Public Health Commons^™

Mental Health, Chronic Disease, And Substance Use: Findings From Rural Texas, Subi Gandhi, Ryan Glaman, Elizabeth Wachira, Muna Bashir, Sushma Sharma, Chelsea Mowles, Jasmine Luttrell

Journal of Social, Behavioral, and Health Sciences

There are vital links among mental health conditions, chronic diseases, and substance use disorders. Simultaneous examination of the relationship among these three conditions is essential for providing well-integrated care to rural residents who have limited resources and for representing medically underserved areas. We aimed to assess the burden of behavioral health conditions and chronic diseases from a rural Texas community to garner context-specific insights and inform effective health promotion strategies in similar communities. We conducted a cross-sectional study among 181 residents from various zip codes in a rural Texas county. A self-administered, 18-item health-needs questionnaire was used to collect data …

Social Cognitive Theory Constructs That Predict Betel Nut Chewing Among Secondary Students In The Solomon Islands, Lepani Waqatakirewa, Manoj Sharma, Hadi Danawi, Ambrose Roots Gali

Journal of Sustainable Social Impact

Background: After alcohol, tobacco, and caffeine, areca or betel nut is the fourth most commonly abused substance in the world. The prevalence of betel nut use in the Solomon Islands is estimated at 68% in young people. Long-term use can result in detrimental health outcomes such as oral cancers and metabolic syndrome.

Methods: The purpose of this quantitative cross-sectional study was to determine whether the constructs of social cognitive theory (SCT) can predict betel nut use in Year 12 secondary students in the Solomon Islands. Five SCT constructs of expectations (outcome expectations and outcome expectancies), self-efficacy, self-efficacy to overcome barriers, …

Health Expectations, Risk Tolerance, And Walking In Peripheral Artery Disease-Related Claudication, Sherene Sharath, Panos Kougias, Neal Barshes

Journal of Social, Behavioral, and Health Sciences

We examined the association between health expectations, baseline physical activity, and self-reported symptom severity among patients with claudication: calf pain that occurs during walking and is relieved at rest. Beliefs and attitudes toward exercise influence the behavior. When walking is prescribed as an alternative to surgical intervention with the intention of decreasing symptom severity, as is the case with claudication, it is important to assess patient perceptions, beliefs, and expectations. Through a phone survey, participants described the severity of their symptoms via the Walking Impairment Questionnaire. Data were collected on (1) health expectations and attitudes, assessments of value placed on …

Guidelines For Managing Dysautonomia Dysfunction, Angela Coleman Webb

Walden Dissertations and Doctoral Studies

Dysautonomia dysfunction (DD) is a disorder of the autonomic nervous system. Over 70 million people suffer from some type of DD, and the average length of time from symptoms to diagnosis is 6 years. Most facilities and providers choose not to treat DD due to the number of symptoms and the difficulty of being able to diagnose correctly. The purpose of this project study was to create guidelines for the diagnosis, treatment, and management of DD. The research question addressed the effectiveness of these guidelines to help nurses and providers caring for patients with DD provide better care. Watson’s theory …

Stress On Correctional Officers In High Demand And Low Control Work Environments, Amy Whiting

Walden Dissertations and Doctoral Studies

Many major health concerns can be caused due to stress that stems from the demands put upon a person from their job. Correctional officers can experience high demands from their job as well as little control due to on-the-job experiences, such as being assaulted by an inmate, witnessing an assault by an inmate on another correctional officer, or having a complaint filed against them by an inmate. The purpose of this study was to determine if there is a relationship between these experiences and stress-related symptoms, such as gastrointestinal issues, headaches, neck or back pain, difficulty concentrating, and more while …

Assessment Of Multidrug Resistance Among Tuberculosis Patients In Lesotho, Jerry Yakubu Yahaya

Walden Dissertations and Doctoral Studies

The emergence of multidrug-resistant tuberculosis (MDR-TB) jeopardizes the tremendous efforts in the fight against tuberculosis in Lesotho. To understand the occurrence of MDR-TB, it is important to identify the associated risk factors and how to address them. There is a literature gap on the sociodemographic risk factors associated with MDR-TB in Lesotho. This study assessed whether there is any significant association between age, employment, income, sex, education, place of residence and MDR-TB. The association between HIV and MDR-TB was also evaluated. Guided by the health belief model and social cognitive theory, a retrospective case-control study design and a proportionate stratified …

Social Capital And Food Insecurity In Two Counties In Wisconsin, Yvonne Denise Greer

Walden Dissertations and Doctoral Studies

Hunger and food insecurity are public health issues with 38 million people in the US struggling with food hardship. This study examined if there was a relationship between four types of social capital (SC) (bonding, bridging, community structural-formal, and community structural-informal), income, and food insecurity risk (FIR), in two counties in Wisconsin. A quantitative descriptive correlational study design involving multiple linear regression analysis and the integral model framework was conducted with cross-sectional secondary data from the 2014-2016 Survey of the Health of Wisconsin. Participants were from Milwaukee (n = 335) and Dane County (n = 235). Results revealed that in …

Predictors Of Homelessness Among Female Veterans And Civilians, Victoria Caridad Justiniano Quinones

Walden Dissertations and Doctoral Studies

Homelessness among female veterans is a problem that is likely to increase as growing numbers of women in the U.S. military reestablish themselves into their communities as veterans. There has been increasing concern about the greater risk for homelessness found among female veterans when compared to their nonveteran counterparts, so further investigation of homeless incidence by gender is also warranted. This quantitative, exploratory study was grounded in the social ecological theory, the Balshem and colleagues conceptual model of risk factors for veteran homelessness, and the Susser, Moore, and Link conceptual model which investigated causal pathways that are possible risk factors …

Examining Health Care Utilization Among Adult Heart Disease Patients With Self-Reported Depressive Symptoms, Courtney R. Lockett

Walden Dissertations and Doctoral Studies

Health care costs are most commonly concentrated among small groups of high-cost patients, or high utilizers. Many of these patients receive unnecessary and ineffective care and often critical health care needs can go unmet, even when substantial care from multiple sources is received. Thus, there is a need to look into high utilizing patients for not only quality improvement but also effective resource allocation. The operational problem for health care administrators is managing resources and improving quality of care by targeting specific medical conditions that may be high utilizers of medical resources. The purpose of this study was to identify …

The Factors Urban African American Men Perceive As Preventing Early Prostate Cancer Screening, Joel Mongo

Walden Dissertations and Doctoral Studies

Prostatic carcinoma, or prostate cancer, is the leading cause of death among adult males in the United States. The highest rate of prostate cancer is found in males of African American ethnicity, as males within this cohort are 50% more likely to develop prostate cancer than other ethnicities. African Americans men are 1.6 times more likely to develop prostate cancer and 2.4 times more likely to die from it than Caucasians. The purpose of this qualitative study was to examine the perceptions of urban African American men about factors that prevent them from seeking and receiving prostate cancer screening, and …

Alzheimer's Disease: Risk And Protective Factors To Improve Detection And Prevention, Darryl Clay Nevels

Walden Dissertations and Doctoral Studies

Alzheimer’s disease (AD) is a growing epidemic and is the sixth-leading cause of death in the United States. Individuals with AD often have comorbidities due to the aging process. There is a lack of research on comorbidities as associated risk factors for AD. The leading hypothesis indicates that cardiovascular health issues, environmental exposure, social isolation, and amyloid-beta plaques influence cognitive health and are associated with AD. This study, guided by Finch and Kulminski’s AD exposome, is a caveat to explore a patient’s physical history of cardiovascular health, modifiable behavior, social isolation, and an AD diagnosis. Participants provided health information collected …

Factors Affecting Fetal Death Among Women With Cesarean Section(S) In The United States, Iheanyi Emmanuel Nwosuh

Walden Dissertations and Doctoral Studies

AbstractThe United States has a higher rate of fetal death compared to other industrialized nations. Although many studies on the factors that contribute to fetal death have been conducted among women in general, little of this phenomenon is known among women who have had a previous Cesarean section (C-section). The purpose of this study was to explore the factors of fetal death among women with a previous C-section(s) and offer suggestions for interventions. The social determinants of health theory was used with other social constructs to provide a theoretical and conceptual framework for the study. As part of the cross-sectional …

Health Department Prevention/Education Plans And Perceived Risks Of Zika Infection, Lacey Jacques

Walden Dissertations and Doctoral Studies

AbstractZika virus is an infectious disease caused by the bite of an infected mosquito that has been linked to increased rates of microcephaly and other devastating birth defects. The existing body of knowledge has focused on the individual-level factors that influence a person’s decisions about prevention activities and risk perceptions related to Zika virus. The purpose of this study was to determine the relationship between state-level plans for prevention and education and individual-level risk perceptions. Rosenstock’s health belief model lays a foundation for why individuals make the health decisions they do and helps explain how these can be influenced for …

The Relationship Between Types Of Workplace Trauma Exposure, Burnout, And Ptsd In Mental Health Workers, Armando Dominguez

Walden Dissertations and Doctoral Studies

Work-related traumatic exposure has been studied but has not been concisely defined in the widest range of research studying trauma exposure. Specifically, it is not known from previous research whether direct, indirect, and vicarious trauma exposure predict burnout and PTSD in acute care mental health care workers. The emotional processing theory was used as theoretical foundation informing this study as the habituation of response to stress and trauma has been shown to occur incidentally and cumulatively; the theory supports the concept of dichotomous and continuous type of trauma exposure over time. The purpose of this study was to use a …

Oral Health Behaviors, Attitudes, And Dental Diseases In Native American/Alaskan Native School-Age Children, Tawanda Martin

Walden Dissertations and Doctoral Studies

Dental disease is a highly preventable pediatric disease, and 70% of Native American/Alaskan Native (NA/AN) preschool children have a history of dental caries, which is 3.5 times higher than in the general population. This study aimed to conduct a meta-analysis examining the impact of oral health behaviors and attitudes of NA/AN parents and guardians on dental disease in NA/AN school-age children. The impact of frequency of flossing and brushing, consumption of sugary foods, dental visits, dental attendance reason, sealants, fluoride treatment, and oral health education by NA/AN parents and guardians on children’s caries and periodontal diseases status was explored. Additionally, …

Comprehensive Sex Education, Religious Affiliated Organizations, And Std Knowledge Among Young Adults, Leslie Marie Shaffer

Walden Dissertations and Doctoral Studies

AbstractEvery year there are approximately 20 million new cases of sexually transmitted diseases (STDs) in the United States, and half of these are among young adults. Stark County, Ohio recently experienced an increase in chlamydia, gonorrhea, and syphilis cases among 18- to 24-year-old individuals. Public health practitioners have since called for research regarding factors that affect STD knowledge and perceptions in this population. This cross-sectional study was guided by the social-ecological model and assessed the association between attendance at a religious-affiliated institution, access to comprehensive sex education, and STD knowledge. One hundred thirty-eight (n=138) participants, aged 18 to 24 years, …

Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli

Walden Dissertations and Doctoral Studies

AbstractNurses who work in the critical care unit are more likely to experience work-related stress, fatigue, understaffing, undesirable performance outcomes, and compromised workplace safety than general care nurses. Nurse managers in these units possess insights into nurses' stress-inducing challenges, in addition to managerial and administrative perspectives. Yet there is a lack of available knowledge about the experiences of critical care nurse managers in addressing nurses' work-related stress. The purpose of this study was to explore critical care nurse managers’ experiences of potential strategies to effectively address work-related stress among nurses. The job-demand resource model was the theoretical framework for the …

Comparative Effectiveness Study Of Acute Ischemic Stroke Care Between Stroke Belt And Non-Stroke Belt Hospitals Using The Get With The Guidelines-Stroke Program, Michael Earl Brown Jr

Walden Dissertations and Doctoral Studies

Stroke is a leading cause of mortality in the United States, particularly in a cluster of states termed the stroke belt. This study examined the efficacy of the Get With The Guidelines (GWTG)-Stroke program in stroke belt hospitals (SBHs) compared to non-stroke belt hospitals (NSBHs) regarding disparities related to mortality and acute ischemic stroke (AIS) treatment (i.e., recombinant tissue-type plasminogen activator [r-tPA] rates, Door-to-Needle [DTN], Door-to-Imaging [DTI]). Use of the GWTG-Stroke program was assessed to determine if SBHs and NSBHs were quantitatively equivalent in terms of specific core stroke measures. This quantitative employed an equivalence study design with over 2.9 …

Providers’ Perspectives On Barriers Associated With Repeat Teen Pregnancies In Rural Southeastern United States, Vanessa Iheoma Iheanachor

Walden Dissertations and Doctoral Studies

Teen (or adolescent) pregnancy remains a significant public health problem in the United States. Rapid repeat pregnancy, defined as any pregnancy that occurs within 24 months of a previous birth, has been linked to adverse maternal and neonatal outcomes. The purpose of this quantitative, cross-sectional study was to understand the perceptions of health care providers (HCPs) regarding barriers that influence repeat pregnancies among adolescents in rural southeastern United States. The theoretical framework that guided this study was Urie Bronfenbrenner’s social ecological model. A survey instrument was developed and disseminated to HCPs using Qualtrics, an online survey platform. Data (n=32) were …

Spirituality-Based Programs For African American Women, Sophelia Predom Kelly

Walden Dissertations and Doctoral Studies

Because spirituality or personal value conflicts might arise between social workers and their clients, the purpose of the study was to understand personal and spirituality value conflicts. The theoretical framework for this study was adult transformative learning theory. The research questions examined how the participants described personal and spirituality value conflicts. Data were collected from interviews with two groups from Houston, Texas; Group 1 represented homeless or previously homeless African American women who self-identified as spiritual but nonreligious, and Group 2 represented White licensed master social workers. Researcher responses to the same interview questions were also recorded. Thematic data analysis …

Hospital Readmission Reduction Penalties And Chronic Obstructive Pulmonary Disease Readmissions, Anthony Aduro

Walden Dissertations and Doctoral Studies

AbstractChronic obstructive pulmonary disease (COPD) is a serious disease that affects the respiratory system, creating poor patient outcomes. Additionally, persons with COPD have higher hospital readmission rates than other patient populations. Not only is hospital readmission indicative of poor patient outcomes, but hospital readmissions are costly to healthcare organizations as well. High readmission rates are associated with wasted resources and money, and negatively impact organizational performance. The Centers for Medicaid and Medicare Services (CMS) implemented the Hospital Readmissions Reduction Program (HRRP) to reduce the rate of avoidable hospital readmissions for diseases including COPD. However, how HRRP penalties have impacted readmission …

Readiness Of Adolescent And Young Sickle Cell Patients To Transition From Pediatric To Adult Care, Tanisha D. Belton

Walden Dissertations and Doctoral Studies

Patients with sickle cell disease (SCD) face many challenges as they enter adulthood; therefore, preparing for the transition to adult care is crucial. Assessing the knowledge and skills adolescents and young adults (AYAs) possess before transitioning to adult care can aid in the success of their transition. However, a gap exists regarding factors attributed to guiding patients’ sense of readiness. The purpose of this quantitative study, driven by the theory of self-care management of SCD, was to examine the self-perceived readiness of SCD patients as they prepare to transition to adult care. Cross-sectional survey data were collected from 68 sickle …

The Impact Of Electronic Cigarettes Use On Traditional Cigarette Uses Among U.S. Adolescents, Ismail Mensah Dwumfour-Poku

Walden Dissertations and Doctoral Studies

The increased usage of e-cigarettes among adolescents in the United States (U.S.) is a major public health concern. According to the Centers for Disease Control and Prevention (CDC), nicotine, an active ingredient in e-cigarettes, is the most addictive drug in use today. The purpose of the current study was to explore the relationship between smoking of e- cigarettes and the risk of smoking traditional cigarettes among middle and high school students in Grades 6 through 12 in the U.S., and to determine if demographic factors contribute to this predisposition. This, quantitative cross-sectional study used the social ecological model as the …

Relationship Between Early Years’ Activities Of Daily Living And Alzheimer’S Disease Onset, Linyi Fan

Walden Dissertations and Doctoral Studies

A few promising studies have indicated that activities of daily life (ADL) may be a useful way of predicting Alzheimer’s Disease (AD). However, the existing cross-sectional studies fail to show how ADLs in early years predict AD, and how social factors influence health either in addition to or in interaction with individual risk factors. Using a social epidemiology framework, this study examined the relationship between early years’ ADL and the development of AD in later years. This quantitative study included 4,526 participants derived from the Health and Retirement Study (HRS) dataset. The dependent variable was whether the participant has been …

Exploring Infant Massage As Standard Nonpharmacological Treatment For Neonatal Opioid Withdrawal Syndrome, Christine Ann Perez

Walden Dissertations and Doctoral Studies

The opioid epidemic in the United States has increased opioid use in women of reproductive age, leading to in utero exposure causing withdrawal symptoms in newborns known as neonatal opioid withdrawal syndrome (NOWS). State perinatal quality collaboratives (SPQCs) have been used in hospitals with quality initiatives (QIs) to improve standardization for NOWS; however, there remains a gap in knowledge in interventions to support the mother-infant dyad such as infant massage. This general qualitative research study explored the process and experiences of implementing infant massage as a standard practice for NOWS to inform national, state, and local policy. Participants in the …

Parents’ Perspectives On Early Intervention For Children With Autism, Tiffany Schmidt

Walden Dissertations and Doctoral Studies

The purpose of this study was to analyze parent perspectives on early intervention services for children with autism. Research has shown a significant positive impact of early intervention on children with autism. A total of eight parents participated in this basic qualitative study guided by social cognitive theory. Participating parents were those whose child had an autism diagnosis and were receiving or had received early intervention services in Southeast Michigan. Data analysis included establishing themes and codes to organize the data into categories. Thematic analysis was applied by analyzing interview transcripts. The research questions used to collect data addressed parents’ …

Lived Experience Of Albanian Migrants Who Became Obese After Moving To The United States, Briseida Xhelaj

Walden Dissertations and Doctoral Studies

The problem of obesity is significant in the United States, and more information is needed about the factors that increase the risk for obesity among migrant populations like Albanian Americans. The purpose of this study was to discover the lived experience of Albanian migrants who became obese after moving to the United States. This study was guided by the social ecological model. The research questions were used to examine how individual, relationship, community, and societal level factors impacted lifestyle changes and obesity for Albanian American migrants after moving to the United States. This qualitative study involved the use of a …

Health Department Prevention/Education Plans And Perceived Risks Of Zika Infection, Lacey Jacques

Walden Dissertations and Doctoral Studies

AbstractZika virus is an infectious disease caused by the bite of an infected mosquito that has been linked to increased rates of microcephaly and other devastating birth defects. The existing body of knowledge has focused on the individual-level factors that influence a person’s decisions about prevention activities and risk perceptions related to Zika virus. The purpose of this study was to determine the relationship between state-level plans for prevention and education and individual-level risk perceptions. Rosenstock’s health belief model lays a foundation for why individuals make the health decisions they do and helps explain how these can be influenced for …

Perceptions Of Implicit Bias In New York City Healthcare System During Covid-19, Kiesha Jackson

Walden Dissertations and Doctoral Studies

Implicit bias has been identified as a significant problem that hinders effective healthcare delivery. The purpose of this qualitative exploratory phenomenological study was to examine whether implicit bias influenced healthcare services for African Americans with comorbidities aged 30 and over living in New York City during the COVID-19 pandemic. Current studies show healthcare disparities, revealing barriers with healthcare delivery; however, they do not disclose a patient’s lived experience qualitatively, which constituted a gap in the literature. The frameworks of the behavioral model of health services use, and social construction and policy design guided this study. Research questions addressed (a) whether …

Attitudes Of State Public Health Laboratory Directors Towards Iso/Iec 17025 Accreditation, Christine Kilonzo

Walden Dissertations and Doctoral Studies

The impact of ISO/IEC 17025 accreditation in state public health laboratories (SPHLs) is understudied. There is a scarcity of research on SPHLs involving behavioral intent regarding ISO/IEC 17025 accreditation. The theory of planned behavior (TPB) was utilized to evaluate SPHL directors’ attitudes towards and intent to seek or maintain ISO/IEC 17025 accreditation. To test the questions of whether the three constructs of the TPB, attitude, subjective norms and perceived behavioral control are significant predictors of intent to seek or maintain ISO/IEC 17025 accreditation, and whether there are significant differences in these constructs towards the accreditation between SPHL directors based on …