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Articles 1 - 30 of 2132
Full-Text Articles in Public Health
A Spatiotemporal Study Of Environmentally Associated Pulmonary Diseases In Georgia, Jason Raymond Baum
A Spatiotemporal Study Of Environmentally Associated Pulmonary Diseases In Georgia, Jason Raymond Baum
Walden Dissertations and Doctoral Studies
Exposures to particulate dust matter (PM10 and smaller) from aggregate comminution facilities (ACF) can lead to the onset of environmentally associated pulmonary diseases (EAPDs); acute and chronic asthma (Type I allergic hypersensitivity reaction), chronic pulmonary disease, interstitial lung disease (ILD), and lung cancer. In this environmental epidemiological research study, three primary spatial and spatiotemporal research questions related to nonoccupational exposures from 118 facilities across Georgia were evaluated. Secondary data analysis was conducted from the Centers for Disease Control and Prevention’s (CDC) 2018–2023 Behavioral Risk Factor Surveillance System (BRFSS) and the Metropolitan Statistical Areas, Micropolitan Statistical Areas, and Metropolitan Divisions to …
Effectiveness Of Pancreatic Cancer Screening In High-Risk Elderly Individuals In Florida, Adeleke A. Aromolaran
Effectiveness Of Pancreatic Cancer Screening In High-Risk Elderly Individuals In Florida, Adeleke A. Aromolaran
Walden Dissertations and Doctoral Studies
Routine preventive care supports early identification and management of health conditions among adults at high risk for pancreatic cancer. Evidence is limited regarding socioeconomic and health care access factors associated with engagement in routine preventive care among Florida adults aged 65 years and older at high risk for pancreatic cancer. The purpose of this quantitative cross-sectional correlational study was to examine these associations among this population. The health belief model served as the theoretical framework. Secondary data from the 2022 Florida Behavioral Risk Factor Surveillance System were analyzed for N = 4,032 participants using two multivariable binary logistic regression models …
Relationship Between High-Risk Cytogenetic Abnormalities And Tent5 Mutations And Disease Outcomes Of Multiple Myeloma Patients, Erica Lea Richardson
Relationship Between High-Risk Cytogenetic Abnormalities And Tent5 Mutations And Disease Outcomes Of Multiple Myeloma Patients, Erica Lea Richardson
Walden Dissertations and Doctoral Studies
Multiple myeloma (MM) patients have the lowest 5-year cancer survival rates due, in part, to the time it takes for symptoms to develop and the presence of one to four high-risk cytogenetic abnormalities (HRCA). The Terminal Nucleotidyltransferases 5 (TENT5) subfamily, which regulates myeloma cell migration and tumorigenesis, may also increase the risk for developing MM and impact survival rates. The purpose of this study was to investigate the association between the number of HRCA and TENT5 mutation hits with disease outcomes in MM patients while controlling for the stage of the disease (i.e., I, II, or III) at diagnosis. The …
Sociodemographic And Geographic Factors Underlying Breast Cancer Survival Disparities Among Women In The United States, Colletta Brabham-Orr
Sociodemographic And Geographic Factors Underlying Breast Cancer Survival Disparities Among Women In The United States, Colletta Brabham-Orr
Walden Dissertations and Doctoral Studies
Breast cancer-specific mortality in the United States remains higher among women in rural and socioeconomically disadvantaged areas, yet few population-based studies have been conducted to jointly scrutinize demographic and structural determinants of this disparity. Informed by the social determinants of health framework, this secondary data analysis, using records from the SEER Research Plus database, examined the association between age at diagnosis, race and ethnicity, rural/urban residence, county-level median household income, and breast cancer-specific mortality among U.S. women aged 18 and older diagnosed with malignant invasive breast cancer between 2010 and 2020 (N = 285,865). Bivariate chi-square tests and binary logistic …
Impact Of Sexual Orientation On Syphilis Diagnosis Among African American Men In Colorado, Emmanuel Bhatti
Impact Of Sexual Orientation On Syphilis Diagnosis Among African American Men In Colorado, Emmanuel Bhatti
Walden Dissertations and Doctoral Studies
Syphilis remains an ongoing public health concern among African American men. Elevated rates during the COVID-19 pandemic further underscored the need for focused attention on this population. The risk factors driving syphilis diagnosis among African American men during a pandemic like COVID-19 remain poorly understood. The purpose of this quantitative cross-sectional study was to examine the association between sexual orientation and syphilis diagnosis among African American men in Colorado. Social cognitive theory was applied to understand the interaction among sexual orientation, HIV status, age, and syphilis diagnosis. Sexual orientation categories include men who have sex with men (MSM), men who …
Prostate Cancer Survival Among Young Males Within The United States, Maxine M. Findlay
Prostate Cancer Survival Among Young Males Within The United States, Maxine M. Findlay
Walden Dissertations and Doctoral Studies
Prostate cancer incidence has increased among younger men in the United States, and treatment affects both patient survival and family well-being. This quantitative retrospective study examined survival among young men diagnosed with prostate cancer who received chemotherapy, radiation therapy, and/or prostatectomy, while accounting for socioeconomic factors of residence and ethnicity. Social cognitive theory was the framework. Ordinal logistic regression was used to determine whether treatment method, socioeconomic factors of residence and ethnicity predicted survival among young men diagnosed with prostate cancer. Data was sourced from the National Cancer Database Participant User File 2004-2021 specific to prostate cancer. The study cohort …
Socioecological Factors Associated With Advanced Primary Tumor Category At Diagnosis Among Adults With Head And Neck Cancer Residing In Pennsylvania And New Jersey, Diane Elizabeth Crawford
Socioecological Factors Associated With Advanced Primary Tumor Category At Diagnosis Among Adults With Head And Neck Cancer Residing In Pennsylvania And New Jersey, Diane Elizabeth Crawford
Walden Dissertations and Doctoral Studies
Disparities in head and neck cancer (HNC) diagnosis may contribute to poorer outcomes among socially and economically disadvantaged populations. This quantitative secondary data analysis examined associations between socioecological factors and advanced primary tumor category among adults with HNC residing in Pennsylvania and New Jersey. Guided by the socioecological model, deidentified data (N = 350) from two Fox Chase Cancer Center research protocols were analyzed using three domain-specific multivariable logistic regression models. Primary tumor category was classified as lower (Tis–T2) or advanced (T3–T4) based on tumor size and/or local extent. Black participants had greater adjusted odds of advanced primary tumor category …
Evaluation Of The Association Between School Prevention Programs And Adolescents’ Opioid Abuse In The United States, Lida Moazezi
Evaluation Of The Association Between School Prevention Programs And Adolescents’ Opioid Abuse In The United States, Lida Moazezi
Walden Dissertations and Doctoral Studies
This study examined adolescent opioid misuse in the United States and the role of school-based prevention. Guided by the health belief model, the purpose was to test whether participation in school-based drug prevention lessons was associated with past-year opioid misuse among adolescents ages 14–17 and whether race and gender moderated that association. This quantitative, cross-sectional, nonexperimental secondary analysis used the 2019 National Survey on Drug Use and Health (N = 8,965). Analyses included weighted descriptives, chi-square tests, and complex-samples logistic regression controlling for age and socioeconomic status. The sample included adolescents ages 14–17 with complete data on school-based prevention participation, …
Surviving The Divide: Exploring Endometrial Cancer Survival In Idaho’S Urban And Rural Landscapes, Elena G. Estrada
Surviving The Divide: Exploring Endometrial Cancer Survival In Idaho’S Urban And Rural Landscapes, Elena G. Estrada
Walden Dissertations and Doctoral Studies
Endometrial cancer is the fourth most common gynecologic malignancy in the United States, with a rising incidence among postmenopausal women. Although geographic disparities in cancer outcomes have been documented nationally, survival differences by urban versus rural residence and receipt of surgery remain understudied in Idaho. The purpose of this quantitative, retrospective cohort study was to examine the associations of urban versus rural residence, and receipt of surgery with 5-year survival among women in Idaho, a largely rural and underserved state. Guided by the social-ecological model and social determinants of health, this study used secondary data from the National Cancer Institute, …
The Association Of Age, Race, And Gender And Novel Interventions In The Prevention Of Catheter-Associated Urinary Tract Infection, In Washington State, Lamin Darboe
Walden Dissertations and Doctoral Studies
Delayed removal of indwelling urinary catheters (IUCs) contributes to catheter-associated urinary tract infections, a leading healthcare-associated infection. A dot/smart-phrase communication tool, guided by the Health Belief Model construct of cues to action, to promote timely IUC removal interventions was evaluated in this quantitative, cross-sectional study. Secondary data from N = 372 adult patients with acute urinary retention in acute and critical care settings in Washington State were analyzed using SPSS Version 30. Binary logistic regression examined relationships among demographic variables, intervention-related factors (adherence within 48 hours, cosignature within 24 hours, and secure chat communication), and clinical outcomes (IUC removal and/or …
Defining Quality Of Life: The Lived Experience Of Adults With Pulmonary Hypertension And The Impact Of Activity-Induced Respiratory Distress, Bethany Jean Adams
Defining Quality Of Life: The Lived Experience Of Adults With Pulmonary Hypertension And The Impact Of Activity-Induced Respiratory Distress, Bethany Jean Adams
Walden Dissertations and Doctoral Studies
Pulmonary hypertension (PH) is a progressive, life-limiting disease that significantly affects quality-of-life (QoL). Limited research has explored lived experiences of individuals with PH. Guided by Parse’s human becoming theory, this qualitative descriptive phenomenological study explored the lived experiences of individuals affected by PH and examined how activity-induced respiratory distress affected QoL. The research Question was: How do individuals with PH describe the impact of activity-induced respiratory distress on their QoL. I conducted interviews with nine participants, including eight adults diagnosed with PH and one caregiver of an individual with PH. Data were analyzed using Saldaña's comparative coding framework to identify …
Relationship Between Sociodemographic Factors And Opioid Overdose Mortality In Milwaukee County, 2020-2021, Elizabeth David
Relationship Between Sociodemographic Factors And Opioid Overdose Mortality In Milwaukee County, 2020-2021, Elizabeth David
Walden Dissertations and Doctoral Studies
Opioid overdose deaths increased significantly from 2020 to 2021, with Milwaukee County experiencing higher rates than the national and state averages. African American and Hispanic residents faced disproportionately high fatal overdose rates. The purpose of this quantitative retrospective cross-sectional study was to examine the associations among socioeconomic status, race, age, access to treatment (measured by emergency medical services [EMS] naloxone administration), and opioid overdose mortality among underserved minority populations in Milwaukee County. Guided by the social-ecological model, the study analyzed data from the Milwaukee Health Department and the Milwaukee County Medical Examiner's Office across 34 ZIP codes. Inclusion criteria for …
Self-Care Behavior And Diabetes Knowledge In African American Women With Type 2 Diabetes, Rena Renee Barron
Self-Care Behavior And Diabetes Knowledge In African American Women With Type 2 Diabetes, Rena Renee Barron
Walden Dissertations and Doctoral Studies
African American women experience a disproportionate burden of Type 2 diabetes, and limited evidence exists regarding the relationship between diabetes knowledge and self-care behaviors, particularly among African American female veterans. The purpose of this quantitative, cross-sectional study was to examine the relationship between diabetes knowledge and diabetes self-care among African American women with Type 2 diabetes, including a subsample of African American female veterans, and to evaluate whether the COVID-19 pandemic (2017–2019 vs. 2021–2023) moderated this relationship. Additional variables included age, marital status, physical health, and mental health. Guided by the social-ecological model, de-identified data from the Behavioral Risk Factor …
Examining The Association Between Socioeconomic Factors And Cervical Cancer Among Minority Women In The United States, Darla Fils
Walden Dissertations and Doctoral Studies
Cervical cancer remains a significant public health concern, with African American and Hispanic women experiencing disproportionately higher incidence and mortality rates in the United States. Socioeconomic factors, including income, education, employment status, and place of residence, may contribute to these disparities by affecting access to preventive services, timely diagnosis, and follow-up care. This quantitative cross-sectional study examined associations between these factors and cervical cancer incidence among African American and Hispanic women while controlling for age and health insurance status. Guided by the socio-ecological model, the study used 2022 Behavioral Risk Factor Surveillance System data from N = 33,886 African American …
Prenatal Health Factors Of Pregnant People Associated With Second Degree Postpartum Hemorrhage Across The United States, Elizabeth Simpler
Prenatal Health Factors Of Pregnant People Associated With Second Degree Postpartum Hemorrhage Across The United States, Elizabeth Simpler
Walden Dissertations and Doctoral Studies
Secondary postpartum hemorrhage (SPPH) is a significant contributor to maternal morbidity in the United States and occurs after hospital discharge during the postpartum period. Persistent disparities in terms of maternal outcomes suggest access to prenatal care alone may not adequately address clinical and social factors associated with SPPH. Guided by the Social Ecological Model, which recognizes that health outcomes are influenced by a collective approach to examining health. The purpose of this study was to examine associations between SPPH, prenatal care access, and social determinants of health from 2019 to 2022 while controlling for maternal age, race, and delivery type. …
Psychosocial Experiences Of Secondary School Students Living With Sickle Cell Disease While In School In Lagos State, Nigeria, Toluwalope Yetunde Onuwe
Psychosocial Experiences Of Secondary School Students Living With Sickle Cell Disease While In School In Lagos State, Nigeria, Toluwalope Yetunde Onuwe
Walden Dissertations and Doctoral Studies
Sickle cell disease (SCD) is a lifelong genetic condition significantly impacting the physical, emotional, and social health of those affected. Nigeria has one of the highest global burdens of SCD, yet there is limited research on the psychosocial experiences of secondary school students living with SCD in educational settings. This qualitative study explored these experiences among students in Lagos State, Nigeria. Using the social ecological model and interpreted through the social model of disability, the study examined how school environments, educational practices, and institutional support influenced students' psychosocial well-being and perceived health. Twenty secondary school students participated in 4 in-person …
Implementing Routine Trauma Screening Using The Ace Questionnaire And Pcl-5, Esther Amune
Implementing Routine Trauma Screening Using The Ace Questionnaire And Pcl-5, Esther Amune
Walden Dissertations and Doctoral Studies
This evaluation of a quality improvement initiative addressed inconsistent trauma screening and electronic documentation at an outpatient site. The baseline trauma-screening completion rate was 60%, below the organization's 80% target. The gap was relevant to nursing because nurses support screening, documentation, referral, coordination, and follow-up. The practice-focused question addressed whether the Adverse Childhood Experiences (ACE) Questionnaire and the Posttraumatic Stress Disorder Checklist for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), or PCL-5, would improve documented screening completion and trauma-informed treatment planning over 10 weeks. The purpose was to incorporate both tools into care and …
Immigration Status And Lung Cancer Diagnosis In U.S. First-Generation Immigrants, Valeriya Lockwood
Immigration Status And Lung Cancer Diagnosis In U.S. First-Generation Immigrants, Valeriya Lockwood
Walden Dissertations and Doctoral Studies
The healthy immigrant effect (HIE) is an observed phenomenon in which immigrants exhibit better health outcomes than native-born residents, though relatively few studies have examined its role in chronic diseases in the United States. The purpose of this quantitative cross-sectional study was to assess the associations between immigration status, age, sex, race/ethnicity, median household income, and geographic location and lung cancer diagnosis in first-generation immigrant adults aged 18 or older. The subsequent health trajectory model provided the theoretical framework for the study. Data were obtained from the SEER*Stat Database 1975-2022 (N = 1,993). Binomial regression analysis showed that immigrants were …
Public Perceptions Regarding Surveillance Of Lyme Disease In Tennessee, Shaheena Yasmin Asad
Public Perceptions Regarding Surveillance Of Lyme Disease In Tennessee, Shaheena Yasmin Asad
Walden Dissertations and Doctoral Studies
Lyme disease (LD), a tick-borne illness, has been a growing concern in the state of Tennessee. Studies have established environmental concerns regarding a growing tick population and identified a gap between reported cases and disease burden in Tennessee. Despite this information, it remains classified as a low-incidence reporting state, raising concerns about underreporting that indicate an ineffective current surveillance system. Because the public perception regarding surveillance of LD is unknown, the purpose of this qualitative study was to explore how adults in Tennessee perceived LD as a credible public health threat within the context of the current surveillance system. Guided …
Measuring Health System Readiness In Saint Lucia Using International Health Regulations Capacity Indicators, Melissa Steele
Measuring Health System Readiness In Saint Lucia Using International Health Regulations Capacity Indicators, Melissa Steele
Walden Dissertations and Doctoral Studies
Emerging infectious diseases continue to challenge national health systems, particularly in small island developing states with limited preparedness resources. Limited evidence comparing the International Health Regulations (2005) State Party Self-Assessment Annual Reporting (IHR SPAR) capacities of small island developing states with those of high-income countries limits efforts to identify preparedness gaps and strengthen health systems. The purpose of this quantitative comparative study was to evaluate Saint Lucia's preparedness using IHR SPAR indicators, compare its preparedness with the United States, and assess changes between 2023 and 2024. Guided by the World Health Organization Health System Framework, a quantitative cross-sectional design using …
Demographic And Socioeconomic Factors Related To Visceral Leishmaniasis Infection In South Sudan, Duncan Ochieng Ochol
Demographic And Socioeconomic Factors Related To Visceral Leishmaniasis Infection In South Sudan, Duncan Ochieng Ochol
Walden Dissertations and Doctoral Studies
Visceral leishmaniasis, a severe parasitic disease that is invariably fatal, is characterized by frequent outbreaks, and is associated with poverty. South Sudan is among the countries with the highest burden of visceral leishmaniasis. However, few studies have investigated factors associated with visceral leishmaniasis in the country. This study investigated demographic (age, gender, marital status, education level and occupation) and socioeconomic factors (transport, access to health services and residence) that may be associated with visceral leishmaniasis infection in South Sudan. The study was anchored on the socioecological model conceptual framework, which describes the interaction between individual and their social environment and …
From Fields To Flu: Mapping H5n1 Zoonotic Risk In California Rice Fields, Mariati Messinger
From Fields To Flu: Mapping H5n1 Zoonotic Risk In California Rice Fields, Mariati Messinger
Walden Dissertations and Doctoral Studies
Highly Pathogenic Avian Influenza (HPAI) H5N1 threatens agriculture, wildlife, and public health in California, where flooded rice fields in the Central Valley provide surrogate wetland habitat for migratory waterfowl and may create ecological interfaces for viral spillover into poultry systems. This quantitative ecological study examined whether county-level rice acreage, Lesser Snow Goose activity, and their interaction were associated with poultry HPAI H5N1 outbreak incidence during complete winter seasons available for analysis. Guided by One Health and disease ecology frameworks, secondary data from USDA, eBird, PRISM, and public surveillance sources were analyzed for 36 county-winter observations using negative binomial regression, logistic …
Medical Recommendations And Bmi Among Black And Hispanic Adolescent Females, Dorothea Polk
Medical Recommendations And Bmi Among Black And Hispanic Adolescent Females, Dorothea Polk
Walden Dissertations and Doctoral Studies
Adolescent obesity persists as a critical public health challenge in the United States, with Black and Hispanic adolescent females experiencing elevated rates. Adolescent obesity contributes to serious long-term health risks, but provider counseling may support body mass index (BMI) management. Guided by the social-ecological model, this study examined whether receiving medical recommendations to control or lose weight was associated with BMI among Black and Hispanic adolescent females aged 16–19 years and whether meal preparation habits and food security status moderated this association, controlling for age, household income, and race/ethnicity. This quantitative, cross-sectional secondary analysis used multiple linear regression analyses to …
Time Series Analysis Of Temperature And Pollen Exposure On Asthma Outcomes In Atlanta, Georgia, Victoria Okereke-Viktorsson
Time Series Analysis Of Temperature And Pollen Exposure On Asthma Outcomes In Atlanta, Georgia, Victoria Okereke-Viktorsson
Walden Dissertations and Doctoral Studies
The effects of climate change contribute to volatile temperature changes, which coupled with pollen exposure pose a significant threat to asthmatic people, potentially impacting methods for asthma management. The purpose of this ecological time-series study was to use the carbon dioxide theory of climate change, Dutch hypothesis, and social ecological model to estimate the relationship between average temperature and average pollen concentrations on average asthma morbidity outcomes for adults living in metropolitan Atlanta from 2020 to 2022 (N = 37,913). Results varied in terms of years, socioeconomic status (SES) vulnerability, gender, and racial group. Overall, a linear regression model revealed …
Risk Factors For Metabolic Syndrome Among U.S.-Born And Non-U.S.-Born Hispanics In The United States, Banessa Maldonado
Risk Factors For Metabolic Syndrome Among U.S.-Born And Non-U.S.-Born Hispanics In The United States, Banessa Maldonado
Walden Dissertations and Doctoral Studies
Current knowledge regarding risk factors for metabolic syndrome (METS) among Hispanic individuals of Mexican descent remains limited. Using data from NHANES 2017–2020, this study compared factors contributing to METS and included U.S.-born and non-U.S.-born Hispanic adults of Mexican descent aged ≥ 18 years living in the USA (N = 949) with assessed METS. Grounded in the social ecological model and social determinants of health, this research evaluated dietary habits, lifestyle patterns, and acculturation processes using multivariate logistic regression and stratified analyses. Educational attainment was associated with METS, but the association was not statistically significant in adjusted models p = 0.528. …
Relationship Between Internet Use, Perceived Social Support, And Obesity Among African American Young Adults, Marketta Mccollough
Relationship Between Internet Use, Perceived Social Support, And Obesity Among African American Young Adults, Marketta Mccollough
Walden Dissertations and Doctoral Studies
The disproportionately high prevalence of obesity among African American young adults is a significant public health crisis rooted in systemic inequities. The purpose of this quantitative cross-sectional study was to examine the relationships between internet use for health information, perceived social support (online and offline), and obesity in this population. Grounded in the social cognitive theory (SCT), this study investigated how these behavioral and environmental factors interact to influence body mass index. Using secondary data from the 2021–2023 National Health and Nutrition Examination Survey, a complex samples logistic regression with a Bonferroni correction (α = .0125) was conducted on an …
Association Between Resource Availability And Wellbeing Of Autism Patients In Ghana, Kwabena Aduse-Poku
Association Between Resource Availability And Wellbeing Of Autism Patients In Ghana, Kwabena Aduse-Poku
Walden Dissertations and Doctoral Studies
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that presents significant challenges for children and families in Ghana, where resources remain limited. Grounded in the social ecological model, this quantitative cross-sectional study examined the associations between autism management programs and wellbeing, defined briefly as independent functioning in daily life and learning of autism patients enrolled in selected institutions in Accra and Kumasi, Ghana. Data were collected from N=122 autism patients using structured questionnaires that were completed by caregivers and program staff. Binary logistic regression analyses were conducted to assess relationships between program type, regional location, and years of enrollment and …
Association Between Opioids And Leukemia/Lymphoma In Adults Living In The United States, Brenda Sue Newberry-Colasanti
Association Between Opioids And Leukemia/Lymphoma In Adults Living In The United States, Brenda Sue Newberry-Colasanti
Walden Dissertations and Doctoral Studies
Opioid prescribing rates and opioid misuse remain high throughout the United States. Exposure to opioids has been positively associated with various cancers; however, research evaluating associations between opioid exposure and hematologic cancers like leukemia and lymphoma is limited. Using the Socio- Ecological Model as a foundation, this quantitative cross-sectional study aimed to analyze the association between medicinal opioid use, opioid misuse, and leukemia/lymphoma while exploring how selected social determinants of health (SDOH) may modify that relationship. Secondary data were pooled from the 2015–20-year United States National Survey on Drug Use and Health (NSDUH). One thousand three hundred and twenty binary …
Health Literacy And Diabetes Self-Care Behavior, Eucharia Amaefule
Health Literacy And Diabetes Self-Care Behavior, Eucharia Amaefule
Walden Dissertations and Doctoral Studies
Limited health literacy is a significant barrier to effective diabetes self-management among adults with type 2 diabetes mellitus (T2DM), yet nationally representative evidence using comprehensive health literacy measures remains limited. Guided by the health belief model, the purpose of this quantitative, secondary data analysis using cross-sectional data was to examine the relationship between health literacy and diabetes self-care behaviors among U.S. adults with T2DM and determine whether education level moderated this relationship. Data from the 2016 Behavioral Risk Factor Surveillance System were analyzed for U.S. adults (N = 9, 535) with self-reported T2DM. Diabetes self-care behaviors included blood glucose monitoring, …
Food And Drug Administration Audit Outcomes And Their Association With Class I And Class Ii Food Recalls, Mark Baker
Food And Drug Administration Audit Outcomes And Their Association With Class I And Class Ii Food Recalls, Mark Baker
Walden Dissertations and Doctoral Studies
Foodborne illness and food recalls remain major public health concerns in the United States. Guided by the Theory of Planned Behavior, the purpose of this quantitative secondary analysis was to examine whether Food and Drug Administration (FDA) inspection classifications, warning letters, and prior 24-month inspection frequency were associated with facility involvement in a subsequent Class I or Class II food recall. Question-specific analytic files were created from publicly available FDA administrative records. Eligible records included FDA-regulated food facilities with qualifying inspection or warning letter events and sufficient data to assess recall involvement within a 12-month follow-up period. The final analytic …