered nurses and midwives, advanced duties performed by them and the circumstances, their views and willingness for autonomous practice, and doctors’ degree of acceptance. Research population composed of registered nurses, midwives and medical doctors in primary healthcare. The conceptual framework for this study was based on the scope of practice, standards and competencies of the APN established by the International Council of Nurses (2008). A 12-item checklist of typical duties of APN from …

The Influence Of Food Insecurity, Low-Income, And Race On Diabetes Self-Management Practices Among Women With Diabetes, Jill La Capria

Walden Dissertations and Doctoral Studies

Diabetes is a chronic condition affecting more than 30 million adults living in the United States. Diabetes self-management (DSM) can prevent or delay the complications of diabetes and improve clinical outcomes; however, data show that low-income, food insecurity, female gender, and race contribute to challenges performing effective DSM. The health belief model was the theoretical framework for this cross-sectional study, which examined how food insecurity, low-income, and race affect DSM activities in women with diabetes. The sample population from the 2017 Behavioral Risk Factor Surveillance System survey consisted of 1,842 women with diabetes who were 18 years of age or …

Use Of Medical Care And Suicide Among Veterans, Wyatt Edward Meriwether

Walden Dissertations and Doctoral Studies

Due to rising veteran suicide rates, the veteran population has become a focus of practitioners, research scientists, and policymakers. Although researchers have studied the relationship between suicidality and the environment, more research is required to evaluate how suicidal behavior, suicidal ideation, and suicide risk are associated with a veteran's use of medical care services within the Veterans Health Administration (VHA). Therefore, this study focused on environmental variables (medical care usage and rurality), and their relationship with suicidal behavior (Manuscript 1), suicidal ideation (Manuscript 2), and suicide risk (Manuscript 3). The social ecological model was used to better understand the interaction …

Association Between Substandard Housing And Asthma In African-American Children, Sharmanita Davis

Walden Dissertations and Doctoral Studies

An improved understanding of the role of housing in asthma prevalence among African-American children is essential to addressing the issues associated with asthma and housing that perpetuate racial and ethnic health disparities. This study was conducted to examine the influence of substandard housing on the odds of asthma among low-income African-American children. The social ecological model was used as the theoretical framework for this study, that allowed consideration of the housing environment where African-American children live as an influential determinant of respiratory health. A cross-sectional research design using data obtained from the 2012 National Health Interview Survey and Comprehensive Housing …

Factors That Influence Place Of Delivery Choice Among Expectant Mothers In Ghana, Baba Ibrahim Mahama

Walden Dissertations and Doctoral Studies

Several factors may affect the choice of place of delivery among expectant mothers in Ghana and few studies have examined the choice of place of delivery with a focus on differences between rural and urban areas. In this study, the factors that influence the choice of place of delivery among expectant mothers in both rural (Tolon District) and urban (Tamale) settings in the northern part of Ghana were identified and compared using the conceptual framework provided by Thaddeus and Maine. A mixed-method study was used to examine expectant mothers and their responses related to factors that affect their choice of …

Informal Caregivers' Lived Experiences Caring For A Black Man Receiving Hemodialysis, Tanikka Joy Greene

Walden Dissertations and Doctoral Studies

Numerous quantitative studies have assessed caregiver burden in multiple chronic diseases, but an identified gap and underrepresentation exists in the literature regarding studies using an inductive approach that allow informal caregivers to describe the lived experiences of caring for Black men receiving hemodialysis. The transactional model of stress and coping and the stress process model guided this study. The key research questions centered on the experiences, psychological, physical, and financial limitations associated with caregiving. This phenomenological study used a purposive sample of 15 unpaid primary caregivers over the age of 18 caring for a Black male on hemodialysis from Mecklenburg …

Impact Of Socioeconomic Status And Health-Seeking Behavior On Malaria In Pregnancy, Ifeanyi Livinus Udenweze

Walden Dissertations and Doctoral Studies

Malaria in pregnancy remains a public health challenge in Nigeria despite the fund appropriation for malaria control. The health challenges of malaria in pregnancy vary with populations and there is limited knowledge on the impact of the socioeconomic status and health-seeking behavior on malaria in pregnancy in Nigeria. The objective of this cross-sectional quantitative survey was to examine whether socioeconomic status and health-seeking behavior predict malaria in pregnancy in Nigeria using the social cognitive theoretical model. The data from a 2015 Nigeria Malaria Indicator Survey was used in this study. Data were analyzed using chi-square, binary, and multivariate logistics regression …

Trends In Prevalence And Predictors Of Undernutrition Among Children In South Central, Monica Kabahimba Zikusooka

Walden Dissertations and Doctoral Studies

Undernutrition is a global public health challenge. In Somalia, undernutrition is chronic with the situation often graded for emergency response. The purpose of this study was to provide contextual evidence regarding trends of prevalence and predictors of undernutrition in South Central Somalia. Following the UNICEF conceptual framework of determinants of undernutrition, the study examined which individual, household, and society factors were associated with undernutrition. Using secondary data from cross-sectional nutritional surveys implemented by the Somalia Food Security and Nutrition Analysis Unit from 2007 to 2012, a sample of 75,756 and 60,856 children aged 6-59 months was used in analyzing trends …

Social And Structural Barriers To Safer Sex Among Heterosexual Female Sex Workers, Erika Nikole Harding-Davis

Walden Dissertations and Doctoral Studies

Individuals infected with HIV through heterosexual contact made up 24% (9,578) of all new infections in the United States. Female sex workers are at increased risk of getting HIV and other sexually transmitted infections (STI) because they may be more likely to participate in risky sexual behaviors including sex with multiple partners and condom-less anal/vaginal sex. Guided by the syndemic theory, the purpose of this study was to explore the relationships between social and structural factors (homelessness, substance use, immigration status, and use of healthcare) and risky sexual behaviors (condom-less vaginal sex and multiple sex partners) among female sex workers …

Emergency Preparedness Experiences By Emergency Managers In Rural Hospitals Of The Pacific Northwest, Gabriella Korosi

Walden Dissertations and Doctoral Studies

This qualitative research focused on the emergency preparedness (EP) rule implementation in rural hospitals in the Pacific Northwest. A new law has been implemented that requires hospitals to comply with Medicaid and Medicare law. Learning about the implementation and preparedness process could help rural regions in the Pacific Northwest better prepare for emergencies and comply with the law. The purpose of the study was to gain increased understanding of how the new EP rule of 2016 impacts rural hospitals' preparedness in the Pacific Northwest. The theoretical framework was complexity theory. This study focused on the lived experience of emergency managers …

The Long-Term Health-Related Outcomes Of Breast Ironing In Cameroon, Norbert Nicholas Njume Nkwelle

Walden Dissertations and Doctoral Studies

Breast ironing (BI) practice is a common practice in Cameroon. Most villages and towns continue with BI because they believe it constitutes a positive cultural lifestyle. However, public health officials and other advocates have branded BI as a harmful traditional practice because of the traumatic impact it has on the women who experience it. The purpose of this quasi-experimental study was to examine the perceived long-term health-related outcomes of BI and the quality of life changes on these women. Underpinning this study was the betrayal theory of trauma. A survey was used to collect data from 230 women. Descriptive analysis …

Impact Of Food Insecurity On The Management Of Illness In Wayne County, Ohio, Bernadette Coleen Paul

Walden Dissertations and Doctoral Studies

The incidence of food insecurity coupled with poor management of illnesses poses a

public health challenge. Poor adherence to medication regimens is a contributor to poor

health outcomes, especially among the socioeconomically disadvantaged. Food insecurity

is a global health and nutrition problem that affects approximately 50 million people in

the United States. The number of food-insecure households in the United States has

increased by 12% since 1995, and so has the burden of management of illnesses. The cost

of healthcare has risen from 5% of the Gross Domestic Product (GDP) in 1960 to 20% of

the GDP currently. This quantitative …

Experiences And Perceptions Of Staff Providing Substance Use Disorder Treatment For Adolescents, Connie Jean Rendleman

Walden Dissertations and Doctoral Studies

Substance Use Disorder (SUD) is associated with high mortality rates and remains a public health concern in the United States. Although, numerous interventions are offered for adolescents struggling with substance misuse, minimal research is available on the effectiveness of treatments to reduce recidivism. Researching the most effective treatment offered to adolescents is crucial to treatment adherence and recovery. The purpose of this study is to determine the most effective SUD treatment for adolescent patients by exploring the perceptions and experiences of treatment therapists providing treatment. The trans-theoretical model was used with elements of the social cognitive theory as a guide …

The Role Of Prenatal Care And Systematic Hiv Testing In Preventing Perinatal Transmission In Tanzania, 2011-2012, Nkembi Lydie Bianda, Patrick A. Tschida, Vasileios Margaritis

Journal of Social, Behavioral, and Health Sciences

In 2012, the prevalence of HIV infection among Tanzanian women was 6.3%, and 18% of Tanzanian children were born infected with HIV. The purpose of this study was to determine the importance of prenatal care attendance on comprehensive knowledge of HIV mother-to-child transmission (MTCT), HIV testing and counseling, and awareness of HIV testing coverage services in Tanzania. The study population was Tanzanian women of childbearing. Guided by the health belief model, this cross-sectional survey design used secondary data from the 2011–2012 Tanzania Demographic Health Survey. Factors of interest were comprehensive knowledge of HIV MTCT, HIV testing and counseling, and awareness …

Locus Of Control And Health Promotion For Marginalized Populations, Cara Stephenson-Hunter, Kathryn L. Dardeck

Journal of Social, Behavioral, and Health Sciences

Socioeconomic health disparities in the United States have remained largely unchanged for decades. This remains the case even for preventable illness and disease. Current health behavior theories and interventions rely on the perception of control over one’s fate to achieve desired behavior. In low-income and other marginalized populations, however, hopelessness and the perception of having limited control may make interventions less effective. The purpose of this quantitative study was to examine the role of the locus of control (LOC) as defined by the degree to which one believes outcomes are determined by external forces such as chance or authority figures …

The Self-Perceived Cultural Competency Of Hiv Interventionists, Tonya Herring

Walden Dissertations and Doctoral Studies

Despite significant research and inroads with the human immunodeficiency virus (HIV), disparities in HIV infection continue to widen for African American (AA) men who have sex with men (MSM). In recent times, cultural competence has been receiving increased attention as a possible factor to enhance the quality of health messaging and lessening HIV disparities. However, there is a dearth of research specifically dedicated to AA MSM and culturally competent HIV health messages. To address this gap, this qualitative research was designed to investigate the self-perceived cultural competency among HIV counselors. The theoretical framework for the project was the PEN-3 cultural …

Vitamin D Receptor Gene Polymorphisms Knowledge And Breast Cancer In Texas, Ejike Roland Egwuekwe

Walden Dissertations and Doctoral Studies

Breast cancer is a world health problem and is a leading cause of cancer-related death among women in the United States. However, breast cancer risks were reported to be reduced through exposure to Vitamin D through its Receptors identified as the p53 target gene. The purpose of this study was to assess the associations between VDR gene polymorphisms knowledge/awareness and decisions to reduce breast cancer risks and likelihood of mammogram screening among women in Texas. Data from survey were used. Roy adaptation model was the theoretical framework that guided this quasi- experimental, quantitative research. The dependent variables were decisions to …

Pregnant African American Women Breastfeeding Intentions, Beliefs, Attitudes And Perspectives, Janelle S. Mcclain, Phd

Walden Dissertations and Doctoral Studies

Breastfeeding is the best infant feeding source of nutrition for infants in their early stages of development. However, there is a fundamental gap in the number of African American women that initiate breastfeeding compared to White, Asian, and Hispanic mothers. Social cognitive theory was used to explore the breastfeeding intentions, beliefs, perceived barriers, and perceptions on breastfeeding through a basic qualitative research method. To capture the essence of the lived experiences of African American pregnant women, a purposeful sample of 13 African American pregnant women were invited to participate in the study. Two focus groups discussions pertaining to breastfeeding intentions …

Measuring Effects Of Childhood Adversity On Resilience Level Of Army Veterans, Stephanie Rausch

Walden Dissertations and Doctoral Studies

Veteran suicide is a public health issue that requires more research to understand the multidimensional factors, such as resilience, that lead someone to suicide. Adverse childhood events (ACEs), such as poverty and abuse, have affected how resilience is developed. This study examined the association between childhood factors of socioeconomic status, parental discipline, and being a military child, and adult resiliency level. Dienstbier's theory of mental toughness framed the study, which posits that a child who experiences mild ACEs and has time to recover between events, will be more resilient than children who experience serious ACEs, and children who experience little …