Public Health Commons^™

Factors Affecting Body Mass Index Levels In African American Women Living In North Carolina, Padmini Shanti Kirpalani

Walden Dissertations and Doctoral Studies

The prevalence of obesity has doubled over the past 25 years in the United States, particularly in North Carolina. Obesity is influenced by biological, social, and environmental factors; its prevalence has been found to be higher among African American women and other racial ethnic minorities. Guided by the social ecological model, the purpose of this cross sectional study was to examine the relationship of the psycho-social, psycho-behavioral factors, and body mass index levels (BMI) in African American women living in North Carolina versus their Hispanic American and European American counterparts. A logistic regression model using secondary data from the Behavioral …

The Experience Of Survivorship: Quality Of Life For African American Breast Cancer Survivors, Angela L. Grimmett

Walden Dissertations and Doctoral Studies

African American breast cancer survivors are at a greater risk of experiencing disparities in mortality, treatment, and quality of life. The purpose of this phenomenological study was to explore the impact that breast cancer had on the quality of life of African American breast cancer survivors from a psychosocial, physical, spiritual, and economic perspective. Face-to-face, in-depth interviews were conducted with 9 volunteers who met the eligibility criteria of being breast cancer survivors of African American decent. The sample of survivors ranged in ages 45 to 80 and was between 6 to 30 years postdiagnosis. Giorgi's phenomenological method was used to …

Experiences Of Chronic Disease Self-Management Program Leaders, Laketa Monique Hillman

Walden Dissertations and Doctoral Studies

Chronic conditions are public health threats. The Chronic Disease Self-Management Program (CDSMP) is an evidence-based disease management program that addresses personal self-management of chronic conditions. The CDSMP involves peer trainers who instruct and assist with chronic disease preventive measures. Although disease management demonstrates promise to improving patient self-maintenance, previous researchers have not evaluated how the program affects program leaders. The purpose of this study was to discover how self-help leaders feel about the CDSM program. The overarching research question asked about perspectives that self-help leaders had toward the program. Through a narrative qualitative approach, the perceptions of peer leaders were …

Strategies Ontario Hospital Administrators Apply To Generate Non-Government Revenue To Remain Sustainable, Frank Pieter Martien Naus

Walden Dissertations and Doctoral Studies

Health care administrators in Ontario want to transform health care with a focus on improving efficiency and quality of care, yet they pay little attention to increasing revenue. The purpose of this qualitative case study was to explore strategies Ontario hospital administrators apply to generate nongovernment revenue to remain sustainable. The target study population consisted of 2 chief executive officers and 2 chief financial officers at Ontario academic research hospitals. The conceptual framework for this study included radical organizational change theory supported by complexity leadership theory, and grounded in an evidence-based approach. The researcher conducted open-ended semi-structured interviews and made …

Community And Patient-Centered Medical Home In The Care Of Chronically Ill Patients, Victor A. Carrillo

Walden Dissertations and Doctoral Studies

Large portions of the US population live in poor inner-city communities. Health needs assessment data have shown that these communities have disproportionately high rates of chronic illnesses. The patient-centered medical home (PCMH) model was developed to address the gaps that exist in the primary care system, and emphasizes a redesign of primary care that is patient centered, utilizes multiple levels of healthcare professionals, information technology, and care coordination. However, little evidence exists on the value of this model which may explain why it has not gained wide acceptance by primary care providers. Therefore, this study was designed to examine the …

Perceptions Of Immunizations As Health Prevention Among Female Mexican Immigrants In Oklahoma, Jennifer Doyle

Walden Dissertations and Doctoral Studies

Research on health prevention behaviors of Mexican immigrant mothers regarding immunizations has been limited. As of 2014, Hispanics or Latinos comprised 9.6% of the population of the state of Oklahoma and were the largest minority group within Oklahoma. This minority population has continued to grow at a rapid rate in Oklahoma. The purpose of this study was to explore the perceptions of immunizations held by Mexican immigrants who are mothers residing in Oklahoma. The aim of this study was to identify their perceived risk of contracting a vaccine-preventable disease if not immunized and knowledge of immunizations as a health prevention …

Attitudes And Beliefs Towards Prostate Cancer Screenings And Diagnosis Among Zimbabwean Physicians, Adoniah Mavura Mukona

Walden Dissertations and Doctoral Studies

Zimbabwean men at risk of developing prostate cancer (PC) are diagnosed late or not at all. A cross sectional, quantitative study was done in Zimbabwe to establish physicians' attitudes and beliefs towards PC screening and diagnosis. Descriptive statistics were obtained to determine physicians' beliefs and attitudes using the Physician Attitudes and Beliefs Questionnaire Survey. The instrument incorporated validated instruments, the Burns' Cancer Belief Scale and Physician Survey on Prostate Cancer Screening, and demographic questions to measure specific independent variables, potentially influencing attitudes and beliefs. Means and standard deviations were conducted for continuous variables for beliefs and attitudes, and frequencies and …

Risk Factors And Outcomes For Bloodstream Infections Among Patients With Skin Infections, Michael Rybak Rybak

Walden Dissertations and Doctoral Studies

Acute bacterial skin and skin structure infections (ABSSSI) are common infections within the local community, and they result in higher morbidity and health care costs. While risk factors for skin and soft tissue infections have been previously evaluated, risk factors associated with secondary bloodstream infections (BSI) has not been investigated, especially in an intercity patient population with limited health care resources. In this case control investigation, 392 patients consisting of 196 cases (ABSSSI + BSI) and 196 controls (ABSSSI) were investigated to determine risk for BSI. Both sociodemographic and underlying conditions were evaluated. According to bivariate analysis of cases and …

Risk Of Alzheimer's Disease Among Older Hispanic/Latinos With Diabetes, Kathy Bianco

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is the 6th leading cause of death in older Americans. Currently there is no cure for AD, and even though the specific cause is unknown, diabetes mellitus type 2 (DM2) is regarded as a risk factor. Hispanics have a higher incidence of DM2 and possibly AD. I chose a life course theoretical model for this quantitative cross-sectional study to illuminate the variables most pertinent to a pathway from good health to poor health. The variables chosen were hypertension (HTN), obesity, smoking, stroke, dyslipidemia, and lower educational attainment. The research questions were used to examine biologic, metabolic, sociologic, …

Influence Of Teacher Participation On Student Fitness And Student Participation In Physical Education, Whitney Morris

Walden Dissertations and Doctoral Studies

Physical activity plays a key role in the health of children. Childhood obesity is increasing in the United States, and children are spending less time being physically active. Active participation by a physical education (PE) teacher in physical activities has been suggested as a means of promoting student fitness. The purpose of this quasi-experimental quantitative study was to determine whether modeling of physical activity by a PE teacher would increase student participation and physical fitness. Bandura's social learning theory provided the theoretical framework for the study. Participants included 311 4th and 5th grade elementary students enrolled in physical education classes. …

Impact Of Medicare And Medicaid Beneficiaries With Selected Conditions On Emergency Department Utilization, John K. Amoh

Walden Dissertations and Doctoral Studies

Chronic Obstructive Pulmonary Disease (COPD) and Congestive Heart Failure (CHF) are conditions that represent significant and ongoing medical costs, including frequent emergency department (ED) visits, hospitalizations, work absences, and disability. This retrospective cross-sectional study, examined the effects of the frequent ED visits due to COPD and CHF on the beneficiaries of Medicare and Medicaid in Maryland. The goal was to identify the factors that led these patients to visit the ED, the impact of these visits on Medicare utilization and costs across Maryland, and preventative intervention strategies to control this population's costs of care. Secondary data were analyzed from 2010-2012 …

Effect Of Reduced-Fee Dental Hygiene Treatment And Oral Health Perceptions Among Socioeconomically Deprived Persons, Janeime Necole Asbury

Walden Dissertations and Doctoral Studies

Access to oral health care remains problematic for millions of Americans. Factors such as socioeconomic status, age, race, and lack of dental insurance benefits inhibit the ability of many to obtain preventative oral health care. The aim of this study was to explore the effect of preventive oral health treatment and education at reduced-fee dental hygiene facilities on the oral health behaviors and perceptions of socioeconomically deprived persons within the state of Georgia. This study was based on the health belief model constructs. A convenience sample of 102 participants was recruited from the individuals who visited two dental hygiene colleges …

Gestational Age, Birth Weight, And Incidence Of Adult Type 2 Diabetes Among Southeast Alaska Natives, Renee Elaine Crawford

Walden Dissertations and Doctoral Studies

American Indian and Alaska Native adults are 2.6 times more likely to have adult onset diabetes resulting from higher weight at birth. Pregnant women, providers, and Indian Health Service administrators may benefit from timely information during pregnancy to intervene and prevent Type 2 diabetes. The purpose of this study was to examine the role of birth weight in the development of Type 2 diabetes among Southeast Alaska (SEA) Natives. Guided by the socioecological model, this study examined the extent to which birth weight and gestational age predict the incidence of Type 2 diabetes. The study used a quantitative research design …

Self-Efficacy And Self-Management Assessments On Hispanic Patients With Diabetes, Yesenia Dejesus

Walden Dissertations and Doctoral Studies

Hispanics are at increased risk for diabetes and are 40% more likely to die from the condition than are non-Hispanic Caucasians. The purpose of this project was to determine the effects of diabetes education conducted in Spanish by bilingual staff on the self-management and self-efficacy of a sample of 50 volunteer adult Hispanic clinic patients with diabetes. The education intervention incorporated the American Diabetes Association's Diabetes Self-Management Education program materials. Bandura's self-efficacy theory was selected as the theoretical support for the project that relied on self-management education of the patients to improve their self-efficacy to undertake the interventions necessary to …

Wellness Intervention As A Quality Of Life Predictor In Mentally Ill Veterans, Tosha Lashon Ellis

Walden Dissertations and Doctoral Studies

Veterans with serious mental illness (SMI) are at high risk of developing conditions such as insulin resistance, obesity, and smoking, which may lead to chronic medical problems. As a result, the morbidity and mortality of people with SMI are high compared to the general population. It appears that integrated care improves the wellbeing of veterans; however, there is a gap in the literature on wellness-based interventions for veterans with SMI. The purpose of this cross-sectional study was to evaluate the association between a wellness intervention for veterans and their perceived quality of life (QOL). Social cognitive theory was the theoretical …

The Lived Experiences Of Hiv+ Community Health Workers Serving Hiv+ Clients, Phronie Lynn Jackson

Walden Dissertations and Doctoral Studies

Numerous studies have focused on the effectiveness of community health worker (CHW) programs in producing positive health behaviors and health outcomes for the clients CHWs serve; however, there has been a gap in the literature regarding how the health of HIV + CHWs is impacted by their jobs. A phenomenological design was used to gain insight into the lived experiences of HIV+ CHWs (HIVCHW) who provided services to HIV positive clients. Fifteen HIVCHW were recruited using criteria and snowball techniques. Data were collected via audio recorded personal interviews regarding respondents' perceptions of their work and how it impacted their own …

Heroes Or Victims: The Lived Experiences Of Women On Female Genital Mutilation/Cutting In Northwestern Nigeria, Sarah Kasham Philips

Walden Dissertations and Doctoral Studies

The custom of female genital mutilation/cutting (FGM/C) is a traditional practice inimical to women's health with profound implications. There is a gap in the literature on the lived experiences of women who have undergone FGM/C and their statuses within their communities. Guided by the social cognitive theory and the ecological model, this qualitative study aimed at explicating the attitudes and perceptions of women in the northwest region of Nigeria towards the practice of FGM/C, to illuminate how the women view themselves in their society and the inspiration for the continued practice of FGM/C. Interview and observation data were gathered from …

Health Care Provider Perceptions Of High Blood Pressure Screening For Asymptomatic African American Teens, Juanita Braxton

Walden Dissertations and Doctoral Studies

Health care provider perceptions of typical practices play a significant role in evaluating the efficacy of screening and diagnosis of teen high blood pressure in African Americans. African American adults are more likely to develop high blood pressure than are any other ethnic group; however, there is a gap in the literature concerning high blood pressure in teens. Approximately 1 to 5 of every 100 children has high blood pressure. This purpose of this phenomenological study was to explore the perspectives of health care providers on high blood pressure screening and diagnosis of African American asymptomatic teens. The health belief …

The Relationship Between Health Risk And Workplace Productivity In Saudi Arabia, Sarah Lorraine Hayman

Walden Dissertations and Doctoral Studies

Rising worldwide rates of noncommunicable diseases (NCDs) in the Middle East, principally Saudi Arabia, have put an increasing load on the health system and employers. Middle Eastern organizations have been slow to develop targeted health programs, which include an emphasis on employee productivity. The purpose of this study was to determine the relationship, if any, between employee lifestyle and workplace productivity. Productivity is the amount of work produced based on the time and cost required to do so. The underlying theoretical foundations of this research were the socioecological health model and the human capital model. The quantitative, ex post facto …

Hospital Preparedness: Effects Of Designated Preparedness Coordinators On Hospital Preparedness For Special Hazard Classes, Rodney Sinelair Jones

Walden Dissertations and Doctoral Studies

Since 9/11, little statistical rigor has been placed on identifying the correlates of hospital preparedness. This quantitative study explores the research question: Is there a correlation between the employment of a designated hospital preparedness coordinator and the reported level of preparedness for: (a) general preparedness; (b) chemical, biological, radiological, and nuclear (CBRN) events; (c) pandemic disease outbreaks; (d) mass casualty events; and (e) internal infrastructure failure, as assessed by an online survey. Alternative analysis was conducted to assess the relationship between access to resources and the 5 dependent variables. Using complexity theory as the theoretical framework, point biserial correlation and …

Perception Of Nutrition And Utilization Of Healthy Food Ideas When Making Food Choices., Judy Pilgrim-Hector

Walden Dissertations and Doctoral Studies

The availability of nutrition information is an important aspect of health care and equally important is access to cultural and theoretical nutrition evidence to increase awareness on ways to manage a diet in ethnic communities. The problem was the shortage of culturally appropriate nutrition data to educate Caribbean immigrants. The purpose of the study was to acquire culturally profound nutrition information on Caribbean immigrants' distinctive philosophical perception on nutrition and food choices. A phenomenological approach was used to examine ways in which the participants integrate nutrition facts when making food choices. The theory of reasoned action was the main conceptual …

Hiv/Aids-Related Stigma And Discrimination Toward Women Living With Hiv/Aids In Enugu, Nigeria, Chinyere Fidelia Nnajiofor

Walden Dissertations and Doctoral Studies

HIV/AIDS-related stigma and discrimination (S&D), lack of social support, poverty, and gender inequalities have been identified as factors in the increased prevalence rate of HIV transmission in Enugu, Nigeria, especially among women ages 15 to 49 years. Despite the funding of reduction programs, HIV/AIDS-related S&D remain a major driving force in the increased rate of new HIV cases in Enugu. This study addressed a perceived need for behavioral change intervention approaches that span all societal factors to reduce the HIV infection rate in Enugu Nigeria. The study was guided by Goffman's (1963) social S&D theory. The sample was composed of …

Nigerian Cancer Survivors' Perceptions Of Care Received From Health Care Professionals, Olusegun Akinsuli

Walden Dissertations and Doctoral Studies

Cancer patients worldwide receive care from multidisciplinary teams, and patients

sometimes have little or no knowledge about the different treatment options available, making communication with their care providers an important influence in how they perceive their care. Patient satisfaction with care is an important factor in determining survivorship. The increasing prevalence of cancer worldwide has become a huge public health issue. The World Health Organization has warned that the potential gains from combatting infectious diseases in Nigeria might be lost because of the increasing prevalence of cancer. The purpose of this grounded theory study was to obtain the perceptions of …

Perceptions Of Employed People With Narcolepsy, Chantelle L. Jones

Walden Dissertations and Doctoral Studies

Many companies have used perceptions of their employees to understand how sleep disorders affect their working environment. Sleep disorders have had an undesirable effect on employee performance and often result in employee modifications to accommodate their condition in the workplace. Though information is available concerning employees' experiences pertinent to working with sleep disorders, research focusing on how employees with narcolepsy perceive their work environment appears to be missing from the literature. The purpose of this study was to gain understanding of perceptions of employees with narcolepsy about their work environment and strategies that may influence others to promote positive health …

Experiences Of Heterosexual Couples Who Undergo Hiv Counseling And Testing In Nakuru-Kenya, Stephen Kinyua Mucheke

Walden Dissertations and Doctoral Studies

The increase in new human immunodeficiency virus (HIV) infections among heterosexual couples in Africa may reverse the gains made by HIV prevention programs. HIV screening among such couples remains low and understudied.This qualitative study focused on the motivations for HIV screening among heterosexual couples. The primary research goal was to examine the lived experiences of heterosexual couples who were screened for HIV and received their results in Nakuru-Kenya. The health belief model (HBM) served as the theoretical framework and as a basis for the secondary questions which sought to explore the participants' perceptions on HIV based on the constructs of …

Bone Health Education For Osteoporosis Risk Reduction In Premenopausal Women: A Quality Improvement Project, Gloria Nichols Nichols

Walden Dissertations and Doctoral Studies

In the United States, about 8.5 million women live with osteoporosis. Osteoporosis is a debilitating systemic skeletal disorder characterized by low bone mass and reduced bone mineral density that occurs with the loss of estrogen. The mortality rate for this group is about 3 to 4 times higher than other women and as many as 1 in 3 experience a fracture. Guided by the Health Belief Model, this project evaluated how a bone health fact sheet impacts knowledge about osteoporosis and self-efficacy for preventative behavioral change in premenopausal women (age 40-58 years). The project also evaluated if an electronic medical …

Effectiveness Of Cognitive Screening For Heart Failure Patients, Comfort Nkengla

Walden Dissertations and Doctoral Studies

Cognitive impairment is commonly seen in the elderly population. It is unclear if cognitive deficit in heart failure (HF) patients is a primary factor for higher hospital readmission rates in this population. The Centers for Medicare and Medicaid Services have established strict guidelines for reimbursement on readmissions that occur within 30 days. It is imperative that organizations identify and rectify issues that impact readmissions. The aim of this project was to determine if there is a reduction in HF readmission after patients are screened for cognitive impairment. Orem's self-care model guided the project by providing a framework of inquiry regarding …

Relationship Between Nurse Training And Physical Restraints In Nursing Homes, Terah Tessier

Walden Dissertations and Doctoral Studies

According to the Centers for Medicare and Medicaid Services (CMS), approximately 1.3 million U.S. residents are residing in nursing homes. CMS enforced regulations in the Nursing Home Reform Act. Training in the use of restraints in nursing homes is monitored through the CMS standards. The purpose of this study was to determine whether there was a correlation between training standards of health care practitioners and their use of restraints in nursing homes based on the patterns of citations by RNs and CNAs. Data were collected from Kansas, Louisiana, and Ohio within the CMS Nursing Home Data Compendium. The key research …

African Americans' Understanding Of The Provisions Of The Affordable Care Act, Ewang Theo Epie-Alobwede

Walden Dissertations and Doctoral Studies

African Americans as a group tend to have numerous health issues, and by the time they seek healthcare, the conditions often advance into more serious ailments. Researchers have shown that cultural distrust of the U.S. healthcare system coupled with some discriminatory practices has hindered African Americans seeking care and taking full advantage of the healthcare system. With the introduction of the Patient Protection and Affordable Care Act (ACA), there is some confusion about the application of the law, resulting in many intended beneficiaries misinterpreting it, and not accessing quality healthcare. This interpretive phenomenological study explored how African Americans in the …

Perceptions Of Stroke Risks Among West African Male Immigrants In San Diego, Lawrence Agi

Walden Dissertations and Doctoral Studies

The incidence and knowledge of the risk factors of stroke across ethnic groups in the United States have been examined in multiple studies. However, it is not well known if the foreign-born African immigrants who constitute about 4% of the U.S. immigrant population are at a higher risk of the incidence of stroke than are other nonimmigrant population in the U. S. This ethnographic study explored the perceptions of Anglophone African male immigrants residing in San Diego on the risk factors of stroke. The theoretical framework for this study included the health belief model and the health promotion model. Data …