Public Health Commons^™

Contextual Factors And Direct Exposure To Hiv: Influences On Youth Sexual Intention, Hadiza Ladidi Osuji

Walden Dissertations and Doctoral Studies

Youth are having sexual intercourse at an early age and as such, are engaging in risky behaviors that are associated with adverse health outcomes, including HIV infection. Little research has been undertaken to examine the influence of contextual factors on youth intentions to delay sexual involvement. To address that gap, this study aimed to examine the influence of age, gender, race, immigration status, HIV knowledge, HIV-related stigma, concern about HIV, direct exposure to HIV/AIDS, peer pressure, and religious influence on youth intentions to delay sexual involvement. Delayed sexual involvement was conceptualized as youth attitudes towards abstaining from sex, their knowledge …

Laying The Foundation For New Approaches In Evidence-Based Sex Education Curriculum Programs: A Family Life Policy Change, Rina Marie Prosser

Walden Dissertations and Doctoral Studies

The teen pregnancy rate in Henry County, Tennessee has increased over the years. The purpose of this project was to develop an evidence-based family life education policy for possible adoption by the board of education to address the persistent high teen pregnancy rate for girls aged 15-17 in the county. This present study resulted in a revised policy that was based on a comprehensive policy termed Abstinence-Centered Plus Contraception. An 18-member collaborative, organizational, and community project team, made up of community leaders, nurses, counselors, teachers, and students, assisted in the development and adoption of the policy, practice guidelines, and the …

Marketplace Clinics Complementing Community-Based Diabetes Care For Urban Residing American Indians, Robert Steven Rick

Walden Dissertations and Doctoral Studies

The American Indians population in Minneapolis, Minnesota has experienced limited health care access and threefold diabetes health disparity. The purpose of this study was to measure the extent to which collaborating marketplace clinics and community-based support groups expanded diabetes care and provided self-management education for this largely urban Indian neighborhood. The marketplace clinics located in nearby CVS, Walmart, Target, and Supervalu stores committed financial support, certified educators, and pharmacy staff for the community-based support group. The study was conducted within the patient activation measure (PAM) analytical framework to assess the participants' acquired knowledge, skills, and confidence for diabetes self-management. A …

Obesity And Workplace Injury In Hazardous Occupations Among The Hispanic/Latino Population, Barbara Klyde

Walden Dissertations and Doctoral Studies

Over the past 20 years, adult obesity has increased in the United States, especially among the Hispanic/Latino population. In 2010, the Occupational Safety and Health Administration Environmental and Safety News, reported that younger workers, ages 18 to19 years of age, worked in the most high-risk occupations such as agriculture, construction, fishing, and manufacturing. The reported fatality rates for these occupations were 5.6 times greater for Hispanic workers compared to other race/ethnicity groups reported by the Bureau of Labor Statistics in 2013. This study determined whether obesity contributed to workplace injury or mortality in hazardous occupations, using federal, state, and independent …

Acceptance And Uptake Of Influenza Vaccination By Health Care Workers, Leshonda Wallace

Walden Dissertations and Doctoral Studies

Influenza is a preventable infectious disease, against which vaccination is the primary means of protection. Health care workers (HCW) are among the most vulnerable to the illness and are likely to be sources of infection transmission while caring for patients. Circumstantial evidence suggests higher rates of vaccination coverage by HCW will coincide with a lower incidence of influenza transmission, yet a gap remains in the literature regarding governing health agencies' (i.e., licensing boards, medical and nursing associations) influence on the influenza vaccination practices of their constituents. Moreover, discrepancies exist between governing health agencies' and the National Vaccine Advisory Committee's recommendations …

Effect Of A Lifetime Health And Fitness Class On College Students, Tiffany Tara Young Klockziem

Walden Dissertations and Doctoral Studies

Physical inactivity and obesity, both of which are modifiable cardiovascular disease (CVD) risk factors, increase substantially during the transition from adolescence to young adulthood. CVD is the 5th leading cause of death in people ages 18 to 29. This disease has enormous social and financial repercussions; however, many college age students do not see chronic disease as a personal threat. Few researchers have examined chronic disease risk in young adults or used a consistent, objective measurement of physical activity. A pre-post, quasi-experimental study was conducted to evaluate the association between a health and fitness class, physical education 215 (PHED 215) …

Factors Impacting Body Mass Index Of Hispanic Youth In A Weight Loss Program, Elizabeth Maria Hartman

Walden Dissertations and Doctoral Studies

Youth obesity prevalence rates in the United States are trending down; however, for Hispanic youth, rates are increasing despite efforts toward a reduction. The purpose of this study was to evaluate the impact of a culturally focused intervention program on weight reduction of Hispanic youth age 2 to 19 through examination of body mass index (BMI) percentile outcomes comparing age, gender, distance to program, time in program, and season of enrollment. Review of literature supports ecological and cultural approaches requiring behavior modification tailored to family and community as successful in decreasing youth obesity. However, researchers have yet to establish how …

Identifying Cultural Themes In A Shared Experience Of Water Hygiene Education Partners, Sarah M. Etheridge-Criswell

Walden Dissertations and Doctoral Studies

Lack of safe drinking water and lack of water hygiene literacy contribute to a large disease burden in rural areas of Africa, and children suffer disproportionately more than adults from diarrheal diseases caused by nonpotable water. Research is needed to help merge education and water sanitation to provide more effective methods of preventing diarrheal diseases. The ecological model and hygiene improvement framework were used to guide the study. The purpose of this phenomenological study was to describe the shared experiences of people participating in the water hygiene education program provided by Lifewater International. Lifewater is a nonprofit organization focused on …

Mining And Hiv/Aids Transmission Among Marampa Mining Communities In Lunsar, Sierra Leone, Alphajoh Cham

Walden Dissertations and Doctoral Studies

Since the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) was first reported in Sierra Leone in 1987, its prevalence rate has stabilized at 1.5% in the nation's general population. However, concerns exist regarding the potential increase in high-risk populations, particularly among mineworkers and commercial sex workers. The potential spread of HIV/AIDS as a result of labor migration may threaten the mining sector, which has been identified as a critical driver of recent economic growth and development. A gap remains in the literature regarding the contextual factors in mining communities that lead to high rates of HIV/AIDS. Therefore, the purpose of …

Race/Ethnicity, Diet, And Physical Activity Behavior Among College Students, Ronda Herbert

Walden Dissertations and Doctoral Studies

Scarce knowledge exists about the lifestyle of college students from heterogeneous racial/ethnic backgrounds and how race/ethnicity may influence their diet and physical activity behaviors. College students, especially those who are members of minority groups, are at risk for unhealthy lifestyles resulting in negative health outcomes. The purpose of this quantitative study was to examine the role of racial diversity on dietary and physical activity habits. The study was guided by social cognitive theory, and the research questions examined the relationship between race/ethnicity on diet and physical activity in a multiracial ethnic population. The study research design was a quantitative cross-sectional …

Maternal Depression, Infant Feeding Practices, And Weight Gain Among African American And Hispanic Women, Alphonsus Maduwuba Agbaere

Walden Dissertations and Doctoral Studies

Childhood overweight and obesity are public health concerns that have negative health consequences and affect many children. Efforts are needed to identify children who are at a higher risk of developing overweight and obesity so that early detection and treatment may be offered. The intent of this study was to investigate the differences in the effects of postpartum depression on infant feeding practices and infant weight gain between Hispanic and African American women. Data were obtained from Infant Feeding Practices Study 11, a longitudinal study involving mothers in their third trimester through infants first year of life. The overall test …

Increasing Knowledge About Alpha-1 Antitrypsin Deficiency In The Chronic Obstructive Pulmonary Disease Population, Maureen Ann Wentink Barta

Walden Dissertations and Doctoral Studies

The purpose of the project was to increase awareness about alpha-1 antitrypsin deficiency (AATD) in chronic obstructive pulmonary disease (COPD), particularly among those with a familial history of genetic factor AATD; an additional goal was to understand its relationship to COPD. COPD is the third leading cause of death in the United States, with more than half of COPD patients experiencing significant disabilities. Major causes for COPD include smoking, air pollution, secondary smoke, upper respiratory infections, hereditary factors, occupational factors, environmental factors, and socioeconomic factors. Genetic factors, however, also play a significant role in early onset COPD and in those …

Concordance Of Genotyping And Phenotyping In The Classification Of Methicillin-Resistant Staphylococcus Aureus, Ali M. Bazzi

Walden Dissertations and Doctoral Studies

Methicillin-resistant Staphylococcus aureus (MRSA) strains have spread in Saudi Arabia, increasing morbidity, mortality, and financial burdens. Recent studies have suggested the phenotyping methods typically used to classify MRSA as either health care MRSA (HA-MRSA) or community-associated MRSA (CA-MRSA) cases are unreliable, because they lack concordance with the results of genotyping. Yet the expense associated with genotyping precludes its use in the Saudi Aramco population in Saudi Arabia. The absence of a standardized and affordable method to classify MRSA into CA-MRSA and HA-MRSA has been a challenge for infection control programs in Saudi Arabia. The objective of this quantitative, secondary data …

Uterine Fibroid Symptom Severity And Impact On Health-Related Quality Of Life Among African American Women, Ilisher Ford

Walden Dissertations and Doctoral Studies

A disproportionate number of African American women are at increased risk for uterine fibroid tumors (UF) compared to their Caucasian, Asian, and Hispanic counterparts. Researchers have indicated that women diagnosed with UF can have a poorer health-related quality of life (HRQOL) when compared to women who do not have a diagnosis of UF. The overall aim of this study was to explore the impact of UF symptoms on the HRQOL of African American women. A quantitative, cross-sectional design was employed utilizing the revised version of Wilson and Cleary's model of HRQOL. A sample was gathered of 80 participants who were …

Female Genital Mutilation/Circumcision: Culture And Sexual Health In Igbo Women In Dallas-Fort Worth, Texas, Dorothy Ebere Ukoha

Walden Dissertations and Doctoral Studies

Female genital mutilation (FGM) is practiced primarily in many African countries as well as some in Asia and the Arab Peninsula; however, it also takes place elsewhere around the globe among those who migrate from countries to which it is indigenous. This study was designed (a) to investigate the prevalence of FGM among the Igbo women in the Dallas-Fort Worth (DFW) area in Texas and (b) to understand the factors that support the continuation of the practice and the effects on women's sexual health. Using a quantitative approach to examine a variety of social variables aligning with the ecological framework, …

Underserved Patients' Perspectives On How The Ehr Impacts Their Health, Marie Mirna Lexima

Walden Dissertations and Doctoral Studies

Our modern health care system requires technology that can deal with multidisciplinary and complex processes, operations, and situations. The EHR, by far, is one of the greatest health information technology innovations that satisfy these requirements because of its efficiency and the effectiveness of its features. This study sought to develop an in-depth understanding of how underserved patients' perspectives about their health and illness, can contribute to greater use of the EHR. It also sought to improve their health outcomes and maintain sustainable change in the lives of the underserved. A quantitative non-experimental design study was conducted over a 6-week period …

Predictors Of Condom Use Among Middle-Income, African American Women, Yvonne Maire Reed

Walden Dissertations and Doctoral Studies

Abstract

The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome

(AIDS) continue to be a major public health threat, not only within the United States but

also on a global scale. Within the U.S. heterosexual population, African Americans

(AAs) continue to bear the greatest burden of new HIV infections. Additionally,

HIV/AIDS interventions have focused on low-income AA women, virtually ignoring

their middle-class counterparts who may be subject to the same sexual risks. The purpose of this quantitative, cross-sectional study was to determine whether if there was an association between the 5 constructs of the Health Belief Model (HBM) and …

Spheres Of Influence: Understanding African American Males' Perceptions And Attitudes Toward Infant Feeding Practices, Makeva M. Rhoden

Walden Dissertations and Doctoral Studies

Although U.S. breastfeeding rates have steadily increased since 2000, there continues to be a disparity in breastfeeding rates for African American (AA) women compared to their non-Hispanic White counterparts. A male partner's perception, specifically his positive attitude toward breastfeeding, may influence breastfeeding initiation and duration rates. This study was an exploration of AA male perceptions and attitudes toward breastfeeding and what effect masculinity ideology (gender norms) has on such attitudes. The socio-ecological model (SEM) was used as the theoretical framework to examine the various environmental levels that intersect with one another to influence these attitudes. A mixed methods study design, …

Barriers To The Influenza Vaccination In Veterans, Zina Floyd

Walden Dissertations and Doctoral Studies

Influenza is the eighth leading cause of death in the United States, accounting for 56,000 deaths annually and leading to an average of more than 200,000 hospitalizations every year. Adults 65 years of age and older account for 50% to 60% of influenza-related hospital admissions and an estimated 90% of influenza-associated deaths occur in people age 65 and older. During the 2011 to 2012 influenza season, approximately 50 % of veterans between 45 and 70 years of age refused the influenza vaccine within the metro-area outpatient Veteran Administration (VA) facility in Atlanta, Georgia. The aim of this project was to …

Determinants Of Hiv Stigma Among Healthcare Workers In Ghana, Catherine Gyamfua Dawson-Amoah

Walden Dissertations and Doctoral Studies

HIV-related stigma and discrimination is a complex concept that affects HIV reduction interventions. HIV-related stigma occurs among healthcare providers resulting in reduction of quality of care of people living with HIV. Social psychological research into stigma reduction has led to the development of many stigma reduction interventions, but has not resolved the underlying problem. This study was designed to identify predictors of stigmatizing behavior among healthcare workers in Ghana using the social cognitive theory (SCT) for use in developing an evidence-based intervention. The study used a cross-sectional research design incorporating a preexisting survey, Measuring HIV Stigma and Discrimination Among Health …

Differentiating Demographic Factors In Latino Patients With Type 2 Diabetes, Carol Lynne Manning

Walden Dissertations and Doctoral Studies

The American Diabetes Association (ADA) data suggest that Latinos share a greater burden of disease than do non-Latino Whites with type 2 diabetes. As a result of poor glycemic control, Latinos also suffer consequences such as blindness, kidney disease, and limb amputation more often than do other ethnic groups. The purpose of this study was to compare demographic factors of Latinos with well-controlled type 2 diabetes, as measured by a HgbA1c of 7 or less (n = 118) to Latinos not well controlled (n = 105). This cross sectional study used a secondary data set with a sample selected from …

Albumin Levels In Hispanic Dialysis Patients With And Without Type Ii Diabetes, Hector Hernandez

Walden Dissertations and Doctoral Studies

Albumin provides the vital scaffolding for growth and tissue repair and supports oncotic blood pressure and hemodynamics. In hemodialysis patients, albumin aids with fluid removal by drawing excess fluid from edematous tissues back into the blood where it can then be removed by a dialyzer. The hyperglycemia seen in dialysis patients with Type II diabetes progressively damages kidney glomeruli, which permits albumin seepage into the urine, thus lowering serum albumin. The conceptual framework underpinning this research is the van't Hoff theory of osmotic pressure. Under this framework, the solute-solvent relationship largely contributes to the osmotic movement of fluid. The purpose …

Diabetes Among Hispanic Immigrants: The Impact Of Age At Migration, Nancy Hahn

Walden Dissertations and Doctoral Studies

Diabetes is a disease that affects the Hispanic population in disproportionate numbers. With larger numbers of immigrants coming to the United States who are of Hispanic origin, the individual risk and health burden of this disease will have a major impact on the quality of life and the health care system. Research into the influence of the timing of changes in lifestyle suggested an association between specific levels of socioecological exposures and certain health conditions. This study examined that possibility. The use of the National Health Interview Survey, 2005-2011, provided adequate data for examining whether age at migration was associated …

Sociodemographic Predictors Of Medication Nonadherence Among Latinos Diagnosed With Diabetes Type Ii, Bianca L. Tristan

Walden Dissertations and Doctoral Studies

Latinos of low socioeconomic status are disproportionately affected by diabetes Type II complicated by poor adherence to diabetes Type II medications and management programs. Self-management of diabetes Type II is a tool used to teach health education to patients with diabetes. The objective of this retrospective quantitative study was to explore if there are predictors of nonadherence to diabetes Type II medications and programs among Latinos with diabetes Type II. Data from 200 patient records from a community clinic in Fresno County California were analyzed using both bivariate and multivariate analysis. Selected sociodemographic independent variables were age, gender, income, migrant …

Women's Experiences With The Follow-Up System For Cervical Cancer In A Developing Country, Christine Carol Richards

Walden Dissertations and Doctoral Studies

Although Grenada has an extensive health care infrastructure and cervical cancer screening rates are relatively high, Grenada also has a disproportionate rate of morbidity and mortality from cervical cancer. The aim of this study was to explore factors that contribute to these disproportionate rates in Grenada. Using a phenomenological qualitative approach, Andersen's behavioral model of health care utilization and a systems based model for assessing care were used as a guide to explore Grenadian women's follow-up experiences with Pap test and cervical cancer screening. Purposive sampling was used to recruit 8 women for semi-structured in-depth interviews. Data were collected on …

Predictors Of Full Childhood Immunization Status In Owerri, Nigeria, Osuala Uzor Kelvin

Walden Dissertations and Doctoral Studies

Full (complete) childhood immunization against tuberculosis, poliomyelitis, diphtheria, tetanus, hepatitis B, yellow fever, measles, and the maternal retention of immunization documentation are the most cost-effective interventions against vaccine-preventable childhood diseases. The full childhood immunization rate in Nigeria has not reached the expected target level of compliance at 90%. Using the social ecological model, this study investigated the influence of maternal satisfaction with postnatal services and paternal support on full childhood immunization status; it also examined the association between maternal factors and the maternal retention of immunization documentation in Owerri, Nigeria. The hypotheses were that maternal satisfaction with postnatal services and …

The Role Of Sociodemographic Characteristics And Antiretroviral Prophylaxis On Risky Sexual Behavior Among Men Who Have Sex With Men, Leonard Obodo

Walden Dissertations and Doctoral Studies

Recent multicenter, randomized, double blind clinical trials have shown no association between HIV preexposure prophylaxis (PrEP) and increased sexual risk behavior among high-risk men who have sex with men (MSM). However, little research has been conducted under natural conditions devoid of clinical trial controlled environment to confirm the lack of association between PrEP and increased sexual risk behavior. Also, research has shown conflicting associations between sociodemographic characteristics and sexual risk behavior among MSM. In this cross-sectional, web-based, primary data analysis, MSM who reside in United States of America (USA) and who make use of PrEP for HIV prevention were examined …

Crash Risk Associated With Cellular Phone Use While Driving, Tiffani Ann Fordyce

Walden Dissertations and Doctoral Studies

There are inconsistencies in the published literature on the effect of cellular phone use while driving. The objective of this study was to estimate an adjusted nationwide crash rate associated with cell phone use while driving and to compare statewide crash rates prior to and following the implementation of legislation banning cell phone use while driving. Crash rates in nationally representative databases were calculated based on imputed values for cell phone use using the propensity score method. The imputed nationwide crash rate for fatal crashes (1.61 per 100 fatal crashes) and all crashes (1.409 per 100 crashes) represented a 2 …

Predictors Of Obesity Among Nigerian Immigrants In The United States, Olawunmi Obisesan

Walden Dissertations and Doctoral Studies

Obesity has been identified as a significant risk factor for chronic diseases, contributing to health disparities in minority and vulnerable populations. Though research has identified an increased risk for obesity in the Hispanic immigrant population, there is little or no research on the heterogeneity of obesity predictors in specific immigrant populations in the United States. This study examined the predictors of obesity in the Nigerian immigrant population in the United States. Guided by the social ecological model and the segmented assimilation theory, this cross-sectional study collected primary data from 205 Nigerian immigrants in the United States using the CDC's Behavioral …

Third-Degree Family Health History And Perception Of Disease Risk, Liana Carrasco Romero

Walden Dissertations and Doctoral Studies

Chronic diseases are a significant cause of illness and mortality in the United States. Hereditary predisposition to chronic diseases is a useful indicator for identifying people at risk for disease development. An ideal tool for determining this predisposition is the CDC, NIH, and AAFP recommended third-degree family health history (FHH). The aim of this quantitative, cross-sectional study, based on the theoretical frameworks of social constructivism and the health belief model, was to assess the possible influence between the completed third-degree FHH and the participant's perception of disease risk. Two-hundred seventy-three participants were recruited from health care facilities and from the …