Public Health Commons^™

Hiv Testing And Black Men Who Have Sex With Men, Stephaun Elite Wallace

Walden Dissertations and Doctoral Studies

HIV incidence among Black men who have sex with men (BMSM) is extremely high in contrast to their estimated population size and compared to other racial groups. Researchers have established that a significant proportion of these new cases annually originate from HIV transmission by BMSM who are unaware of their HIV status. The purpose of the study was to assess the relationship between age, sexual behavior, social support, substance use, internalized homophobia, depression, and HIV test history in BMSM. Guided by the social ecological model (SEM) as the conceptual framework, a quantitative cross-sectional study was designed to analyze secondary data …

Obesity Epidemic In The Military: Implications For Veterans, Tracy Lewis

Walden Dissertations and Doctoral Studies

The purpose of this study was to examine the impact of overweight and obesity on veterans' careers. Obesity, once thought unproblematic for the military, is being recognized as a health concern that has expansive implications for the health and readiness of service men and women, as well as for veterans. There is an abundance of information on obesity within the general population, but research on the impact of obesity on military careers is limited. This quantitative, cross-sectional research study investigated how obesity is a challenge throughout a veteran's career, from enlistment to retirement, using an online survey to gather data …

Socioeconomic Determinants Of Physical Activity Among Adult Arab Immigrants In Edmonton, Alberta, Samer Kobrosly

Walden Dissertations and Doctoral Studies

Little is known about leisure-time physical activity (LTPA) habits of Arab immigrants in Canada. Leisure-time physical activity has been linked to decreased risks for cancer, cardiovascular disease, and all causes mortality and increased life expectancy. Socioeconomic status has been recognized as a significant factor affecting health and wellbeing due to its impact on individuals’ attitudes, experiences, and exposure to several risk factors. The purpose of this cross-sectional descriptive study was to explore the levels of participation in LTPA among adult Arab immigrants in central Alberta, Canada, to examine the socioeconomic determinants of LTPA, and to investigate which individual, social, and …

Fruit And Vegetable Consumption, Physical Activity, And Colorectal Cancer Among African Americans, Stella Francoise Nanga Ndzana

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is a deadly and costly cancer, especially among African Americans. The purpose of this quantitative, retrospective, cross-sectional study was to examine African Americans' health behaviors that may have an association with CRC. The Health Belief Model was used to guide this study. The study addressed whether there is a statistical association between fruit intake, vegetable intake, and physical activity, and the occurrence of CRC while controlling for confounders, such as body mass index, smoking status, and income level. After conducting an overall analysis, the final research question examined if the association varied by race. In this study, …

Program Evaluation Of The Employee Health And Wellbeing Program, Alicia Carmen Marlena Perez

Walden Dissertations and Doctoral Studies

Health promotion and disease prevention are a focus of population health management. Without ongoing and rigorous evaluation, these programs may be in jeopardy of continuing. The purpose of this project was to conduct a descriptive population health- focused evaluation of a large-scale health system's employee health and wellbeing program. Guided by the Center for Disease Control and Prevention (CDC) framework for program evaluation in public health and National Center for Organization Development guidelines, a nurse-led evaluation was conducted using 5 specific data sets emphasizing organizational structure, employee health offerings, employee surveys, Pathway to Excellence survey, and program contributions. A descriptive …

Accessibility Of Innovative Services In Radiation Oncology, Patricia Sansourekidou

Walden Dissertations and Doctoral Studies

The field of radiation oncology (RO) involves the use of highly advanced techniques to treat cancer and safely spare healthy organs. The discipline has experienced rapid growth in the past 25 years, with technological advancement as the driving force. Available data and an instrument to effectively measure the accessibility of innovation in the field were lacking. The purpose of this study was to investigate the accessibility of innovative services in RO in the United States and assess possible diffusion patterns. Two hundred and forty medical physicists practicing in RO in the United States completed a custom Internet-based survey. The diffusion …

Oromo Ethiopians Perceptions Of The Prevalence, Causes, Treatment And Prevention Of Trachoma, Linda L. Gross

Walden Dissertations and Doctoral Studies

In Ethiopia, one of the primary contributors to blindness is trachoma, which is an infectious ocular disease. There is no record of any prevention programs in rural Ethiopian villages of Oromia, where the prevalence of trachoma is high. The original purpose of this phenomenological study was to explore the perceptions of rural Oromo villagers in Ethiopia on the causes, treatment, and prevention of trachoma, using the health belief model and the social-ecological model as a theoretical framework. Due to a security situation in Ethiopia, final interviews were conducted with immigrant Ethiopians in the US, all of them from the trachoma-endemic …

Parental Perception Of Physician Cultural Sensitivity And Adherence To Asthma Treatment, Narue Jaynelle Wright-Jegede

Walden Dissertations and Doctoral Studies

In the United States, asthma remains a major cause of frequent urgent care visits, hospitalizations, and preventable deaths among children. Nationwide, the chronic disease continues to fall disproportionately on minorities, mostly residing in urban localities. When a child is diagnosed with asthma, the parents are typically tasked with managing the child's condition. Establishing a collaborative partnership between parents and their child's primary physician is significant for improving asthma self-management among youth. Using the theory of reasoned action as a theoretical framework, this mixed-methods study examined whether a relationship exists between parental perceptions of physician cultural sensitivity and parental care in …

Implementation Of A Transcultural Nursing Education Program To Improve Nurses' Cultural Competence, Ann Marie Elizabeth Edwards

Walden Dissertations and Doctoral Studies

The exponential growth of culturally diverse populations in the United States has led to a multicultural patient population while the nursing workforce remains predominantly White. At the project site, managers identified that staff nurses struggled to deliver culturally competent care. The purpose of this project was to improve the cultural competence of registered nurses (RNs) through a transcultural nursing education program. Leininger's transcultural nursing theory guided the project. Sources of evidence used to develop a face-to-face educational program included peer-reviewed journals, credible websites, and the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-R tool. Aggregate pretest and …

Lived Experiences With Social Networking Technology To Improve Physical Activity, Paula Nobles Eubanks

Walden Dissertations and Doctoral Studies

Research suggests that Black women living in the United States are not engaging in sufficient physical activity, which is a major factor negatively impacting their health outcomes. Black Girls Run (BGR) is a targeted national health movement using the capacity of social networking technology as a tool to interact with and inspire Black women to live healthy through running. Literature lacked the voice and perspective of Black women who were embracing the innovation of technology to positively improve their health behaviors. The purpose of this qualitative phenomenological study was to gain a better understanding of the composite experiences of women …

Beliefs And Opinions Of Low-Income Residents Living In A Food Desert In A Gulf Coast State, Kimberly Lakeidra Willis

Walden Dissertations and Doctoral Studies

This study was an investigation of the access problem to fresh and affordable fruits and vegetables and how limited access influenced the beliefs and opinions of residents of a food desert as designated by United States Department of Agriculture. Many researchers have documented that price, availability, and transportation are barriers to fruit and vegetable consumption, particularly among low-income individuals. Researchers in other studies have concluded that these barriers are further exacerbated by an individual's distance from a supermarket or grocery store. However, much less information is available regarding the beliefs and opinions about life in a food desert and how …

Preventing Obesity And Type 2 Diabetes In Immigrant Populations, Maxwell K. Chikuta

Walden Dissertations and Doctoral Studies

Obesity-related diseases have been increasing in African immigrants throughout the United States. Although research has been done to identify risk factors associated with many ethnic groups in the United States, only a few studies exist that explore obesity and type 2 diabetes diseases among Central African immigrants. The conceptual framework for this qualitative case study was social constructivism and the health belief model. The primary research question addressed the potential underlying causes for an increase in obesity and type 2 diabetes among Central African Immigrants. The secondary research questions explored how culture, illiteracy, and religion contribute to the problem of …

Family Predictive Factors Of Rural Malaria Prevalence In Nsukka, Eastern Nigeria, Gabriel Ugwuja Ugwu

Walden Dissertations and Doctoral Studies

Children in early childhood are still suffering from burdens of malaria-related morbidity and mortality. There have been insufficient studies on how family-level factors may predict the prevalence of malaria (PoM), and negatively impact the control of malaria in rural areas, especially among children. In this study, potential family factors were explored to address the challenges associated with the increase in PoM among the children in rural areas of Nsukka. Socioecological framework guided this study at the interpersonal level. The quantitative cross-sectional study used secondary data from Demographic and Health Surveys (DHS) of 2015 in Nsukka rural communities. Data were analyzed …

Globalization Of Clinical Research And Assessment Of Global Access To Treatments Approved Between 2006-2015, Rafael Duncan Escandon

Walden Dissertations and Doctoral Studies

Globalization in clinical research and development has increased since the 1990s. Products approved in the United States (U.S.) and European Union (EU) include increasing numbers of research participants from low- and middle-income countries. The purposes of this quantitative correlational study were to investigate the lag time, or drug lag, between U.S. approval and the approval of selected drugs in all countries that hosted their pivotal clinical trials. The study population was limited to products approved first in the U.S. between 2006 and 2015. The health capability model and research for health justice framework were the theoretical frameworks for the study. …

Connecticut Primary Care Physicians And Chronic Lyme Disease, Yvette P. Ghannam

Walden Dissertations and Doctoral Studies

The prevalence of chronic Lyme disease (CLD) remains relatively unknown in Connecticut because there is not an agreement on what CLD is and how it should be diagnosed in addition to which pathological agent causes CLD. The aim of this quantitative study was to assess whether there were significant differences between two groups of primary care physicians (PCP) working in Connecticut from two different points in time regarding their knowledge in the diagnosis, treatment, and management of CLD. A knowledge, attitude, and practice model was used as the underlying theoretical framework for this study. A random cross-sectional survey was mailed …

Parental Perception Of Physician Cultural Sensitivity And Adherence To Asthma Treatment, Narue Jaynelle Wright-Jegede

Walden Dissertations and Doctoral Studies

In the United States, asthma remains a major cause of frequent urgent care visits, hospitalizations, and preventable deaths among children. Nationwide, the chronic disease continues to fall disproportionately on minorities, mostly residing in urban localities. When a child is diagnosed with asthma, the parents are typically tasked with managing the child's condition. Establishing a collaborative partnership between parents and their child's primary physician is significant for improving asthma self-management among youth. Using the theory of reasoned action as a theoretical framework, this mixed-methods study examined whether a relationship exists between parental perceptions of physician cultural sensitivity and parental care in …

Quality Improvement Initiative To Improve Patient Attendance In Diabetes Self-Management Education Classes, Charon Denise Randel

Walden Dissertations and Doctoral Studies

Diabetes self-management education (DSME) is a key resource in the battle against diabetes and its secondary effects. This quality improvement project was conducted to address the decreased attendance rates of DSME classes in a community health center in the southern United States. The practice question for this project explored process-related strategies to increase patient attendance in DSME classes. Based on review of patient reports of reasons for nonattendance and an evaluation of peer reviewed literature on improving attendance in DSME, the following strategies were implemented: (a) alternative solutions such as providing patients with the dates for a year of initial …

Cardiovascular Exercise Participation And Obstructive Sleep Apnea Among Adults Over Normal Weight In The United States, Marytherese Agwara

Walden Dissertations and Doctoral Studies

Obstructive sleep apnea (OSA) is a type of sleep apnea that is common, complicated, and a major contributor to cardiovascular diseases, neurocognitive impairment, and mortality. This disease has additional negative impacts on patients' lives by contributing to daytime sleepiness and low productivity at work as well as absenteeism and work-related injuries. Several studies have been conducted to assess the relationship between cardiovascular exercises and OSA; however, a definite conclusion is lacking. The purpose of this quantitative cross-sectional study was to assess the relationship between cardiovascular exercise participation and OSA by examining the relationship between total cardiovascular exercise participation per week …

Characteristics Of Young People Seen In The Emergency Department For Assault-Related Injuries, Robyn Coons

Walden Dissertations and Doctoral Studies

Violence is among the most serious threats to the health and safety of young people between the ages of 10 and 24 in the United States. The purpose of this cross-sectional quantitative study using secondary data from the CDC's 2015 National Hospital Ambulatory Medical Care Survey (NHAMCS) data set was to examine the characteristics (age, sex, race and ethnicity, insurance or payer source, and housing status) of young people between the ages of 10 and 24 who seek medical care for assault-related injuries through the emergency department (ED). The social ecological model was used to examine the complex interplay between …

Evaluation By Geospatial And Spatiotemporal Distribution Of Tularemia Cases In Arkansas, Toni Kathleen Beavers

Walden Dissertations and Doctoral Studies

Tularemia is a vector-borne disease of global concern with diverse regional foci. Arkansas is an endemic state with differences in case distribution and land suitability supporting host and vector sustainment. The aim of this study was to conduct a geospatial and spatiotemporal assessment of factors associated with case distribution and timeliness and completeness of public reporting. Guided with direction from spatial epidemiology and nidality, referring to the association of ecology, climate, and proximity of disease, analysis included secondary data collected from the Arkansas Department of Health between 1995 and 2018. Using Poisson-based software, 2 clusters were found: a high-risk cluster …

Factors Contributing To High Readmissions For Congestive Heart Failure Among African Americans, Shavonda Caprice Devereaux

Walden Dissertations and Doctoral Studies

Abstract

African Americans are disproportionately affected by heart failure, with prevention and treatment of heart failure being a public health concern in the United States. The purpose of this retrospective quantitative study was to examine the primary variable race, specifically African Americans, and how this variable relates to 30-day readmission post discharge when controlled with geographic location (urban vs. rural), gender, and insurance status. The expanded chronic care model was used as a framework to shape health promotion, prevention efforts, and social determinants of health and to enhance community involvement related to chronic disease issues. The research questions were focused …

Staff Education Program On Diabetes Using Self-Care Behaviors, Ruth Adhiambo Ogot

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus affects patients' health across the globe and is costly to manage. The chronic high blood sugar of diabetes is linked to cardiovascular and kidney damage, impaired functional status, and multiple organ failure. To lessen the complications associated with diabetes and promote self-care in those with the disease, health care professionals must be vigilant in offering diabetes education to patients with each clinic or primary care visit. Lack of diabetic educators in the clinic that provided the setting for this study indicated a need to increase clinical staff competency in teaching self-care and diabetes management to patients. …

The Relationship Between Limited Partner Availability, Masculine Ideologies, And Condom Use, Diakima Y. Thomas

Walden Dissertations and Doctoral Studies

One in every 4 people living with the Human Immunodeficiency Virus (HIV) are women. The leading cause of infection is heterosexual contact. The purpose of this quantitative, correlational study was to examine the relationship between gender ratio perception and masculine ideology and a woman's decision to use condoms during her sexual activity. The theory of gender and power and the theory of planned behavior served as the theoretical frameworks for this study. The perceptions of gender ratios, as measured by the Gender Ratio Imbalance Beliefs and Behaviors Scale (GRIBBS) subscale, GRIBeliefs, and masculine ideologies, as measured by the Gender Role …

Factors Affecting Breastfeeding In Preterm Infants, Evangeline Starks Glover

Walden Dissertations and Doctoral Studies

Even though initiation of breastfeeding among term and preterm infants has increased, the incidence and duration among preterm infants continues to lag because of the unique challenges of breastfeeding preterm infants. African American mothers have the lowest rates of breastfeeding initiation and duration, and their preterm infants are less likely to receive breast milk while in the neonatal intensive care unit. The objective of this cross-€sectional quantitative study was to evaluate the relationship between breastfeeding and maternal sociodemographic factors as well as medical and obstetrical conditions for infants born between 32-€37 weeks gestational age in South Carolina from 2009 to …

Psychosocial Consequences Of Parental Wrongful Conviction On Children, St.Jean Jeudy

Walden Dissertations and Doctoral Studies

This qualitative multiple-case study sought to provide an in-depth understanding of how children living in broken families-due to the wrongful conviction of parent(s)-developed psychosocial issues. The theoretical frameworks applied to this study were the social learning theory, the social control theory, the role-modeling theory, and the general theory of crime. A purposeful sample of 13 adults who were children at the time of their parents’ wrongful incarceration were drawn for phone and in-person interviews. The data were transcribed and analyzed to code, sort, and organize; to analyze connections in the information, and to compare and contrast cases. The multiple-case study …

Strategies For Patient Engagement In A Self-Management Program For Adults With Diabetes, Carolinee Jokotola Ogungbayi

Walden Dissertations and Doctoral Studies

Patients' lack of adherence to diabetes self-management education and support (DSMES) recommendations is a challenge for healthcare. One approach to addressing patient noncompliance with DSMES is through education of staff on current guidelines. In an outpatient facility in South Texas, staff training on current DSMES guidelines was recommended as one of the solutions to the problem of Type 2 diabetes mellitus (T2DM) complications observed among clinic patients. An educational module was created to increase staff knowledge on T2DM and to assist staff members in teaching patients to self-manage T2DM. The module was built on the self-management and health promotion models, …

Predicting Outcomes Of American Youths' Shift Toward E-Cigarette Use, D J. Resendez

Walden Dissertations and Doctoral Studies

There has been a shift toward e-cigarette use and away from tobacco smoking among American youth. Despite effects of ongoing public health campaigns that bring attention to the harmful effects of tobacco and nicotine use generally, youths might not perceive e-cigarette use to be unhealthful in terms of psychological functioning. This study was an investigation of the impact of the method of tobacco use (cigarette or e-cigarette), past cessation attempts, cravings or needs to use tobacco, and serious cognitive difficulties, upon youths' intentions concerning future tobacco usage. The conceptual framework was based upon the self-medication hypothesis, biopsychosocial model, and social …

The Effectiveness Of Two Types Of Adjunct Acupuncture Exposures On In Vitro Fertilization Outcomes, Lindsey Vacovsky

Walden Dissertations and Doctoral Studies

One out of every 8 couples experiences infertility. Few publications exist examining the association between the addition of adjunctive therapies when applied to the in vitro fertilization (IVF) procedure and pregnancy outcome. The purpose of this study was to compare the effectiveness of 2 types of adjunct acupuncture exposures on IVF outcomes by applying the concept of the epidemiology triad. The association between the type of adjunct acupuncture exposure received (the independent variable) and pregnancy (the outcome) was determined via binary logistic regression using SPSS software. Medical records of women having received the IVF procedure along with adjunct acupuncture were …

Cultural Factors Affecting African Americans Of Caribbean Descent With Type Ii Diabetes, Ruth Runette Aguy-Paulsaint

Walden Dissertations and Doctoral Studies

Type II diabetes is a significant problem in the United States that had affected almost 10% of the American population and over 13% of African Americans. Although culturally competent diabetes education and treatment programs have been significantly more successful, little is known about the cultural factors affecting type II diabetes in African Americans of Caribbean descent (AACD). The purpose of this qualitative, phenomenological study was to explore the cultural factors relevant to the treatment and prevention of type II diabetes among AACD. The theoretical framework for the study consisted of cultural adaptation theory and the transtheoretical model. Data collection consisted …

Primary Care And Behavioral Health Services In A Federally Qualified Health Center, Svetoslav A. Arsov

Walden Dissertations and Doctoral Studies

Between 2013 and 2016, 8.1% of U.S. adults 20 years and older suffered from depression, but only 29% of them sought help. This project addressed the low depression screening rate in a Federally Qualified Health Center (FQHC) that supported integrated care. The purpose of the project was to evaluate the integration of behavioral health into primary care in an FQHC through the rate of depression screenings. Two theoretical frameworks, the find-organize-clarify-understand-select/plan-do-study-act model and the Centers for Disease Control and Prevention's framework for program evaluation in public health were combined into a list of questions and data validity tests that were …