Public Health Commons^™

Retention, Viral Suppression, And Care Models In Hiv Positive Children And Adolescents In Cameroon, Eveline Mboh Khan

Walden Dissertations and Doctoral Studies

Human Immunodeficiency Virus (HIV) remains a significant public health problem in Sub-Saharan Africa with poor treatment outcomes in children and adolescents (C&As). There is a lack of information on the effects of various HIV care models (Child and Adolescent Friendly Clinic model and Support Group model) on retention in care and Viral Suppression (VS) in Cameroon. This study was carried out to identify the care model with the best outcomes for C&As, inform national scale-up strategies, resource prioritization, and contribute to the existing literature. A quantitative retrospective cohort review approach guided by the social cognitive theory was used to analyze …

An Interpretive Qualitative Study Of Idaho Head Start Families Facing Food Insecurity, Sherry Deiter

Walden Dissertations and Doctoral Studies

The purpose of this basic interpretive qualitative study was to examine food insecurity among Idaho Head Start enrolled families, focusing on barriers and deterrents to accessing available nutrition assistance programs. The social-ecological model (SEM) was used as the theoretical foundation for this study. Based on this model, the research questions were designed to explore experiences of participants related to individual, interpersonal, community, organizational, policy, and educational factors that influenced food insecurity. Parents who had children enrolled in Idaho Head Start programs that met purposeful sampling criteria were recruited for the study. A total of 11 parents, all who had experiences …

Evaluating Integrated Treatment On Recidivism For Female Offenders In Criminal Justice System, Oyin T. Popoola

Walden Dissertations and Doctoral Studies

The burden of co-occurring disorders (CODs) among offenders in the criminal justice system (CJS) in the United States, particularly among the female population, is threatening the communities. About 80% of women in the CJS were diagnosed and treated for CODs, and 63% tend to be rearrested. The study examined the possible influence of CODs, integrated treatment of CODs, and gender, on recidivism while controlling for other demographic factors. The study was based on the conceptual framework of integrated dual disorder treatment (IDDT) and feminist criminology theory. Cross-sectional quantitative study design was applied on a secondary dataset from the 2017 Treatment …

Sexual Orientation, Body Mass Index, And Methamphetamine Use Among Chicago Youth, Nileshkumar Panchal

Walden Dissertations and Doctoral Studies

Drug use and obesity are two of the most challenging health-related issues that young people face. Obesity, substance abuse, and drug addiction lead to brain dysfunction, which can decrease the quality of life and academic performance as well as increase the vulnerability of developing chronic diseases. To date, there has been little research to determine whether sexual orientation influences the relationship between body mass index (BMI) and methamphetamine use. Focusing on youth, the relationship between BMI, methamphetamine use, and sexual orientation were examined in this study through secondary data analysis of the Youth Risk Behavioral Surveillance System in Chicago. Guided …

African American Maternal Mortality In The United States: A Quantitative Analysis Of Chronic Disease And Maternal Deaths, Glory Inyang

Walden Dissertations and Doctoral Studies

African American women have higher rates of chronic disease including diabetes and cardiovascular related disease compared to White women and are 3 to 4 times more likely to die during childbirth, more than any other ethnic group in the United States. . When African American women become pregnant these conditions may influence their maternal health outcomes. This study aimed to determine difference in pregnancy related death associated with chronic conditions between African American women and White women. Based on secondary/archival data from the Center for Disease Control and Preventions' 2017 National Center for Health Statistics Mortality Multiple Cause Files a …

The Caregiver Advise Record And Enable (Care) Act And Compassion Fatigue In The United States, Karen Marie Johnson

Walden Dissertations and Doctoral Studies

The transition from hospital to home can be complicated, leaving family caregivers in stressful situations that they may not know how to handle. The burden that is placed on these individuals has led researchers to focus on the public health implications of caregiving in hopes of identifying at-risk caregivers. This quantitative analysis identified what relationships exist between caregiver compassion fatigue among family caregivers and training or education received per the Caregiver Advise Record and Enable (CARE) Act and if education influences readmission rates. A purposive sample of 385 family caregivers participated in this study. The Care Transitions Measure (CTM-15), the …

Tetanus Immunity Among Adults In The Democratic Republic Of The Congo, Sue K. Gerber

Walden Dissertations and Doctoral Studies

Although tetanus is not a contagious disease, it can be deadly for people who are exposed and do

not have protective immunity against tetanus, which can be acquired only through vaccination.

Most studies on adult tetanus protective immunity are from high-income countries; limited

studies occur in Africa, and none has been reported from the Democratic Republic of the Congo

(DRC). This study sought to determine protective immunity against tetanus among adults in

DRC in relation to their age, sex, place of residence, and for women, antenatal care. The primary

purpose of this observational cross-sectional study using a nested serosurvey within …

Meat Intake And Prostate Cancer In African American Men, Uchenna Njoku

Walden Dissertations and Doctoral Studies

African American men have more prostate cancer and are more than twice as likely to die of the disease as Caucasian men, and the reasons for this racial disparity have not been clarified. Identifying lifestyle and dietary risk factors of prostate cancer is an important public health issue. Studies on the association between meat intake and prostate cancer risk have produced inconsistent results. The purpose of this cross-sectional quantitative study was to determine whether there is an association between total meat intake and total prostate cancer risk among African American men when controlling for age, income, educational level, physical activity, …

Behavioral, Demographic, And Clinical Determinants Of Hiv Serostatus In Zambian Women, Debebe Masresha Gebreyohannes

Walden Dissertations and Doctoral Studies

The rate of human immunodeficiency virus (HIV) infection shows a diminishing trend at the global level while it shows increasing in intensity of mortality, morbidity, and burden in Sub-Saharan Africa. The intertwined behavioral, demographic, and clinical determinants fueled the incidence of infections in Zambian women. The purpose of this study was to determine the association between demographic, behavioral, and clinical determinants with HIV serostatus in Zambian women. With the conceptual framework of the World Health Organization’s Commission for Social Determinants of Health (CSDH) and quantitative method of MANOVA, this study examined Zambian Demographic Health Survey data for Zambian women of …

Impact Of Education On Hiv Testing Among African American Women In The United States, Florence Matimbah Mbangowah

Walden Dissertations and Doctoral Studies

Improved and increased human immunodeficiency virus (HIV) testing among African American women in the United States could facilitate early detection of the virus. The purpose of this cross-sectional quantitative study was to determine if there was a significant association between HIV testing participation and education level (i.e., high school, college, post-college level) based on access to healthcare after accounting for insurance, income, employment, marital status, English language proficiency, and vision quality. The integrated theory of health behavior change, the theoretical framework used for this research, proposes that changes in health behavior can be improved by various factors such as fostering …

Sociopolitical Determinants Of Parental Acceptance Of Childhood Vaccination In Abuja, Nigeria, Lawrence Madu Ohammah

Walden Dissertations and Doctoral Studies

Despite the efficacy of vaccines, some parents still reject vaccination of their children, resulting in low vaccination coverage, a greater burden of vaccine-preventable diseases, and high infant mortality. The purpose of this study was to investigate the sociopolitical determinants of vaccination status among children, aged 0-24 months, and identify the factors that drive vaccine hesitancy. The social ecological model served as the theoretical framework. The study research design was a quantitative cross-sectional survey. An interviewer-administered questionnaire was used to collect primary data from parents and caregivers in 384 randomly selected households from 48 settlements in the Abuja Municipal Area Council. …

Hiv Positive African American Women’S Lived Experiences And Clinical Outcomes, Christie Olejemeh

Walden Dissertations and Doctoral Studies

African American (AA) women are disproportionately affected by HIV/AIDS. The infection rate for AA women continues to increase, and literature lacks information specifically on education for AA women regarding viral suppression at diagnosis. The purpose of the study was to understand the lived experiences of AA women living with HIV in the District of Columbia, particularly how they acquired knowledge of viral suppression. To understand their experiences with antiretroviral medications, viral suppression, discrimination, and stigma, this qualitative study applied a hermeneutic phenomenological approach. The theories of resilience and empowerment were applied. Ten HIV positive AA women living in the District …

Guidelines For Chronic Back Pain: An Education Module For Health Providers, Ron Pascual

Walden Dissertations and Doctoral Studies

Effective chronic back pain management and patient self-care guidelines are necessary for healthcare providers treating patients with complaints of low back pain (LBP). The purpose of this doctoral project was to provide an evidence-based educational program aimed at improving the knowledge and skills of healthcare professionals regarding the Center for Disease Control (CDC) and American Chronic Pain Association (ACPA) guidelines, emphasizing alternative pain management treatments. The staff education project was supported by the biomedical pain model and chronic care model. A panel of 3 experts including the clinic’s board-certified anesthesiologist and pain management specialist, clinical manager, and leading medical director …

Exploring Health Literacy In The Acute Care Setting In A Rural Border Region, Shiloh Williams

Walden Dissertations and Doctoral Studies

Health literacy is important to ensuring patients have the necessary knowledge and skills needed to actively participate as a member of their own healthcare team. Patients with low health literacy are at increased risk for poor outcomes and limited participation in decisions affecting their health or treatment plan. Using the Social Ecological Model (SEM) as a framework, the purpose of this study was to determine the relationship between medical-surgical registered nurses, medical-surgical patients and the registered nurse’s (RN) assessment of their patient’s health literacy of those who live in a rural-border region. The study’s sample consisted of 84 pairs of …

Risk Factors For Polysubstance Abuse: A National Secondary Data Analysis Study, Dakota Mcmurray

Walden Dissertations and Doctoral Studies

Substance abuse is a serious public health problem in the United States and globally. Abuse of more than one substance is considered polysubstance abuse and can cause more harm than abuse of only one substance. Polysubstance abuse compounds the problems of addiction because of the variety of substances that may be used and the resulting side effects. This quantitative cross-sectional secondary data analysis, guided by the socio-ecological theory, assessed patient characteristics and how predictive they were for polysubstance abuse. The study sample of 986 patients was analyzed by binomial logistic regression to assess the association between patient-related factors and polysubstance …

Use Of Managerial Epidemiology By Healthcare Leaders In Ambulatory Settings, Chantelle Schenning

Walden Dissertations and Doctoral Studies

Despite many health reforms, the United States continues to struggle with limited healthcare access, exponential healthcare costs, and poor quality of care. Overcoming these challenges requires healthcare leaders’ effective navigation of industry transformation towards population health and a shift in patient volume to ambulatory healthcare settings. Research has demonstrated that the use of managerial epidemiology, an application of epidemiology tools and principles to management decision-making within healthcare organizations, can better serve the health of the population and could improve the triple aim of inadequate access, high costs, and poor quality. However, the adoption of this practice is weak and its …

Effectiveness Of An Educational Intervention To Reduce Preanalytical Specimen Errors, Carol Ann Lineberry

Walden Dissertations and Doctoral Studies

A rejected blood specimen can be very costly to a hospital as well as to the patient. Many errors occur in the preanalytical phase in which nurses and assistive personnel are often involved because they are usually not trained to do so. This staff education project was designed to decrease the number of laboratory rejections of blood specimens in a local hospital setting. Knowles’s adult learning theory was combined with the knowledge translation framework, proposed by Fredericks, Martorella, and Catallo, so that evidence-based changes in practice could occur more readily. There is a 20-minute in-service educational intervention followed by an …

Perceptions Of Fruits And Vegetables Amongst Supplemental Nutrition Assistance Program Recipients, Latasha Shanelle Reddick

Walden Dissertations and Doctoral Studies

Supplemental Nutrition Assistance Program (SNAP) benefits are the primary source of food for Georgians with an annual income under the federal poverty level. This program provides monthly monetary benefits to allow the purchase of food through an Electronic Benefits Transfer (EBT) card. Georgia SNAP beneficiaries do not receive nutrition counseling or have purchasing restrictions associated with their benefits. Previous research has indicated that there is a significant benefit to eating fruits and vegetables. The purpose of this qualitative study was to apply the health belief model theory to understand the viewpoint of Georgia SNAP beneficiaries regarding fruits and vegetables. Data …

Faith, Medication Adherence, And Cardiovascular Disease Among African American Churchgoers, Linett Lorain Brice

Walden Dissertations and Doctoral Studies

Getting African Americans to adhere to medical management strategies to reduce negative health outcomes of cardiovascular disease (CVD) and CVD risk factors may be challenging. The purpose of this cross-sectional quantitative study was to examine whether levels of faith in God's healing, when it comes to taking medications, was associated with medication adherence to hypertension and/or diabetes mellitus type 2 (DMII) medications, and whether those factors were associated with prevalence of CVD and uncontrolled symptoms of CVD risk factors, namely hypertension and DMII. Social cognitive theory provided the framework for the study. Data were collected from surveys completed by 102 …

Perceptions Of Newly Licensed Registered Nurses About Homecare As A Practice Area, Tamara M. Kelley Frazier

Walden Dissertations and Doctoral Studies

The demand for competent nurses working in a home care setting continues to grow because of decreased length of stay in hospitals and population needs for chronic care management when homebound. Nursing educational programs introduce students to community health and home care nursing, which could influence a student nurse's choice of home health care as an initial practice setting. This qualitative study examined the perceptions of newly licensed registered nurses (NLRNs) about home care as an initial practice area. Ten NLRNs not working in home health care areas responded to 16 open-ended interview questions that were based on the career …

Quality Of Life For Persons With Chronic Disease Utilizing Mobile Integrated Healthcare, Dr John Robert Ash

Walden Dissertations and Doctoral Studies

The use of mobile integrated healthcare-community paramedicine (MIH-CP) has the potential to be integrated into existing chronic disease management initiatives as a means of reducing unnecessary hospitalizations and costs as well as improving quality of life (QOL). The purpose of this study was to analyze the relationships between demographics, noncommunicable disease type (NCD), and changes in self-perceived, self-reported QOL for those who have participated in an MIH-CP program. The research design for this study was a pretest/posttest design using secondary data that were obtained from a research partner using the MIH-CP intervention and collecting QOL data using the Euroqol QOL …

Demographics, Naloxone Accessibility, And Repeat Opioid Overdose In The United States, Craig Hamp Booker

Walden Dissertations and Doctoral Studies

Approximately 2.1 million people in the United States suffer from opioid use disorder, and over 47,600 people die from opioid-related overdoses each year. Opioid overdose is often treated with naloxone, a quick-acting medication that counteracts the effects of an overdose. This quantitative, correlational study was conducted to determine whether demographics (gender, age, and race) and naloxone accessibility were predictors of repeat opioid overdose in a Tennessee county in the United States. The study was developed and conducted using principles of the diffusion of innovations theory. Descriptive and inferential analyses were conducted using secondary, county-level data (n = 967) from emergency …

Levels Of Albuterol Inhaler With And Without Spacers In Children With Asthma, Jefferson Libed Pambid

Walden Dissertations and Doctoral Studies

Children with asthma remain a problem in public health because asthma drastically impacts children’s daily activities, increases absenteeism in school, and causes difficulties in sleeping. Researchers have demonstrated that poor asthma management is due to a lack of education about the correct inhaler technique, and the appropriate doses are not inhaled. Researchers have yet established whether asthma symptoms improve based on the doses inhaled with or without a spacer and whether children are most likely to experience fewer asthma episodes or attacks if they receive professional instruction. The purpose of this study was to fully understand the influence of an …

Barriers To Mental Health Services Related To Stigma In Northern California, Kandalena Ary

Walden Dissertations and Doctoral Studies

California Senate Bill 1041 recognized mental health as a contributing barrier for individuals struggling to achieve independence from aid through the California Work Opportunity and Responsibility to Kids (CalWORKs) program to meet the needs of the state's low-income families while reducing barriers to self-sufficiency. As mental health illnesses continue to increase, the engagement and utilization of services have not increased. The purpose of this study was to explore county policy infrastructure addresses making mental health services known, accessible, and increase participation to decrease barriers in utilization of available resources. The research questions were used to examine the effectiveness of processes …

Physician–Patient Communication: Association With Health Literacy In African Americans Living With Type 2 Diabetes Mellitus, Brittany Egeh

Walden Dissertations and Doctoral Studies

Health literacy is needed throughout care to understand basic health, prevent diseases, understand diagnoses, and treatment and management of complicated diseases, such as Type 2 diabetes mellitus (T2DM). Inadequate physician–patient communication is related to medication errors and overall understanding of basic health information in chronic condition such as T2DM. The purpose of this study was to examine the association between physician–patient communication and health literacy, glycemic control, diabetic knowledge, and demographics. The target population consisted of African Americans, ages 18-75, diagnosed with T2DM. Primary data were collected from a family medicine clinic using 4 questionnaires: s-TOFHLA (short form of functional …

Risks For Hiv Infection Among Adolescent Girls And Young Women In Mozambique, Isabelle Casavant

Walden Dissertations and Doctoral Studies

Adolescent girls and young women (AGYW) living in Sub-Saharan African countries constitute 17% of the population, yet they account for one third of all new human immunodeficiency virus (HIV) infections. To prevent HIV infections among AGYW, it is necessary to understand why they are disproportionally infected. The purpose of the dissertation was to identify risk for HIV among AGYW living in a southern district of Mozambique. The analysis was driven by the Modified Socio Ecological Model and performed using a quantitative dataset collected for the Chokwe Combination Prevention of HIV (N=3354). Logistic regression analysis was conducted to assess whether an …

Impact Of Race-Related Stress And Intraracial Microaggressions On Self-Efficacy Of African Descendants, Samina Long

Walden Dissertations and Doctoral Studies

Race-related stress such as ancestral trauma and experiences of out- and in-group microaggressions can be intergenerationally transmitted from parent to child. The current study was conducted to address the need for research on race-related trauma and out- and in-group discrimination by providing evidence-based research on whether African descendants experiencing and witnessing race-related stress and intraracial microaggressions results in low self-efficacy. The purpose of this quantitative, multiple regression design was to explore the relationships among race-related stress, intraracial microaggressions, and self-efficacy, which may provide clarity on the psychological impact of these stressors. This study addressed the question of whether race-related stress …

Planned Behavior And Congolese Physicians’ Practice: Predicting Advanced Preventive Health Services Provision, Jean-Clément Milabu Mumbusi

Walden Dissertations and Doctoral Studies

The provision of preventive services, health promotion, and health maintenance has become the cornerstone of primary care practice in the United States and other Western countries to prevent morbidity and premature mortality and to increase the quality and years of a healthy life. Unfortunately, the delivery of these advanced preventive health services (APHS) has been sporadic in the Democratic Republic of Congo, a country with poor health indicators. The purpose of this cross-sectional mixed-method study was to apply Ajzen’s theory of planned behavior (TPB) to predict the intention of Congolese primary care physicians (PCPs) in the provision of APHS. Using …

Sex Bias In The Diagnosis Of Chronic Obstructive Pulmonary Disease, Olga Ivan Belitchenko Ryan

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, disability, and cost globally and in the United States. Various sources point to women experiencing greater morbidity, increased health care resource use and higher incidence of mortality resultant from COPD. While exact causality is not fully understood, it is possible that social bias towards COPD in women impacting screening and timely diagnosis may be a contributing factor. This current investigation involved the social ecological model. In this cross-sectional secondary analysis of Behavioral Risk Factor Surveillance System, 2017 data, differences in screening through use of breathing testing among 6334 …

Medical Skepticism And Diabetes Management In African Americans, Pamela Bouyer

Walden Dissertations and Doctoral Studies

Type 2 diabetes (T2DM) in African Americans is a manageable disease, and self-management interventions reduce complications and hospital stays. However, in the African American population, traditional T2DM self-management interventions do not produce long-term effects on lifestyle and behavior changes. Researchers have analyzed the barriers and interventions associated with the disease, but the problem still exists. Medical skepticism may influence T2DM management and health outcomes in African Americans. However, there is scarce literature addressing the relationship between medical skepticism and health outcomes (eye and kidney problems). The purpose of the study is to assess the relationship between medical skepticism and outcomes …