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Walden Dissertations and Doctoral Studies

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The Association Of Age, Race, And Gender And Novel Interventions In The Prevention Of Catheter-Associated Urinary Tract Infection, In Washington State, Lamin Darboe Aug 2026

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 Aug 2026

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 Aug 2026

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 Aug 2026

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 Aug 2026

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 Aug 2026

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 Aug 2026

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 Aug 2026

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 Aug 2026

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 Aug 2026

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 Aug 2026

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 Jul 2026

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 Jul 2026

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 Jul 2026

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 Jul 2026

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 Jul 2026

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 Jul 2026

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 Opioids And Leukemia/Lymphoma In Adults Living In The United States, Brenda Sue Newberry-Colasanti Jul 2026

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 …


Association Between Resource Availability And Wellbeing Of Autism Patients In Ghana, Kwabena Aduse-Poku Jul 2026

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 …


Health Literacy And Diabetes Self-Care Behavior, Eucharia Amaefule Jul 2026

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 Jul 2026

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 …


Community Health Workers’ Experiences Distributing Harm Reduction Supplies During Covid-19 In The Barren River Area Development District, Angel Nichole Shoemake Jul 2026

Community Health Workers’ Experiences Distributing Harm Reduction Supplies During Covid-19 In The Barren River Area Development District, Angel Nichole Shoemake

Walden Dissertations and Doctoral Studies

Community health workers (CHWs) distributing sterile injecting equipment help reduce infectious disease transmission among people who inject drugs; however, limited research exists regarding their experiences delivering harm reduction services during public health emergencies in rural areas. The purpose of this qualitative study was to explore CHWs’ experiences and perceptions of health risks, operational barriers, and social influences affecting harm reduction service delivery during the COVID-19 pandemic in the Barren River Area Development District. The health belief model guided this study, emphasizing perceived susceptibility, severity, barriers, benefits, and self-efficacy. Data were collected through semistructured Zoom interviews with eight purposively sampled CHWs …


Examining Hiv Testing In Black Americans In The Southern United States: Association Between Sexual Orientation, Gender Identity, Healthcare Access, And Hiv High-Risk Behaviors, Shavon Wolfe Jul 2026

Examining Hiv Testing In Black Americans In The Southern United States: Association Between Sexual Orientation, Gender Identity, Healthcare Access, And Hiv High-Risk Behaviors, Shavon Wolfe

Walden Dissertations and Doctoral Studies

Examining factors that affect HIV testing in the Black/African American population is important because socioeconomic hardship, stigma, and restricted access to healthcare all lead to gaps in early diagnosis and prevention treatment to prevent further spread of infection. However, most studies have focused on these factors separately, leaving less understanding of how they work together to influence HIV testing behavior. Guided by the health belief model, this study examined the relationship between sexual orientation, gender identity, healthcare access, and HIV high-risk behaviors. The study examined the relationship between sexual orientation, gender identity, healthcare access, and HIV testing, and the influence …


Exploring Lifestyle Transitions And Perceptions Of Weight And Health Among College Students In Huntsville, Texas, Keyonna Nicole Thomas Jul 2026

Exploring Lifestyle Transitions And Perceptions Of Weight And Health Among College Students In Huntsville, Texas, Keyonna Nicole Thomas

Walden Dissertations and Doctoral Studies

College students aged 18–25 transitioning to independent living often experience changes in diet, physical activity, stress, and time management that increase health risks. These challenges may be amplified in semi-urban communities by limited access to healthy food, transportation barriers, and scheduling constraints. This qualitative phenomenological study explored how college students in Huntsville, Texas, perceived and interpreted these lifestyle changes and their influence on perceptions of health and weight. Guided by the social ecological model, the study included 12 participants who were 18–25 years old, enrolled in college, living independently in Huntsville, Texas, and able to describe their experiences with lifestyle …


The Association Between Food Insecurity, Housing Insecurity, Self-Care Practice And Depression Among Black Immigrants In The United States, Beatrice Ngozi Mbaocha Jul 2026

The Association Between Food Insecurity, Housing Insecurity, Self-Care Practice And Depression Among Black Immigrants In The United States, Beatrice Ngozi Mbaocha

Walden Dissertations and Doctoral Studies

The prevalence and poor prognosis of depressive symptoms remain significant among adult Black immigrants in the United States. This study examined the complex interplay between food insecurity, housing insecurity, self-care practices, and depression among adult Black immigrants in the United States. Grounded in the socioecological model, this quantitative cross-sectional study analyzed data from N = 469 noninstitutionalized Black immigrant adults (54.2% female, 45.8% male) using the 2023 National Health Interview Survey. Binary logistic regression was employed to assess the probability of depressive symptoms as a function of food insecurity, housing insecurity, and self-care practices, controlling for age, gender, and employment …


Fecal Fatty Acids And Other Risk Factors Associated With Multiple Sclerosis Score, Progression And Diagnosis Among Hispanic Adults, Juliana Ayala-Viqueira Jul 2026

Fecal Fatty Acids And Other Risk Factors Associated With Multiple Sclerosis Score, Progression And Diagnosis Among Hispanic Adults, Juliana Ayala-Viqueira

Walden Dissertations and Doctoral Studies

Multiple sclerosis (MS) is a chronic neurological condition with insufficient research regarding risk factors influencing MS severity score (MSSS), progression and diagnosis among Hispanic adults living in the United States. This cross-sectional study assessed factors associated with MS score, progression and diagnosis using secondary data from the International Multiple Sclerosis Microbiome Study (iMSMS). Guided by the ecological model, the study included N = 576 participants with MS. Manuscript 1 explored the association between body mass index (BMI), sodium consumption, and the MS severity score in a Hispanic adult population. A multiple linear regression was conducted to examine whether age and …


The Impact Of Social Determinants Of Health On Alcoholism Among African American Communities Aged 65 And Older, Kymberly Williams Jul 2026

The Impact Of Social Determinants Of Health On Alcoholism Among African American Communities Aged 65 And Older, Kymberly Williams

Walden Dissertations and Doctoral Studies

Alcohol use disorder among African American older adults (aged ≥65) remains an underrecognized contributor to preventable morbidity and diminished quality of life. Although previous research has identified individual risk factors for alcohol misuse, little is known about how social determinants of health shape alcohol use among this population. The purpose of this descriptive phenomenological study was to explore how family support, experiences of racial discrimination, religious engagement, and economic stability influence late-life alcohol use. Cultural Resilience Theory guided the exploration of how cultural resources and structural stressors influence alcohol use. Five African American adults aged 65 years and older were …


Cytoskeletal Protein Expression In Autism Spectrum Disorder: A Psychoneuroimmunological Perspective On Sars-Cov-2, James Birch Jul 2026

Cytoskeletal Protein Expression In Autism Spectrum Disorder: A Psychoneuroimmunological Perspective On Sars-Cov-2, James Birch

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic heightened concerns about health disparities among individuals with autism spectrum disorder (ASD). Limited understanding of the biological factors underlying health variability may hinder efforts to reduce disparities and improve care for neurodivergent populations. Guided by the psychoneuroimmunology framework, this quantitative study investigated whether cytoskeletal gene expression was associated with neuroimmune variability in ASD and SARS-CoV-2 populations. Three genes –Nck-associated protein 1 (NCKAP1), WAS/WASL-interacting protein family member 1 (WIPF1), and actin-related protein 2/3 complex subunit 1B (ARPC1B)—were evaluated using two publicly available Gene Expression Omnibus datasets GSE212645 (ASD vs. sibling-matched controls, N = 40) and GSE152641 (SARS-CoV-2-positive vs. …


Spatiotemporal Patterns Of Vaccine Uptake For Measles Outbreaks In Katsina State, Nigeria, Zeenat Kabir Asma'i Jul 2026

Spatiotemporal Patterns Of Vaccine Uptake For Measles Outbreaks In Katsina State, Nigeria, Zeenat Kabir Asma'i

Walden Dissertations and Doctoral Studies

Measles remains a public health concern in Nigeria despite the availability of effective vaccines, yet limited research has comprehensively examined spatiotemporal patterns and contextual determinants of vaccination coverage and measles incidence in Katsina State. Guided by the socioecological model, this quantitative ecological study examined spatiotemporal patterns of measles incidence among children aged 9–59 months of age across 183 wards in 34 local government areas of Katsina State, Nigeria, from 2018 to 2022. Confirmed cases (n = 376) were analyzed using negative binomial regression and spatial methods, including Moran’s I, SaTScan, and geographically weighted regression (GWR). Urban wards had higher incidence …


Caregiving And Mental Health Among Mothers During The Covid-19 Pandemic, Makayla Elise Techentine Jul 2026

Caregiving And Mental Health Among Mothers During The Covid-19 Pandemic, Makayla Elise Techentine

Walden Dissertations and Doctoral Studies

The 2019 coronavirus (COVID-19) pandemic led to reliance on family members or friends to care for the sick, resulting in a burden of informal caregiving stressors and relationship to mental health. Guided by the stress process model, this quantitative, cross-sectional study aimed to assess the relationship between caregiving stressors and the mental health of mothers of children aged 18 years or younger who were serving as informal caregivers. Secondary data from the 2020-2021 Behavioral Risk Factor Surveillance System (N = 1,772) considered the independent variables related to caregiving stressors, including hours spent caregiving, time since becoming a caregiver, personal care …