Public Health Commons^™

Suicidal Ideation, Suicidality, And Hiv/Aids Infection Or Diagnosis Among Asian American Sexual Minorities, Francis Azih Ngene

Walden Dissertations and Doctoral Studies

Asian American men who have sex with men (MSM) are an understudied minority. They are particularly affected by HIV/AIDS and are also impacted by psychosocial and mental health factors of depression, substance use, drug use, and alcohol use/abuse, any of which may lead to suicidal ideation and suicidality. These associations have not been widely studied in this population. The purpose of this quantitative study was to use the 2015 National Survey on Drug Use and Health data to examine these psychosocial and mental health issues and their association with suicidal ideation, suicidality, and HIV/AIDS infection or diagnosis among Asian American …

Health Behaviors Of Fruit And Vegetable Consumption, Physical Activity, And Breast Cancer Among African American Women, Nicole Ekoue

Walden Dissertations and Doctoral Studies

Breast cancer incidence is suddenly increasing among African American women. Recent studies indicate that health behaviors are thought to confer important health benefits and have the potential to lowering breast cancer incidence. Guided by the social ecological model, the purpose of this quantitative, cross-sectional study was to investigate the association between health behaviors of fruit consumption, vegetable consumption, and physical activity and breast cancer after adjusting for age, body mass index, and smoker status. Social support and income level were assessed as modifiers. Using the 2012 to 2017 Health Information and National Trends Survey data, this study was conducted with …

Pharmacy Manager Strategies For Reducing Financial Losses From Adverse Drug Events By Polypharmacy Patients, Francis Rudden

Walden Dissertations and Doctoral Studies

Every year over 100,000 deaths occur in the U.S. from adverse drug events derived from medication errors. Medication errors account for an annual cost of $100 to $200 billion. Healthcare pharmacists lack strategies to reduce adverse drug events and medication errors from taking place. Grounded in complex adaptive system theory, the purpose of this qualitative multiple case study was to explore strategies to reduce advere drug events and medication errors. The participants were 5 pharmacist managers in a county in central Florida. These pharmacists were from different community pharmacies, and each had a minimum of 5 years’ experience in the …

Experiences Of College Freshmen Women Who Eat In A Social Environment, Kylie Cowens Blodgett

Walden Dissertations and Doctoral Studies

The social cognitive theory suggests that social surroundings influence health behaviors, and social modeling literature supports that eating behaviors are influenced by social norms. Eating decisions are especially vulnerable to social influence during the transition to college, although current interventions do not address social influence in the context of the eating environment itself or consider how men and women may experience this environment differently. This generic qualitative study explored how freshmen women perceived their experiences eating in a cafeteria setting. The research questions investigated freshmen women’s perceptions about social influence on self-efficacy, self-regulation, outcome expectations, and modeling of normative information …

Hiv/Sti Screening, Testing, And Prophylaxis Among Sexual Assault Survivors In U. S. Emergency Departments, Elizabeth A. Cita

Walden Dissertations and Doctoral Studies

Use of HIV screening/testing and prophylaxis has been found to be low in the general emergency department (ED) population. Less is known about the use of HIV/sexually transmitted infection (STI) screening, testing, and prophylaxis among sexual assault survivors who present to EDs. The main research questions asked whether there was a relationship between race, socioeconomic status (SES), geographic region, or age, HIV/STI, treatment, and prophylaxis among sexual assault survivors that present to U.S. EDs. This study was a secondary analysis of data collected in the NHAMCS years 2010 to 2016 and included 112 geographic primary sampling units, about 480 hospitals. …

Social Support And Hiv Among Young Transwomen Of Color, Cynthia Joycelle Tucker

Walden Dissertations and Doctoral Studies

HIV is an emerging epidemic among young transgender women of color (YTWC). Researchers have documented the challenges and issues that YTWC encounter, including discrimination, isolation, and violence. However, little is known about whether social support can impact these challenges as an avenue to improve HIV preventive behaviors and HIV status. Using secondary data from the Life Skills HIV study, this research assessed how social support affects HIV preventive behaviors among 298 YTWC residing in Chicago. The study was grounded in the modified social-ecological model and Spearman’s rank correlation and logistic regression analyses was used to determine whether there was an …

Lifestyle Factors And Social Determinants As Predictors Of Weight/Body Mass Index, Uthman Alhaji Baba

Walden Dissertations and Doctoral Studies

Obesity is a major public health concern that includes the risk of developing cardiovascular disease and premature death in adults. Previous studies have established the relationship between gender, educational level, household income and respondents’ weight but additional research is needed to factor the nature of education in relation to gender differences, diet, and other important behavioral mediators such as social determinants. The purpose of this quantitative cross-sectional study is to determine the extent to which frequency of physical activity, household income, social determinants of health (money for balanced meals, finances at the end of month, and poor mental health), respondent …

Association Between Certificate-Of-Need Laws And The Health Outcomes Of Home Health Patients, Peter A. Atemnkeng

Walden Dissertations and Doctoral Studies

The Certificate of Need (CON) law on home health limits start-ups and expansions by providers. Seventeen states and the District of Columbia maintained CON restrictions in 2015. The regulation was intended to control health care cost and expenditure, and to promote quality public health outcomes, as postulated in the public interest theory. The purpose of the study was to assess the association between the CON laws by the states and the health outcomes of the Medicare patients that used home health services in 2015. The provider ratings data from Home Health Compare were analyzed using multiple linear regression models and …

Risk Factors Of Infant Mortality Disparity In Indian River County, Florida, Cecilia Miguelina Escorbore

Walden Dissertations and Doctoral Studies

Infant mortality in the United States is a great concern to families, communities, and professionals in the public health field. More concerning is the infant mortality racial disparity, prevalent throughout the United States. The purpose of this study was to explore risk factors of infant mortality disparity in Indian River County (IRC), Florida. Using socioecological theory as the theoretical framework, this study explored whether there is an association between infant mortality among Black infants and geographic location as well as measures of socioeconomic status (age, educational level, health insurance status, and marital status) associated with infant mortality among Black infants …

Mothers With Diabetes And The Effects Of The Disease To Their Offspring, Rachel Smart-Fadairo

Walden Dissertations and Doctoral Studies

The purpose of this phenomenological was to understand the lived experiences of mothers who were diagnosed with gestational diabetes mellitus and had a child who had been diagnosed with a speech disorder. Despite educational and medical interventions having increased to reduce gestational diabetes, the growing incidence of gestational diabetes signals a disconnect between education, intervention, and prevention. Previous studies have shown that mothers with gestational diabetes mellitus can experience high- risk pregnancies. The long-term effects of the disease on the mother and her newborn child in terms of soaring healthcare cost, loss of work productivity, education, and the emotional health …

Homelessness And Hiv Risk: Experiences, Perceptions, And Beliefs Of Transgender Youth, Darcia Bryden-Currie

Walden Dissertations and Doctoral Studies

Human ImmunodeficiencyVirus (HIV) continues to be a public health concern in the United States, with increased rates of infection among transgender youth. The phenomenon of homelessness is also a significant challenge for transgender youth. Gender expression often results in stigma, and discrimination, many trans youth experience poverty, rejection, and low self-esteem, which are precursors to homelessness. The purpose of this qualitative phenomenological study was to explore the influence that homelessness has on sexual risk associated behaviors in transgender youth. The theoretical framework that guided this study was Bandura’s social cognitive theory. The research questions sought to explore how this population …

Effects Of Government Regulations And Reimbursement Policies On Home Health Administration In Illinois., Sally Nwafor

Walden Dissertations and Doctoral Studies

Recent changes in government regulations and reimbursement policies threaten the financial viability and the ability of home health agencies to provide the necessary services. There is a gap in knowledge about the effect of the changes in healthcare policies on the administration of home health businesses in Illinois. The purpose of this study was to bridge the knowledge gap by investigating the effect of the regulatory and policy changes on home health administration in Illinois. The research question focused on the challenges that home health administrators face due to the changes in government regulation and reimbursement policies, and the strategies …

Socioeconomic Status, Benzathine Penicillin Prophylaxis, And Clinical Outcomes In Patients With Rheumatic Heart Disease, Christopher Sabo Yilgwan

Walden Dissertations and Doctoral Studies

Rheumatic heart disease (RHD) is the major cause of acquired heart disease and death for children and young adults in developing countries. Poverty and social disadvantage are thought to influence the clinical outcomes in RHD patients. Guided by the health lifestyle theory, this study assessed the relationship between socioeconomic status and clinical outcomes (heart failure events and mortality) in patients with RHD. It also examined how adherence to penicillin prophylaxis mediates the effect of socioeconomic status (SES) on clinical outcomes. Using the Nigerian database of the REMEDY study, this study was conducted with 243 participants using Poisson regression and logistic …

Breast Cancer Knowledge, Attitude, And Screening Practices Among Hispanic/Latino Women, Harrindra Seepersaud

Walden Dissertations and Doctoral Studies

Nearly 1 out of every 8 women will develop breast cancer during her lifetime, making breast cancer the most common noncutaneous malignancy in women, particularly among the Hispanic/Latino population. Hispanic/Latino women are more likely than non-Hispanic/Latino women to be diagnosed with breast cancer after the disease has progressed to a fatal stage. This quantitative study measured how knowledge, attitude, and screening practices affect the prevalence and outcomes of breast cancer cases among Hispanic/Latino women while controlling for socioeconomic status factors, using social cognitive theory as a framework. This research uses secondary data analysis of a cross-sectional survey study, the 2014 …

The Perception Of Men's Preferred Female Body Size And Weight Control Behaviors Of Afro-Caribbean Women In The United States Virgin Islands, Alice Victoria Henry

Walden Dissertations and Doctoral Studies

The prevalence of obesity among Afro-Caribbean women living in the United States Virgin Islands (USVI) is a health care issue that can have detrimental effects on society. To reverse the spread of this disease, factors contributing to its prevalence must be understood so that they can be addressed. The purpose of this cross-sectional study was to examine Afro-Caribbean women's perception of the female body size preferred by Afro-Caribbean men and the influence of that perception on the women's weight control behaviors of diet and physical activity. The reasoned action approach was the basis for the theoretical foundation. The research problem …

Telehealth Efforts To Reduce Hospital Readmissions Of Congestive Heart Failure Patients, Sirfornia L. Deasfernandes

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is a chronic condition that affects millions of individuals in the United States. There is no cure for CHF, but medical interventions can help treat the symptoms and improve health outcomes. The purpose of this quantitative study was to determine if telehealth services help to reduce the readmission status of patients diagnosed with CHF. The theoretical framework used in this study was the individual and family self-management theory to help focus on self-management behaviors that contribute to improving the patients' health outcomes. The research questions were focused on addressing CHF patients receiving telehealth services and whether …

Predictors Of Colorectal Cancer Screening Among Maryland Adults, Aged 50–75 Years, Pamela Manwi Asangong

Walden Dissertations and Doctoral Studies

Screening plays an essential role in reducing colorectal cancer (CRC) incidence and mortality rates, yet CRC screening use remains low in Maryland and lower in some age and racial/ethnic groups with limited resources to participate in CRC screening programs. The purpose of this quantitative, cross-sectional study is to investigate whether age group, sex, race/ethnicity, education level, income level, health insurance coverage, and access to health care professional can predict an individual, 50–75 years of age, in Maryland to take action to fully meet the United States Preventive Services Task Force CRC screening test recommendation within the recommended time interval. The …

Association Of Social Support And Depressive Symptoms Among African Americans, Jacketta Renee Cobbs

Walden Dissertations and Doctoral Studies

Depression affects over 120 million individuals worldwide; in the United States, depression is a leading cause of disability for individuals’ ages 15-44 years. Social support can affect both physical and depressive symptoms; therefore, most patients with heart failure (HF) need support from family and/or friends to effectively manage their health condition. This indicates family and/or friends are expected to be the core support system for long term care of those with HF. The purpose of this study was to determine whether social support contributes to depressive symptoms among African Americans with HF. The research questions examined the experience of different …

Relationship Between Pm2.5 Levels And Cancer Incidences In Interior Alaska, Sandra G. Lewis

Walden Dissertations and Doctoral Studies

Exposure to high levels of ambient air particulates < 2.5 microns in diameter (PM2.5) in the Fairbanks North Star Borough (FNSB) and the resulting impact on cancer incidence is the focus of this study. Climate, geography, and culture influence PM2.5 levels, particularly during the long cold season. While this study considers lung cancer incidences from PM2.5 exposure, the primary focus of the study is the incidences of all other types of cancers from exposure to PM2.5, because of the limited research done on this topic. This quantitative, retrospective, cohort study considered the incidences of new cancer diagnoses in the population during a 10-year period (January 1, 2008-December 31, 2017). The 2 FNSB Zip Codes, designated “hot spots,” frequently see spikes in PM2.5 during the long cold season. These areas are densely populated and contain the EPA-regulated air quality monitors. Cancer diagnoses in the hot spot Zip Codes were compared to cancer diagnoses in outlying Zip Codes (non-hot spots) that experience less PM2.5 and are more consistently within the EPA air quality guidelines. EPA monitors are not yet located in the non-hot spots. Cancer patient data were obtained from the Fairbanks Memorial Hospital Cancer Center. The results demonstrated that a strong association was found between PM2.5 exposure and non-lung cancers (OR = 1.37; RR = 1.36; p < 0.001); and between PM2.5 exposure and lung cancer (OR = 1.87; RR = 1.88; p < 0.001). These findings may be used to promote an increased awareness among FNSB residents of the potential impact on cancer diagnoses from inhaling high levels of PM2.5, so residents may change their behavior in favor of alternatives to biomass burning to improve air quality.

Interprofessional Teams As A Strategy To Address Physician Shortages In North Dakota, Judy Ann Solberg

Walden Dissertations and Doctoral Studies

North Dakota health care and political leaders are facing pressure to revise health care delivery in the state. A chronic shortage of health care providers, retention issues, an aging population, and a recent population burst, as well as an abnormally high rate of physician retirement, have made health care access problematic for residents of the rural state. The purpose of this study was to explore and understand the main inhibitors and facilitators of employing interprofessional teams as a strategy to address rural physician shortages in North Dakota. Bandura’s social cognitive theory provided the framework for this phenomenological study of issues …

Social And Ecological Determinants Of Physical Activity For Youth With Cerebral Palsy, George E. Gorton

Walden Dissertations and Doctoral Studies

Physical inactivity is a leading cause of morbidity and mortality, increasing risk for noncommunicable disease and compromised physical, social, and mental health. However, fewer than 20% of U.S. youth meet physical activity guidelines; youth with disabilities are even less active. Physical activity is influenced by personal, family, social, organizational, community, and environmental factors acting within a social-ecological framework. To what extent is not well understood. The purpose of this study was to determine the extent to which social and ecological factors are associated with participation of youth with cerebral palsy in physical activity. The research design was a cross-sectional, quantitative …

Living With Multiple Sclerosis, William Witt

Walden Dissertations and Doctoral Studies

Background: Continuity of care is a crucial characteristic of high quality multiple sclerosis (MS) care. Nevertheless, experiences of MS patients with continuing care are currently understudied, particularly through in-depth methods, such as qualitative approaches. This is despite the significance of continuity of care in improving patient satisfaction and the quality of life of patients with chronic diseases.

Aim: To examine the experiences and perceptions of MS patients with continuity of care through a critical exploration of their lives following hospitalization for an exacerbation.

Design of the study: Qualitative using phenomenological approach.

Participants: Eight participants living with MS. All participants were …

Childhood Obesity: The Healthy, Hunger-Free Kids Act And School-Aged Children, Frankie Jean Alstin-Brooks

Walden Dissertations and Doctoral Studies

Obesity among children in America is at an all time high, 57.3% of the nation’s children will be obese by the age of 35. The purpose of this study was to examine the effectiveness of the Healthy, Hunger-Free Kids Act (HHFKA) policy. The HHFKA modified the nutritional and physical policies in order to reduce the obesity rates by changing their expenditures. Schools in all 50 states that are subject to federal, state and local nutrition regulations were researched. This was a quantitative, non-experimental, correlation study that measured state compliance with the USDA guidelines and tested for an association between compliance …

Chronic Pain Management In The Primary Care Setting, Rebecca Ann Day

Walden Dissertations and Doctoral Studies

Chronic pain is pain that lasts longer than 12 weeks, affects an individual physically in some mental or psychological way, influences an individual’s job performance, and may create a social complication over time. Ensuring the best possible care for the patient’s pain with the least possible complications is the responsibility of the health care provider, including nurse practitioners. Providing a clinical practice guideline (CPG) for the management of chronic pain in the primary care setting was the focus of this project. The comfort theory model was used as a framework for this project as well as the basis of nursing …

The Association Between Central Line Insertion Practices And Central Line-Associated Bloodstream Infections, Mona Elgowainy

Walden Dissertations and Doctoral Studies

Healthcare-associated infections, specifically central line-associated bloodstream infections (CLABSI), continue to remain a serious public health concern in the United States. Though CLABSI can often be prevented, healthcare professionals struggle to have a positive impact on CLABSI rates. The primary purpose of this study was to determine whether CLIP Bundle adherence has an impact on CLABSI standardized infection ratio (SIR) rates in various patient care areas in California. The research questions were focused on assessing whether there was an association between patient care areas, CLABSI rates, and CLIP Bundle adherence scores. A quantitative, cross-sectional study design utilizing secondary data was used …

Severe Maternal Morbidity In Michigan: An Investigation Of Health Disparities, Laura Houdeshell-Putt

Walden Dissertations and Doctoral Studies

Severe maternal morbidity (SMM) rates in Michigan have increased over the past 20 years and continue to affect racial and ethnic women disproportionately. Women experiencing health conditions that complicate pregnancy outcomes have a greater risk of having poor obstetric outcomes that result in a SMM event. To evaluate the distribution of women experiencing health conditions that complicate pregnancy and a SMM event, geographic information systems were utilized in this study. The purpose of this study was to depict trends in the prevalence of 4 health conditions and SMM among women hospitalized for obstetric delivery in Michigan from 2016–2017. The 4 …

Tuberculosis Diagnostics In Ethiopia: Assessment Of Laboratory Procedural Capabilities And Limitations, Yeshimebet Retta

Walden Dissertations and Doctoral Studies

Abstract

Tuberculosis (TB) is a curable and preventable disease; however, in 2015, 10.4 million people were diagnosed with TB, making it one of the top 10 causes of mortality. A major part of the TB disease burden is carried by low and middle-income countries. In Ethiopia, which ranks 15th among 22 countries with a high burden of TB and multidrug resistant TB (MDR-TB), important diagnostic and treatment gaps persist. This quantitative descriptive study was primarily aimed to determine levels of adherence to standardized TB laboratory procedures by calculating and reporting the number of sputum samples, and reporting valid and documented …

Sex Differences In Lyme Disease Symptomatology In The Northeast United States, Jeanine Scotti

Walden Dissertations and Doctoral Studies

Guided by the gender-analysis-matrix theoretical framework, 3 key areas of research inquiries focused on the relationship between sex and Lyme disease, symptoms of Lyme disease and sex, and severity of Lyme disease symptoms on sex. A quantitative secondary data analysis was used to address the research questions. A clinician specializing in caring for individuals with Lyme disease provided the dataset, containing responses to the Horowitz Multiple Systemic Infectious Disease Syndrome Questionnaire for Lyme disease. A cross-sectional, comparative research design incorporating 2 statistical techniques for analysis—the independent samples t test and multivariable regression analyses—was used to examine symptom counts and the …

Evidence-Based Strategies For Improving Medication Adherence Among Psychiatric Patients: A Systematic Review, Omah S. Tsikada

Walden Dissertations and Doctoral Studies

Nonadherence to psychotropic medications among patients with serious and persistent psychiatric disorders, including bipolar disorder and schizophrenia, is approximately 70%. Nonadherence is a common barrier to the treatment of individuals with mental health disorders. However, there is limited awareness of evidence-based interventions and strategies to address this problem. Therefore, the question for this project asks whether a systematic review can identify strategies to improve adherence of psychotropic medications among individuals with serious and persistent mental illness. The purpose of this systematic review was to explore the evidence-based strategies that can aid in increasing medication adherence in patients with mental health …

Social Determinants Of Adherence To Antiretroviral Therapy Among Hiv+ Youth, Wanza Rochelle Bacon

Walden Dissertations and Doctoral Studies

Young adults, especially African American men who have sex with men (MSM) have the lowest rates of antiretroviral therapy (ART) adherence among all age groups; however, they experience greater than 50% of all new Human Immunodeficiency Virus (HIV) infections among individuals 13 to 24 years of age. Despite the availability of ART, young MSM continue to experience suboptimal rates of adherence and are one of the most vulnerable populations for contracting HIV. Grounded in the social cognitive theory, my aim for this quantitative cross-sectional study was to investigate the relationship between diverse social determinants and ART adherence among young adult …