Public Health Commons^™

Maternal And Infant Birth Characteristics As Predictors Of Sudden Unexpected Infant Death, Betty Jean Ezell

Walden Dissertations and Doctoral Studies

Sudden Unexpected Infant Death (SUID) is a public health issue recognized by the United States Centers for Disease Control and Prevention (CDC) as the sudden and unexpected death of a baby less than 1 year old, often during sleep, with no obvious cause. Despite known SUID risk factors for infants and mothers, there is limited research on combinations of infant birth characteristics and mother demographics that could be indicative of a higher risk of infant death. The purpose of this cross-sectional quantitative study was to examine the extent to which infant birth characteristics, delivery characteristics, month prenatal care began, and …

Impact Of Food Assistance Programs On Food Insecurity, Diet Quality And Obesity, Jessica Eileen Hill

Walden Dissertations and Doctoral Studies

Obesity remains a public health issue in the United States because it contributes to chronic diseases. The Supplemental Nutrition Assistance Program (SNAP) was designed to increase food security, alleviate hunger, and increase access to a healthful diet; however, it may have the opposite effect and contribute to obesity. The purpose of this study was to examine to what extent participation in SNAP impacts food insecurity, diet quality, and obesity in U.S. adults. The social-ecological model guided the study which was conducted using a quantitative a cross-sectional research design and secondary analyses of the 2013-2014 National Health and Nutrition Examination Survey …

Georgia Government Leaders' Lived Experience Creating And Implementing Health Equity Policies, Tracy M. Clopton

Walden Dissertations and Doctoral Studies

Georgia’s racial and ethnic minority communities have a continual problem of disproportionately worse health outcomes, including higher chronic disease and behavioral risk factors, compared to their nonminority counterparts. The average cost per year for chronic disease between 2016 and 2030 could be $64.6 billion in medical costs and $26.8 billion in lost employee productivity for Georgia. The purpose of this study was to explore the lived experience of Georgia legislators and health program staff to determine policy solutions to reduce chronic disease and behavioral risk factor disparities in the racial and ethnic minority population. The theoretical lens for the study …

Advanced Practice Registered Nurses And Their Knowledge Regarding The Hindrance Of Obesity, Crystal Rainey

Walden Dissertations and Doctoral Studies

Advanced Practice Registered Nurses and Their Knowledge

Regarding the Hindrance of Obesity

by

Crystal N. Rainey

MSN, Walden University, 2014

BSN, University of Arkansas in Little Rock, 2011

AASN, Southeast Arkansas College, 2009

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2020

Factors Associated With Prostate Cancer Screening Among African American Men In California, Frank Ibe Agodi

Walden Dissertations and Doctoral Studies

In Los Angeles County, California, prostate cancer (PC) is the second primary cause of cancer-related death in men. Previous studies have focused on sociodemographic factors influencing racial and ethnic inequalities in health in the United States. However, research was lacking regarding if and to what extent social-ecological factors predict PC screening, specifically among African American men residing in Los Angeles County. The purpose of this quantitative study, using a cross-sectional design, was to identify the factors that may align with PC screening among African American men living in Los Angeles. African American men aged 45 and older were the targeted …

Self Reported Cardiovascular Disease Risk Factors Among Deaf Users: A Communication Barrier, Dr. Jolene Ayres Ogunjirin

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) is the number one cause of mortality worldwide, and may disproportionately affect the Deaf and Hard of Hearing (DHOH) subpopulation in the United States. It has been suggested that communication barriers among the DHOH subpopulation contribute to the high prevalence of CVD risk factors. To assess this claim, this quantitative study utilized a cross-sectional data set of 400 DHOH and 400 non- DHOH participants taken from the National Health and Nutrition Examination Survey (NHANES) database. The differences of being told by a health professional of having specific CVD risk factors were assessed between the two groups and …

Provider Education Increasing Recommendation For Human Papillomavirus Vaccination, Tiffany Charest Skinner

Walden Dissertations and Doctoral Studies

Human Papillomavirus (HPV) was the most common sexually transmitted disease in the United States in 2018 according to the Centers for Disease Control and Prevention (CDC). The CDC established the Healthy People 2020 initiative for HPV vaccination uptake of 80% to effectively eliminate HPV associated cancers. The project site, a rural multispecialty clinic in the Mid-Atlantic United States reported a 3% vaccination compliance rate, well under the national average and the benchmark of 80% recommended by the CDC. The practice-focused question for this project was to determine how education of primary providers will increase recommendation rates for vaccination of HPV. …

Use Of Spanish Audio Podcast To Educate Visually Challenged Hispanics With Diabetes, Baiju Issac

Walden Dissertations and Doctoral Studies

Diabetes is the leading cause of death among the Hispanic population, requiring solutions at the individual, community, and population levels. Self-management helps to manage diabetes and prevent complications, but it is a challenge in nursing practice. Health care providers use printed information to teach patients about self-management of diabetes. However, patients with visual impairment are not able to use these resources. Limited English proficiency, low health literacy, and visual challenges result in the underutilization of health care services within Hispanic communities. Therefore, the purpose of this study was to develop a Spanish audio podcast and lesson plan as teaching tools …

The Dietary Decision-Making Process Of Women In Nigeria, Gachomo Joanne Mapis

Walden Dissertations and Doctoral Studies

Nigerians have been opting for a more processed Western diet. These changes in dietary choices have aligned with obesity and undernutrition, attributable to micronutrient deficiencies or malnutrition. Many scholars have presented varying intervention strategies ranging from consumption of a variety of foods containing the necessary micronutrients to food fortification. The purpose of this grounded theory study was to explore the perceptions of women in an urban city in Nigeria on indigenous foods and Western dietary influences to determine social interactions, the consequence of the interactions, and the women’s current perceptions of food choices. The social-ecological model was used to explore …

Racial Differences In Hospital Readmission And Reimbursement Rates For Patients With Congestive Heart Failure, Catherine Talongwa

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is associated with a significant economic burden that includes frequent emergency department visits, hospitalizations, and readmissions. The purpose of this study was to examine the differences, if any, between hospital readmission rates and insurance reimbursement rates for non-Hispanic Black and White CHF patients in California. The theoretical framework was Bandura's social cognitive theory. Secondary data for this quantitative study were obtained from the Office of Statewide Health Planning and Development and State Inpatient Databases from Healthcare Cost and Utilization for calendar year 2014-2016. A t-test and Levene's test for equality of variance were conducted on a …

Stroke Prevention Through Education, Laura Lee Ballance

Walden Dissertations and Doctoral Studies

AbstractThis project focused on two concepts: a need for a stroke prevention program and what should be included. The problem with early identification of stroke is not formally addressed at the project site, physician’s office. A physician’s office can play a beginning key role in minimizing the risk of stroke. The purpose of this project was to explore the evidence to support the need for and to determine ideal content for a stroke prevention education program. This program focused on early detection and identification of risk factors to prevent stroke occurrence. The theoretical framework of Pender’s health promotion model aligns …

Age At Diagnosis And Lung Cancer Presentation, Marida Gingras

Walden Dissertations and Doctoral Studies

Lung cancer is the leading cause of cancer-related mortality in the United States because of its lack of symptoms until late stages. It is noted that a 5-year relative survival rate can be improved by earlier cancer detection. The currently recommended age of screening by the U.S. Preventive Services Task Force may not be optimal, and the recommendations are only for smokers. The purpose of this cross-sectional study was to examine the association between the stages of presentation of lung cancer and age at diagnosis using quantitative research. Using the Surveillance, Epidemiology, and End Results (SEER-18) database, 63,107 records were …

Perceptions Of Physician Influence On Healthcare Accessibility, Samuel N. Jacobs-Abbey

Walden Dissertations and Doctoral Studies

A significant portion of the U.S. population across the country has limited access to quality healthcare; however, this situation is more pronounced in rural areas. One potential solution is for healthcare practitioners to move their services to underserved rural areas to improve healthcare coverage. No previous studies have explored the perceptions of practitioners regarding their influence on healthcare access, particularly the potential impact of moving healthcare services to underserved areas. Thus, the purpose of this research was to address this gap. A qualitative phenomenological approach was adopted. A sample of 24 participants was selected using purposive sampling, from the target …

The Association Between Provider Cultural Competence And Type 2 Diabetes Health Behaviors, Bernadette Joyce Mejia-Tran

Walden Dissertations and Doctoral Studies

Provider cultural competence is poorly understood in relation to the outcome of Type 2 diabetes patient health behaviors. The purpose of this study was to examine the association between provider cultural competence and diabetes patient health behaviors. The chronic care model provided the conceptual framework for this study. The research questions were designed to determine whether 5 measures of provider cultural competence play a role in diabetes patient health behavior change. The research design of the study was a quantitative cross-sectional survey using the 2017 National Health Interview Survey. The 2,342 participants included in the study represent a national sample …

Prevention Practices And West Nile Virus Infection Among Ethnic Minorities, Texas, Bayabel Debebe Mengistu

Walden Dissertations and Doctoral Studies

Abstract

West Nile virus (WNV) is a major public health problem and the cause of nearly 25% of the world's economic burden of disease. While the risk factors for developing West Nile fever and West Nile disease from WNV infection have been identified, it is not known how knowledge, attitude, behavior (KAB), access to health care (AHC), and comorbidities are associated with prevention practices of WNV infection among ethnic minorities. The aim of this study was to examine the association between KAB, AHC, comorbidities, and prevention practices of WNV infection among ethnic minorities in Texas. KAB, AHC. Comorbidities were used …

Amyotrophic Lateral Sclerosis Patients' Sociological Resilience, Self-Determination, And Decision-Making For Life-Sustaining Treatments, Jeremy Jon Van Tress

Walden Dissertations and Doctoral Studies

People with amyotrophic lateral sclerosis (ALS) suffer from a rare, progressive, untreatable, and fatal neuromuscular disease. Their decision-making for life-sustaining treatments may not be fully self-deterministic. While researchers have examined resilience and self-determination in people with mental health problems and chronic illness, none have researched these variables in ALS patients from a socioecological framework. The purpose of this study was to explore the relationships between people with ALS socioecological resilience, self-determination, and decision-making for life-sustaining treatments. A cross-sectional concurrent mixed-methods design was used, with online surveys completed by 197 people with ALS who were solicited through the National ALS Registry. …

Area-Level Factors Linked To Obesity In African American And Caucasian Women In Michigan, Marjorie Arrey

Walden Dissertations and Doctoral Studies

Obesity is a major public health crisis, affecting every segment of the U.S. population. African American women have higher prevalence of obesity than all other subpopulations and are disproportionately burdened by the disease and its comorbidities. Despite this disparity, African American women are often underrepresented in obesity research. This research examined obesity-related risk factors specific to African American women compared to those for Caucasian women. The design was based on the socioecological model and social cognitive theory, both emphasizing the impact of social factors on health outcomes. The data set included only adult Michigan women from the NHANES study. Multiple …

Predicting Behavior To Engage In Fall Prevention Practices: The Role Of Interests And Basic Psychological Needs, Jan Fay Kress

Walden Dissertations and Doctoral Studies

AbstractA fall is associated with adverse outcomes that include occupational, physical, cognitive, and psychological decline together with economic and caregiving burden. Despite the continued increase in prevalence of falls globally, most studies address the well-known risk factors of falls but exclude the behavioral risk factors associated with human actions, emotions, and everyday choices. Following the theory of self-determination and person object of interest framework, this quantitative, nonexperimental study was conducted using face-to-face and web surveys to examine the relationship between motivational, relational, and sociodemographic/medical conditions to predict engagement in fall prevention practices in a sample of 75 community dwellers, 65 …

Examining The Mortality Risk Of A Population With Mental Illness, Glorimar Ortiz

Walden Dissertations and Doctoral Studies

Individuals with mental illness experience increased mortality and premature death. In a sample composed of 88% decedents with mental illness who were Black, the findings from three research studies provided insight about excess and premature mortality, odds of dying by cause of death, and risk factors associated with premature mortality. The purpose of this quantitative study was to examine the mortality of a population group with mental illness that was served in a public mental health system (PMHS). The ecoepidemiological life course framework for health, disease, and mortality was used to link mechanisms that may influence health and longevity in …

Hiv Prevention: Pre-Exposure Prophylaxis, Sexual Decision Making, Risk Taking, And Condoms, Jonathan D. Spencer

Walden Dissertations and Doctoral Studies

HIV is an infectious disease that continues to have new cases each year within high-risk populations, such as men who have sex with men (MSM). To help in the fight against new HIV infections within the MSM population, new medications such as pre-exposure prophylaxis (PrEP) are being used. The purpose of this cross-sectional online survey study was to address whether PrEP use had any relationship with (a) sexual decision-making, (b) risk-taking, and (c) condom use in the MSM population 18-64 years of age, after controlling for socioeconomic status, race, and age while using the behavioral disinhibition and risk compensation models. …

Population Density And Spatial Distribution Of Neglected Tropical Diseases In Sierra Leone, Abou B. Funna

Walden Dissertations and Doctoral Studies

Neglected tropical diseases (NTDs) are the most common health conditions affecting the poorest residents of sub-Saharan Africa (SSA). These infections affect an estimated 2 billion people worldwide, including 500 million people living in SSA. About 85% of NTD infections are a result of helminth infections; hookworm is also a common occurrence among SSA’s poorest people, especially children. Schistosomiasis is the 2nd most prevalent NTD after hookworm. This quantitative correlational study investigated population distribution and the spread of NTDs in Sierra Leone. The focus was on 5 major NTDs: ascariasis, hookworm, schistosomiasis, soil-transmitted helminthiasis, and trichuris. Data were obtained from the …

Mothers' Knowledge, Clinic Staff, Community Support, And Breastfeeding Practices, Ubong Usua

Walden Dissertations and Doctoral Studies

Among low-income mothers enrolled in the Women Infant and Child (WIC) program and Medicaid, the rate of initiating breastfeeding immediately after delivery is low (57%) compared to high-income mothers (74%). Among the many factors contributing to this are low-income mothers' poor knowledge of the benefits of breast-feeding and lack of support and encouragement from clinical staff, family, and community. However, few studies have singled out the role of community and family support in improving maternal knowledge and breastfeeding practices. Using the Theory of Planned Behavior framework, this quantitative study used WIC data from the Texas Department of Health and Human …

Factors Affecting Cervical Cancer Screening Among Dominican Women Living In The United States, Cybil Bonhomme

Walden Dissertations and Doctoral Studies

The highest incidence and mortality rates of cervical cancer are seen among minority women groups in the United States. Hispanic women have the highest rate of cervical cancer, contributing to the 2nd highest mortality rate of the disease. Researchers have examined the lower rates of cervical cancer screening among Hispanic women, as compared with other groups of U.S. women, but researchers have not examined cervical cancer screening practices, specifically for U.S. Dominican women. The purpose of this study was to examine the correlation between compliance with cervical cancer screening and major influences including acculturation, socioeconomic status, immigration status, and usual …

Reducing Morbidity: Establishing A Relationship Between Perioperative Normothermia And Colon Surgical Site Infections, Nychie Dotson

Walden Dissertations and Doctoral Studies

Healthcare-associated infections (HAIs) are an emerging public health threat. Every day in the United States, HAIs impact 1 in 31 hospitalized patients. Surgical site infections (SSIs) account for over 40% of all reported HAIs and have an increased risk for morbidity and mortality. Surgery associated with colon procedures present an increased risk for infection, morbidity, and mortality. There has been vast work to prevent colon SSIs; however, there remain areas for improvement and exploration. The main research question evaluated the relationship between maintaining perioperative normothermia and colon SSIs. Secondary research questions explored additional risk factors to include age, gender, obesity, …

Fertility Treatments Of Women In Nigeria: Using Long Versus Short Protocols, Michael Egwu

Walden Dissertations and Doctoral Studies

A global estimate indicates that over 70 million heterosexual married couples live with the burden of infertility, and Nigeria accounts for about 30%. Although protocols exist, it appears there are no standardized treatment guidelines for practicing fertility experts in Nigeria. This study, therefore, aimed to determine which protocol provides a better outcome across a given population of infertile women in Nigeria as a method to move towards developing standardized treatment guidelines. The study was grounded using the Patient-Centered Care Treatment Model, and the method of inquiry was a retrospective, cross-sectional, quantitative, and nonexperimental technique, and the influence of the patient’s …

A Provider Education Program Addressing Barriers To Diabetic Patients’ Self-Care, Henrietta O. Emokidi

Walden Dissertations and Doctoral Studies

Diabetes is the leading cause of death among American Indian/Alaskan Natives and the 7th leading cause of death in the United States. Type 2 diabetes (T2DM) affects 9% of the U.S. population and costs the United States an estimated $245 billion annually. The purpose of this project was to identify patients’ concerns related to their disease and to develop an education program for providers to address these concerns. The project was framed using Orem’s theory of self-care and the middle-range theory of self-care of chronic illness. Five providers in an underserved clinic in Alaska conducted assessments during a primary care …

Perceptions, Practices, And Risk Factors Associated With Typhoid Fever In Nimo Village, Nigeria, George Ilouno

Walden Dissertations and Doctoral Studies

Typhoid fever is a bacterial disease transmitted by the fecal-oral route. In Nigeria, the condition is life threatening and endemic. It affects communities such as Nimo that have limited water, sanitation, and hygiene infrastructure. Previous researchers focused on sanitation and hygienic conditions that contribute to the disease such as household-level hygiene and food and water contamination, including handling practices. However, there is limited knowledge on how the environmental behavior and living conditions of eating and sleeping on a floor harboring fecal materials affect typhoid fever prevalence. The purpose of this qualitative phenomenological study was to explore the perception of the …

Promotion Of Lifestyle Changes By Community Pharmacists Among Adults With Hypertension In Nigeria, Olanike Olawunmi Kehinde

Walden Dissertations and Doctoral Studies

The growing prevalence of hypertension is a global public health problem. Lifestyle modification is the first-line best practice for the management of hypertension, however there is not enough focus on healthcare professionals’ competencies in managing hypertension in Nigeria. The perspectives of Community Pharmacists (CPs) about promotion of lifestyle modification (PLM) among adults with hypertension have not been explored in Nigeria though they play an essential role in healthcare in the community. This phenomenological study was conducted to document the experiences of CPs about PLM by using in-depth interviews. Social cognitive theory and the health promotion model were used as frameworks …

Factors Contributing To Community-Associated Carbapenem Resistant Enterobacteriaceae Infections In The United States, Zabrina Lockett

Walden Dissertations and Doctoral Studies

Carbapenem-resistant Enterobacteriaceae (CRE) health care acquired infections are a serious public health threat due to a high mortality rate, economic burden, and depletion of last resort CRE antimicrobials. CRE infections have emerged as community-associated type infections in the United States. For CRE to now have that type of potential is cause for immediate and extensive action. The prevalence of CRE infection cases that were reported as community-associated CRE and health care acquired CRE by examining specific clinical characteristics between 4 selected states that were reported to respective state health departments and the Centers for Disease Control were explored in this …

Microcystins And Liver Disease Mortality, Insights From An Ecological Study, Rajesh Tirpaul Melaram

Walden Dissertations and Doctoral Studies

Microcystins (MCs) are toxic secondary metabolites produced by freshwater cyanobacteria. Algal bloom subsidence can stimulate MC release, which can impair liver function if orally exposed to in large doses. The purpose of this retrospective, U.S. ecological study was to determine if MC exposure represented an environmental risk factor for liver disease mortality using a socioecological approach. A longitudinal ecological substudy investigated the association between average total MCs in Lake Washington and Lake Manatee and age-adjusted chronic liver disease (CLD)/cirrhosis death rates in Brevard County and Manatee County, Florida (FL). A prediction model of total MCs was deduced by quantifying levels …