Public Health Commons^™

Incidence And Factors Associated With Nonalcoholic Fatty Liver Disease Among Patients With Rheumatoid Arthritis, Ani K. John

Walden Dissertations and Doctoral Studies

Nonalcoholic fatty liver disease (NAFLD) has become one of the most common hepatic diseases worldwide, making the diagnosis and management of NAFLD an emerging public health issue. Theories associated with NAFLD surmise that inflammation may be the root cause, along with the complex interplay of other chronic conditions such as obesity, metabolic syndrome, diabetes, dyslipidemia, and cardiovascular disease (CVD). It is unknown if other inflammatory conditions such as rheumatoid arthritis (RA), along with the use of methotrexate (MTX), might confer increased risk for NAFLD. Longitudinal data collected from a retrospective cohort of 17,481 adult RA patients in the United States …

Obesity Among Women In Rural Kenya: Knowledge, Beliefs, And Perceptions., Ann Mugo

Walden Dissertations and Doctoral Studies

Obesity or being overweight is a prevalent health concern around the world. Despite the growing problem in developing countries such as Kenya, there is scant literature available on obesity or being overweight among women in rural Kenya. This research study provides information necessary for bridging the gap in understanding the perceptions, beliefs, and knowledge of obesity among women in rural Kenya. This study used the social cognitive theory (SCT) framework to assist in understanding the impact of obesity or being overweight among women living in rural Kenya. Participants were women aged 20 to 45 recruited from a local church in …

Factors Associated With Primary And Secondary Sexual Transmission Of Hiv In Concurrent Relationships In Kenya, Daphne Parker

Walden Dissertations and Doctoral Studies

This phenomenological study was designed to understand the lived experiences of a purposive sample of 9 participants from local villages in Nairobi, Kenya, who had sexual behaviors that contributed to higher HIV risk exposure. Past studies have provided information about the increased rates of HIV infection; however, little has been done to identify the solutions for minimizing the negative impact of HIV among concurrent partnerships. The study investigated the role of high risk cultural practices among participants in married and cohabitating unions. The conceptual framework of the study was gender and power theory, which addresses the complex sexual relationships between …

Complexity Of Prostate Cancer Diagnosis In African American Men In The United States, Adam B. Sumlin

Walden Dissertations and Doctoral Studies

Researchers have identified higher incidence rates and mortality rates among African American men (AAM) diagnosed with prostate cancer than they have among urban African American men. This quantitative descriptive study was conducted to measure the association between advanced stage and grade of prostate cancer, demographic location, and prostate specific antigen (PSA) levels over a 5-year period in AAM and European American men (EAM) in rural versus urban communities. This study addressed 4 research questions concerning cancer grade, cancer stage, age, geographic location, PSA level, and the impact that each of these variables had on prostate cancer diagnosis in AAM in …

Chiropractic Student Infection Control Practices And Methicillin-Resistant Staphylococcus Aureus Skin Infections, Jonathon Todd Egan

Walden Dissertations and Doctoral Studies

Chiropractic training involves many hours of skin contact, and chiropractors have manual contact with millions of patients annually, but chiropractic has only had professional clinical hygiene guidance since 2010. Methicillin-resistant Staphylococcus aureus (MRSA) is the most common cause of cultured skin and soft tissue infection (SSTI) in the United States. Using the epidemiologic triad of person, place, and time as a framework, this quantitative, cross-sectional study obtained the first assessment of MRSA SSTI incidence among chiropractic students and its association with infection control behaviors (hand and table hygiene, sharing gowns, and sharing lotion) and initiation of patient care. The study …

Acculturation, Inflammation, And Depression Among Hispanic Adults In The United States, Kristin Marie Marano

Walden Dissertations and Doctoral Studies

Disparities exist in the recognition and treatment of depression among Hispanics in the United States, creating a social, ethical, economic, and public health burden. This study was designed to generate an improved understanding of the causes of and/or contributors to depression within this population. It was specifically designed to 1) assess the prevalence and severity of depression among Hispanic adults in the United States relative to adults of other race/ethnicities in the United States; 2) clarify the inconsistent results in the literature concerning the relationship between acculturation and depression among Hispanic adults in the United States; and 3) fill a …

Associations Between Healthcare Facility Types And Healthcare-Associated Infections, Aretha D. Miller

Walden Dissertations and Doctoral Studies

Healthcare-Associated Infections (HAIs) continue to be an epidemiological issue burdening patients and public health systems worldwide. The purpose of this study was to determine if specific healthcare facility types (Acute Care Hospitals, Long Term Acute Care Hospitals, and Inpatient Rehabilitation Facilities) were associated with particular categories of HAIs: Ventilator-Associated Pneumonias (VAPs), Central Line-Associated Bloodstream Infections (CLABSIs), and Catheter-Associated Urinary Tract Infections (CAUTIs). The theoretical framework for this study was the environmental determinants of infectious disease framework. A single research question focused on whether an association existed among the specified health care facility types and HAIs. Three independent categorical variables were …

Asthma Determinants, Health Care Utilization, And Control Among Women In Puerto Rico, Maria Calixta Ortiz-Rivera

Walden Dissertations and Doctoral Studies

Active asthma and asthma-related health care utilization are higher among adult females than they are among adult males in Puerto Rico. The purpose of this study was to examine the determinants of the risk of active asthma and associated health care utilization and asthma control among women in Puerto Rico. Guided by the Andersen behavioral model, the study included data from the Asthma Call-Back Survey (ACBS) during 2011 and 2012 in Puerto Rico. The associations between active asthma and behavioral, demographic, and environmental factors were assessed using logistic regression. The relationship between asthma-related health care utilization and predisposing, enabling, and …

Use Of Maternal Health Services And Pregnancy Outcomes In Nigeria, Abubakar Sadiq Umar

Walden Dissertations and Doctoral Studies

Maternal health services (MHS) provide primary, secondary, and tertiary levels of prevention to achieve better pregnancy outcomes. However, use of prenatal and natal services among Nigerian women has been ranked among the lowest in the world and, consequently, the country is among the 10 countries with the highest maternal mortality ratio. Moreover, nationwide community-based studies on the use of maternal health services in Nigeria are limited. To address this gap, this quantitative, cross-sectional study analyzed the 2008 Nigerian Demographic and Health Survey (NDHS) data to identify whether Nigerian women's biological, cultural, and socioeconomic characteristics are associated with their use of …

Analyzing Interrelationships Between Food Safety Practices And Inspections Among Food Staff In Manitoba, Kirandeep Kaur Brar

Walden Dissertations and Doctoral Studies

The incidence and prevalence of food safety practices among food staff working in food establishments in Manitoba is underrepresented and has not been adequately reviewed and researched. Uncertified food staff are at higher risk of not following food safety practices that can cause contamination of food and result in foodborne illness. The purpose of this quantitative study was to determine the prevalence of food safety practices among food staff in Manitoba and to determine the relationship between food safety certification and routine health inspections. Pender's health promotion model and Bandura's social cognitive theory were used to explain the relationships and …

What Are The Perspectives Of Osteoporosis Screening Among Black Women?, Angela Alsberry Wilkins

Walden Dissertations and Doctoral Studies

Osteoporosis is a serious disease which often brings pain, disability, hospitalization, and even death. An increasing number of studies have been conducted on the prevention and treatment of osteoporosis in White women, yet a paucity of research exists to explain disparities in screening and treatment of osteoporosis in Black women. This narrative study describes the perspectives of Black women regarding individual barriers to osteoporosis screening. The purpose of this study was to better understand the perspectives of Black women regarding prevention of and screening for osteoporosis. Selections included purposive, criterion sampling of 10 Black women who were 50 years and …

Childhood Attention Deficit Hyperactivity Disorder: A Stress Factor For African Immigrant Mothers, Helen Agatha Awatefe

Walden Dissertations and Doctoral Studies

Children between the ages of 6-17 years suffering from childhood attention deficit hyperactivity disorder (ADHD) need constant attention as they are more likely to be accident proned, hospitalized, disruptive, and educationally challenged. The constant attention required for children with ADHD may impose stress on mothers and primary caregivers, yet this stress has not been sufficiently studied. The objective of this study was to fill a gap in literature by studying the stress experienced by African immigrant mothers living in the United States who are living with and caring for a child with ADHD, and then comparing the level of stress …

Hospital Profiling Of The Cesarean Delivery Procedure For The State Of Georgia, 2012, Denise Frances Giles

Walden Dissertations and Doctoral Studies

Approximately 35.1% of live births for the state of Georgia were delivered by the cesarean delivery procedure with significant variation among hospitals. The purpose of this research was to develop a population-based hospital profiling methodology for study of the cesarean delivery procedure. This was a retrospective, observational design, using a 2012 linked dataset that included maternity deliveries from all nonfederal hospitals. The research was guided by Robson 10 Group Classification System, propensity score methodologies, and ethical precepts, for the development of hospital profiles and the study of variations in the cesarean delivery procedure. Key research questions aimed to determine whether …

Predictors Of Excessive Alcohol Consumption Among U.S. Business Travelers, Jennifer Clore Barrickman

Walden Dissertations and Doctoral Studies

Excessive alcohol consumption (EAC) is an important public health problem. Several researchers have examined work-related influences on EAC, but few have investigated the predictors of EAC related to business travel. This study measured the association between EAC and frequency of business travel, duration of business travel, and job industry among U.S. business travelers. Research was conducted within the social-ecological theoretical framework. Snowball sampling was used to gather data from 187 business travelers. Data were evaluated using bivariate analysis to assess the association between measures of EAC and each independent variable. Multiple logistic regression was used to adjust for covariates. Respondents …

The Association Of Cancer Development In Patients With Systemic Lupus Erythematosus, Rose Michelle Coley

Walden Dissertations and Doctoral Studies

The Association of Cancer Development in Patients with Systemic Lupus Erythematosus by

Rose Michelle Coley

MPH, Walden University, 2011

BS, University of Mount Olive, 2008

Dissertation Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Public Health

Walden University

March 2016

Both cancer and autoimmune diseases have been associated with numerous factors that may independently lead to the development of either disease. When these factors overlap the difficulty in assessing association is compounded. The numerous factors that are thought to cause systemic lupus erythematosus (SLE), which leads to the development of cancer, makes the study …

Behaviors Related To Hiv Infections In Rural Versus Urban Regions Of Nigeria, Michael Ifeanyi Okeke

Walden Dissertations and Doctoral Studies

Efforts by the Federal Republic of Nigeria and international nongovernmental agencies to reduce the impact of HIV in Nigeria have not yielded the anticipated results. This study focused on the association between attitude, religious beliefs, knowledge of HIV, sexual risk behavior, and HIV epidemiology in rural and urban Nigeria. This quantitative study used social-cognitive theory and problem theory. The study was based on the Nigerian Demographic and Health Survey (NDHS) 2013 data including a sample of 33,006 participants. Specific covariates including gender, sexual partners over the past years, age at first sexual encounter, socioeconomic status, and literacy level were obtained …

Effect Of Genetic Background Combined With Excessive Media Screen Time On Markers Of Cardiovascular Risk In United States Youth Aged Newborn To 20 Years, Maria Moroni

Walden Dissertations and Doctoral Studies

Time with media screens (television, computers, videogames, cell phones, and tablets) is the primary activity of youth, second only to sleeping, and represents a major risk factor for cardiovascular diseases (CVD). Additionally, the populations with highest rates of screen time are also those most at risk of CVD from genetic predisposition (i.e., Blacks, Hispanics). The purpose of this descriptive, correlational study, based on cross-sectional analysis of archived data from the 2009 - 2010 NHANES for United States youth, newborn to 20 years old, was to determine whether the combination of media screen time with genetic background is a better predictor …

Risk Factors For Measles Among Hiv-Infected Children In Uganda, Miriam Nanyunja

Walden Dissertations and Doctoral Studies

Measles remains a major global public health problem. Attainment of high population immunity to measles through vaccination is necessary to control this disease. Children infected with HIV infection often experience secondary measles vaccine failure by 2 years of age, making them susceptible to measles. It is not clear whether HIV-infected children on Highly Active Antiretroviral Treatment (HAART), older than 2 years, have a higher risk of measles than HIV-uninfected children. This retrospective cohort study, guided by the proximate determinants framework, was conducted to compare the risk of measles between HIV-infected children on HAART (exposed) and HIV-uninfected peers (unexposed). The age …

Socioecological Determinants Of Obesity Among Hispanic Parents/Child Caregivers In Aurora, Illinois, Deanna Marie Sommers

Walden Dissertations and Doctoral Studies

Obesity has increased during the past 30 years in the United States. Obese adults and children are at risk for cardiovascular disease, diabetes, hypertension, and comorbidities. Parents and child caregivers play key roles in the decisions of family health. Studies exploring sociodemographic and socioecological factors associated with obesity among U.S. Hispanic parents and child caregivers are lacking. Guided by the socioecological model, this study examined the following factors: gender; acculturation; dietary intake of fat, sugar, fruits, and vegetables; and role as food purchaser/food preparer that influenced obesity. A 3-paper-based survey, consisting of a demographic survey, the Block Fat-Sugar-Fruit-Vegetable Screener and …

Perceptions About Sexually Transmitted Diseases In Akwa Ibom State Of Nigeria: A Qualitative Study Of Young Adults Age 18-24, Mfon Archibong Archibong

Walden Dissertations and Doctoral Studies

Despite the ongoing investments in programs to increase sexual health awareness among young adults globally, many youths remain vulnerable to sexually transmitted diseases (STDs). Two-thirds of all STDs occur among youths engaging in high-risk sexual behaviors, which put young adults at higher risk of STDs and can result in serious consequences including infertility. Additionally, the social consequences of STD affect families and communities. While a need exists for increased public awareness of STDs among young adults, extant intervention and prevention activities should be informed by a cultural perspective, including the integration of community and government roles. The purpose of this …

Predictors Of Influenza Vaccination Compliance Among Union And Nonunion Workers In A Pennsylvania Health Care System, Ericka Lynne Kalp

Walden Dissertations and Doctoral Studies

To improve U.S. residents' health, advocates are focusing their efforts on workplace health. Researchers have found that unionization is a positive influence on workers' participation in health promotion programs relating to smoking and obesity prevention. However, the effect of union membership on other health promotion initiatives, such as influenza vaccination compliance among health care workers, has not been examined. The purpose of this quantitative study was to address this knowledge gap between a union and a nonunion health care facility in the U.S. state of Pennsylvania. The health belief model was used to determine if different domains of influenza vaccination …

Experience With Social Support Systems Among Women Exposed To Intimate Partner Violence In Cameroon, Ahone Esther-Alice Ngujede

Walden Dissertations and Doctoral Studies

The southwest and northwest regions of Cameroon have experienced high rates of intimate partner violence (IPV). Limited information is available about IPV victims' experiences with social support systems. This phenomenological study was aimed at investigating IPV victims' lived experiences with social support systems in Cameroon. Some of these systems are the judicial system, police officers, hospitals and clinics, and domestic violence agencies. The Health Belief Model (HBM) and the Transtheoretical Model of Change (TTM) were used to understand how 8 self-identified victims of IPV were able to discuss their lived experiences with social support systems. The research questions addressed women's …

The Impact Of Free Healthcare On Hospital Deliveries In Sierra Leone, Salifu Salito Samura

Walden Dissertations and Doctoral Studies

Improving maternal health has been a challenge for developing nations with very high rates of maternal mortality. Sub-Saharan Africa, particularly Sierra Leone, has some of the highest maternal mortality rates in the world. In an attempt to improve on this, the Sierra Leonean government enacted free maternal healthcare services in 2010. The Sierra Leone Free Healthcare Initiative (SLFHCI) provides free healthcare for pregnant women, lactating mothers, and children under 5 years old. This research explored the impact of the free healthcare on hospital deliveries. The determinant of health model was used to evaluate the effectiveness of the SLFHCI program, and …

Hiv-Positive Status Disclosure Barriers In Stable Heterosexual Partners In Warri, Nigeria., Edith Nkechinyere Ogbozor

Walden Dissertations and Doctoral Studies

Nondisclosure of positive status drives the secondary transmission of human immunodeficiency virus (HIV) infection. This cross sectional quantitative survey study grounded by the consequence theory evaluates fear of stigma, lack of social support, and level of HIV-related knowledge as barriers to self-disclosure of HIV-positive status to stable heterosexual partners. A sample of 303 HIV-infected respondents (111 men and 192 women) accessing antiretroviral therapy at 4 designated centers in Warri, Nigeria, completed the self-administered questionnaires. Logistic regression analysis was used to assess the association between these factors and spousal HIV-positive status disclosure. Results demonstrated: (a) social support availability significantly predicted HIV …

Experiences Of Colorado Parents As They Recognized Their Child's Mental Illness, Lori Salgado

Walden Dissertations and Doctoral Studies

Mental illness is not only the leading cause of disability among adults, but there is also an emerging public health crisis in childhood mental illness. A majority of parents do not recognize symptoms of psychological disorder in their children, and current policies and programs for mental health service delivery are not sufficiently responsive to the early help-seeking dynamics of families. Using a concurrent mixed methods design, this study explored how parents in the Pikes Peak region of Colorado learned to recognize their child's mental illness. Phenomenological interviews, augmented by poetic inquiry and quantitative measurements, were used to discover factors that …

Influence Of Overweight, Obesity, Social Support, And Self-Efficacy On Breastfeeding Outcomes Among African-American Women, Elizabeth Hoo

Walden Dissertations and Doctoral Studies

Breastfeeding reduces morbidity and mortality among mothers and children, yet African-American women breastfeed at lower rates than women of other racial and ethnic groups do. Higher rates of overweight, obesity, and low socioeconomic status may be contributing factors in this population; however, limited research exists regarding the roles of maternal overweight and obesity on breastfeeding outcomes. The purpose of this study was to examine whether social support and self-efficacy positively influence breastfeeding outcomes among overweight and obese African American women. Self-efficacy and social support theories provided the theoretical framework for the study. Research questions examined whether (a) maternal overweight and …

Hiv Knowledge, Intoxication, Risky Behaviors, And Sexual Communication Among Nigeria University Students, Johnpaul Chukwuemeka Ezeonyido

Walden Dissertations and Doctoral Studies

Poor sexual communication among Nigerian youth can create problems for health workers, medical practitioners, and the government in determining what is and is not working in their attempts to reduce sexually-related diseases. This quantitative study used self-administered questionnaires among 107 Nigerian university students, aged 18 to 35, to determine if a statistically significant predictive relationship existed between: (a) beliefs about alcohol, (b) HIV knowledge, (c) risk behaviors, (d) age, (e) religion, (f) gender, (g) sexual activity status, (h) dating status, (i) language, (j) sexual orientation, and (k) tribes of Nigerian university students and their sexual communication with partners. Previous studies …

The Impact Of Post Traumatic Stress Disorder On Recurrent Violent Behavior Among African American Males, Adrian Cox

Walden Dissertations and Doctoral Studies

African American men in their late teens to early 20s account for nearly half the victims of violent crimes. This mixed methods social epidemiological study was designed to identify the social determinants of violence as described by a purposive sample of young adult African American men (n=353) who have experience as a victim or witness to any type of violence to determine the impact post traumatic stress disorder (PTSD) symptoms have on recurrent violent injury. The pathways to recurrence model shaped the theoretical framework of this study. Quantitative data were collected using the Past Feelings and Acts of Violence (PFAV) …

Adherence To Self-Care Management Of Sickle Cell Disease Among Caregivers, Muinah Adenike Fowora

Walden Dissertations and Doctoral Studies

The self-care management of sickle cell disease (SCD) improves mortality rate; however, compliance with SCD self-care management remains a problem. The purpose of this study was to examine the knowledge and factors that influence compliance with SCD self-care management recommendations among caregivers of children with SCD. The health belief model was used as the theoretical foundation of this study, theorizing that caregivers' perceived susceptibility, severity, and benefits of SCD self-care management will influence compliance. The study used a quantitative research design. A cross-sectional survey was administered to 100 caregivers of children with SCD attending sickle cell clinics in Lagos, Nigeria …

Association Between Diabetes/Chronic Disease Incidence And Lifestyle Factors Among African-Born Populations, James Walakerwon Gbala

Walden Dissertations and Doctoral Studies

Numerous studies have revealed that immigrants' health and well-being is challenged by an increased susceptibility to diabetes/chronic disease as they settle in the United States. This study investigated a potential association between the incidence of diabetes/chronic disease and various lifestyles factors among Sub-Saharan African immigrants and refugees. The lifestyle factors studied were sociodemographics, food practices and dietary habits, access to healthcare and insurance, acculturation, and the length of stay in the United States among these immigrants and refugees residing in Minnesota. The health belief and the socioecological models guided this study to improve understanding of Sub-Saharan African's health behavior and …