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Walden Dissertations and Doctoral Studies

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Suicide Attempts And Their Contributing Factors Among African American Veterans, Gervline Blaise Jan 2019

Suicide Attempts And Their Contributing Factors Among African American Veterans, Gervline Blaise

Walden Dissertations and Doctoral Studies

Suicide is one of the leading causes of death in the United States. The rate of suicide attempts among veterans in the United States has increased tremendously since 2001, which has left the Department of Veterans Affairs deeply concerned. The purpose of this study was to examine if there is an association between suicide attempts among African American/Black veterans and mental health support, income level, marital status, education level, and unemployment status. This quantitative study used the socio-ecological model to explain the association of the contributing factors to suicide attempts. Descriptive statistics, chi-square, and logistic regression were used to analyze …


Perceptions Of Access To Healthcare In Cameroon By Women Of Childbearing Age, Wenceslaw Chap Chapnkem Jan 2019

Perceptions Of Access To Healthcare In Cameroon By Women Of Childbearing Age, Wenceslaw Chap Chapnkem

Walden Dissertations and Doctoral Studies

Increased poverty and unemployment rates, minimal investment in social amenities, a shortage of healthcare professionals, poor infrastructure, inadequate social services, and poor institutional and political leadership have weakened the healthcare status of Cameroon's women who have reached the age of childbearing. The World Health Organization expressed increased urgency for healthcare providers and patients to develop new healthcare policies to eliminate health-related disparities. The aim of this phenomenological study was to examine the perceptions of women of childbearing age living in Mamfe rural community in regard to Cameroon's healthcare system and its impact on their lives. The theoretical foundation of the …


Association Of Adaptive Early Phase Study Design And Late Phase Study Results In Oncology, Donna Elise Levy Jan 2019

Association Of Adaptive Early Phase Study Design And Late Phase Study Results In Oncology, Donna Elise Levy

Walden Dissertations and Doctoral Studies

This quantitative study assessed the association of the design methods used for early phase oncology studies (adaptive versus traditional) and the outcome of late stage clinical trials. Differences by cancer type and by drug classification were also assessed. The theoretical and conceptual frameworks used were the general systems theory and the design and evaluation of complex interventions, respectively. Units of analysis were individual oncology studies in the ClinicalTrials.gov database and Bayesian logistic modeling was applied on a random sample of 381 studies initiated after November 1999 to December 2016. When assessing study design and outcome, there were lower odds of …


A Conflictive Triuvirate Consruct Of Epidemiologic Systems Failure, Ngozi Lois Ulinwa Jan 2019

A Conflictive Triuvirate Consruct Of Epidemiologic Systems Failure, Ngozi Lois Ulinwa

Walden Dissertations and Doctoral Studies

Epidemiologic systems failure (ESF) is a major hurdle in minimizing the spread of infectious diseases during outbreaks. The reasons for ESF include the technical limitation of personnel handling epidemic crises, strictly defined health policies that limit the actions of epidemiologists, and personal perspective's reservations towards the intentions of health agencies. The purpose of this triumvirate mixed-methods case study was to examine factors of infectious disease control mechanisms useful for determining ESF. Three juxtaposed pre-emptive factors (technical [T], organizational [O], and personal [P] perspectives were used to determine how the multiple perspectives inquiring systems and fuzzy logic revealed factors causing ESF …


Effects Of Medical Professionals' Communication With Men Sleeping With Men And Hiv/Aids, Dawne D. Dickerson Jan 2019

Effects Of Medical Professionals' Communication With Men Sleeping With Men And Hiv/Aids, Dawne D. Dickerson

Walden Dissertations and Doctoral Studies

The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) initially emerged in the 1980s and ever since, a battle has been underway with regard to understanding some of the root issues attributed to behavior and HIV/AIDS. AIDS is prevalent in the men sleeping with men (MSM) community. There is lack of studies evaluating the quality and quantity of communication between MSM and medical professionals, which can be a catalyst to help reduce HIV/AIDS within this community. The aim of this quantitative study was to evaluate the relationship between quantity and quality of medical professionals' communication and regular HIV …


Ethnic Minority Young Adult Perspectives On Health Literacy Readiness For Adulthood, Selwyn A. B. Carrington Jan 2019

Ethnic Minority Young Adult Perspectives On Health Literacy Readiness For Adulthood, Selwyn A. B. Carrington

Walden Dissertations and Doctoral Studies

Health literacy is a social determinant of health and health disparity and low health literacy contributes to poor health outcomes in ethnic minority young adults (EMYAs). There is a gap in the literature regarding the health literacy readiness (HLR) of EMYAs transitioning to adulthood. The overarching research question concerned the perspectives of EMYAs on HLR for the transition to adulthood. A phenomenological study design was used with a theoretical framework that integrated concepts from the socioecological and health belief models. Twelve purposefully selected EMYAs ages 18-22 from a southern U.S. county participated in the study. Data were collected by telephone …


Help-Seeking Experiences Of African American Men With Depression, Tiffany Coleman Jan 2019

Help-Seeking Experiences Of African American Men With Depression, Tiffany Coleman

Walden Dissertations and Doctoral Studies

Research indicated that depression is now the leading cause of disability globally. Depression and help-seeking experiences among African American men have not been adequately studied. The purpose of this phenomenological study was to explore the help-seeking experiences of African American men with depression. The theoretical framework was Andersen's Behavioral Model of Health Services. Purposive sampling was used to recruit participants. Inclusion criteria were (a) African American men, (b) aged 18 through 65, (c) having a medical diagnosis of depression or symptoms of depression, (d) not currently in treatment, and English speaking. Six African American men with depression or depressive symptoms …


Involving Patient/Family Advisors And Advisory Councils With Patient And Family Engagement, Cortney D. Forward Jan 2019

Involving Patient/Family Advisors And Advisory Councils With Patient And Family Engagement, Cortney D. Forward

Walden Dissertations and Doctoral Studies

Health care consumers are under-represented in literature when defining patient and family engagement. The proportion of people living longer is rapidly growing. Future research is needed to evaluate which strategies of patient and family engagement are most useful in real-world health care settings for patient and families. The purpose of this study was to describe the lived experiences of patient/family advisors working within patient family advisory councils at an academic medical center in the Midwestern United States. The conceptual framework is based on Greenleaf's servant leadership and Bass's transformational leadership. The research questions examined how patient/family advisors describe patient and …


Reducing Child Maltreatment Through Prevention, Chantel Marie Eckert Jan 2019

Reducing Child Maltreatment Through Prevention, Chantel Marie Eckert

Walden Dissertations and Doctoral Studies

Child maltreatment is a public health problem directly linked to poor outcomes across the lifespan, including chronic health conditions and even death. The local population served by the agency in which the project took place experienced an increase in reports of child maltreatment. Agency leadership identified deficiencies in parental knowledge about positive parenting practices as a contributing factor to the problem. To address the problem, the agency implemented a quality improvement evidence-based home visiting pilot initiative. The evaluation of that initiative was the purpose of this project. Bandura's social cognitive learning theory provided the theoretical framework for the project, and …


Logistical Resource Capability During A Mass Casualty Event In Washington State, Todd Devin Brauckmiller Jan 2019

Logistical Resource Capability During A Mass Casualty Event In Washington State, Todd Devin Brauckmiller

Walden Dissertations and Doctoral Studies

The need for increasing efficiencies for medical resource delivery during a mass casualty incident/event is a paramount logistical planning factor that could mean life or death to the citizens affected by a disaster. As such, Washington State has prioritized emergency management and preparedness. Using the just-in-time system by way of Baghbanian' s complex adaptive decision-making theory as the foundation, gave purpose to this qualitative study. This was accomplished by analysis of emergency management professional responses, and to what degree, improvements can be made to the medical resource delivery system during a mass casualty incident/event. Data were collected through semi structured …


Survey Of U.S. Undergraduate Self-Reported Opioid Diversion And Heroin Use, Motives, Sources, And Collective Efficacy As Mediating Factors, Mark Francis Plaushin Jan 2019

Survey Of U.S. Undergraduate Self-Reported Opioid Diversion And Heroin Use, Motives, Sources, And Collective Efficacy As Mediating Factors, Mark Francis Plaushin

Walden Dissertations and Doctoral Studies

Epic morbidity and mortality, and intractability make prescription opioid diversion a wicked problem. Meanwhile, college undergraduates are vulnerable to opioid misuse and its consequences. The purpose of this quantitative study was to assess U.S. undergraduate students' opioid misuse and the relationship between mediating factors. The study's theoretical framework rested on Wakeland's et al. opioid system model and Shaw and McKay's social disorganization theory. This study bridged the gap, measuring collective efficacy and testing its relationship to undergraduate decisions to regulate misuse. Thus, research questions focused on gauging the problem's scope and assessing relationships between factors that drive or potentially regulate …


Social Support And Glycohemoglobin Level Among Older Adults, Emma O. Fakiya Jan 2019

Social Support And Glycohemoglobin Level Among Older Adults, Emma O. Fakiya

Walden Dissertations and Doctoral Studies

Diabetes is a public health concern among older adults in the United States due to the increasing prevalence of diabetes among this age group and the associated long-term and financial impacts. Self-management is a key strategy in the control of diabetes. The purpose of this quantitative study was to examine the association between social support and glycohemoglobin level. The social cognitive theory was the conceptual framework for this study. The research questions were designed to determine whether social support played a role in diabetes management. Data were collected using a cross-sectional survey of secondary data from the 2007-2008 National Health …


Blood Lead Testing Guideline Development For A Public Health Department, Becky Sue Johnson Himes Jan 2019

Blood Lead Testing Guideline Development For A Public Health Department, Becky Sue Johnson Himes

Walden Dissertations and Doctoral Studies

A lack of consistent, evidence-based practices for blood lead testing of children existed in a local public health department (LHD). No known blood lead level is safe, and toxicity can result in behavioral and cognitive impairments. The purpose of this project was to develop and analyze a clinical practice guideline to establish blood lead testing procedures in the LHD to improve testing procedures and enhance future testing within the jurisdiction. The RE-AIM framework was used to address the reach, effectiveness, adoption, implementation, and maintenance of the clinical practice guideline. Five experts evaluated the guideline using the Appraisal of Guidelines for …


Hydraulic Fracturing And Cause-Specific Mortality: A Multicity Comparative Epidemiological Study, Uzoma C. Nduka Jan 2019

Hydraulic Fracturing And Cause-Specific Mortality: A Multicity Comparative Epidemiological Study, Uzoma C. Nduka

Walden Dissertations and Doctoral Studies

Cause-specific mortality (CSM), among other global health estimates, has garnered prominence in the contemporary public health field. CSM has been associated with several factors, however, research comparing CSM for prefracking versus postfracking periods is sparse. Hydraulic fracturing or fracking is a technique of extracting oil and gas from deep underground. The purpose of this study was to evaluate the difference among mean CSM scores from 1975 through 2015 in the available cities and counties of residence in Colorado and to determine the impact of gender, marital status, county of residence, and city of residence on CSM scores (prefracking period 1975-1977 …


Toxic Air Discharge And Infant Mortality: Effects Of Community Size And Socioeconomics, Khabira Salter Jan 2019

Toxic Air Discharge And Infant Mortality: Effects Of Community Size And Socioeconomics, Khabira Salter

Walden Dissertations and Doctoral Studies

Living in counties where manufacturers release environmental toxins, such as those tracked by the Environmental Protection Agency's (EPA) toxic release inventory (TRI), may elevate infants' health risks. Because infant mortality (IM) is a strong indicator of a population's health status, it is an important topic in public health research. The purpose of this research was to examine the potential relationships between IM, community size, and factors related to mothers' SES in counties where more than 25,000 pounds of annual toxic air releases occur. The dependent variable was IM per 1,000 live births in a given community for each of the …


Impact Of Community Factors On The Donor Quality Score In Liver Transplantation, Giovanna Saracino Jan 2019

Impact Of Community Factors On The Donor Quality Score In Liver Transplantation, Giovanna Saracino

Walden Dissertations and Doctoral Studies

An increasing prevalence of metabolic syndrome and obesity has been linked to the rise in transplant indication for cryptogenic cirrhosis and nonalcoholic fatty liver disease (NAFLD), creating a growing challenge to public health. NAFLD liver transplant (LT) candidates are listed with low priority, and their waiting mortality is high. The impact of community/geographic factors on donor risk models is unknown. The purpose of this study was to develop a parsimonious donor risk-adjusted model tailored to NAFLD recipients by assessing the impact of donor, recipient, transplant, and external factors on graft survival. The theoretical framework was the social ecological model. Secondary …


Risk-Taking Behaviors Of First-Generation Sub-Saharan African-Born U.S. Resident Men, Henry K.J. Sinyangwe Jan 2019

Risk-Taking Behaviors Of First-Generation Sub-Saharan African-Born U.S. Resident Men, Henry K.J. Sinyangwe

Walden Dissertations and Doctoral Studies

African-born residents of the United States have a higher incidence of HIV than African Americans. Factors such as lifestyle, habits, behavior practices, and activities may predispose African-born residents to behave sexually in ways that place them at risk of becoming infected with HIV. This study used a qualitative narrative approach to understand the lived experiences first generation Sub-Saharan African-born men who are U.S. residents to analyze the behaviors that expose them to HIV. To analyze data, the study used the health-belief model as the conceptual framework and NVivo for data analysis to assist in identifying, categorizing, and analyzing common themes …


Nursing Program Progression Requirements And Student Success At A U.S. Community College, Deborah Joleen Cipale Jan 2019

Nursing Program Progression Requirements And Student Success At A U.S. Community College, Deborah Joleen Cipale

Walden Dissertations and Doctoral Studies

Although licensed registered nurses (RNs) comprise a significant percentage of the U.S. health care workforce, there is a lack of qualified nurses to meet patient needs. This shortage is expected to intensify as practicing nurses leave the profession. The problem that prompted this study was that an attrition-reduction program implemented in the nursing program at a U.S. midwestern community college did not show a reduction in the average attrition rate. The academic integration construct of Tinto's theory of student departure was used to examine archival academic performance records of 145 students enrolled in the local program from 2010 to 2012. …


Community Health Worker's Perceptions Of Integration Into The Behavioral Health Care System, Juliette Swanston Jenkins Jan 2019

Community Health Worker's Perceptions Of Integration Into The Behavioral Health Care System, Juliette Swanston Jenkins

Walden Dissertations and Doctoral Studies

Mental illness in the United States is a major public health problem. According to the Substance Abuse and Mental Health Services Administration, in 2017, 18.9% of adults in the United States had a mental illness. The purpose of this study was to gain insight into the perceptions held by community health workers (CHWs) regarding their integration into the behavioral health care system in Maryland. Using a social constructivism paradigm and phenomenological approach, a purposive sample of 11 CHWs who supported patients with behavioral health conditions in 17 counties in the state were interviewed. Howlett, McConnell, and Perl'€™s five stream confluence …


Experiences And Attitudes Of Older Homeless Women Toward Healthcare Access, Mary Ann Mueller Jan 2019

Experiences And Attitudes Of Older Homeless Women Toward Healthcare Access, Mary Ann Mueller

Walden Dissertations and Doctoral Studies

Homelessness among older women is a growing problem in many metropolitan areas of the United States. Researchers have indicated that health issues and problems accessing basic care are connected. Older homeless women face increased health issues, multiple challenges related to accessing basic care, and low incomes which put them at higher risk of becoming homeless, staying homeless, and delaying medical treatment. The homeless who lack fulfillment of social support and timely medical care are considered repetitive users of the emergency department and hospital stays. The purpose of this phenomenological study was to explore the experiences and beliefs of older homeless …


Noncompliance With Follow-Up Visits In Primary Care, Amanda Michelle Northern Jan 2019

Noncompliance With Follow-Up Visits In Primary Care, Amanda Michelle Northern

Walden Dissertations and Doctoral Studies

No-show appointments, also referred to as missed appointments, occur 23% to 34% annually in general practice care settings. Missed appointments can lead to reduction in appointment availability, decrease in provider/staff productivity, patient/provider discordance, disruption in continuity of care, and reduced quality of care. There is a gap in the nursing literature regarding effective interventions to reduce missed appointments. The purpose of this quality improvement, secondary analysis project was to determine whether implementation of an evidence-based no-show, nurse-led intervention would reduce missed appointment rates in a family medicine practice. The health belief model and the plan, do, study, act model guided …


African American Masculinity And Its Influence On Hypertension-Related Behaviors, Tangee Denise Thomas Jan 2019

African American Masculinity And Its Influence On Hypertension-Related Behaviors, Tangee Denise Thomas

Walden Dissertations and Doctoral Studies

High blood pressure (hypertension) is known to be one of the leading factors that directly contributes to heart disease and stroke, which are the first and third leading causes of disabilities and death in the general U.S. population. The prevalence of high blood pressure among African American men in the United States ranks as one of the highest in the world. Research indicates the roots of this phenomenon are found in physiological, psychosocial, cultural, and socioeconomic factors differentially affecting the African American population. The purpose of this study was to examine the interaction between African American males' masculine perspective and …


Relationship Between Elevated Blood Pressure/Hypertension In Military Personnel And The Stress Of Combat Deployment, Stephen James Pinkerton Jan 2019

Relationship Between Elevated Blood Pressure/Hypertension In Military Personnel And The Stress Of Combat Deployment, Stephen James Pinkerton

Walden Dissertations and Doctoral Studies

Few studies about elevated blood pressure in the U.S. military exist in which researchers examined exposure to combat and its association with elevated blood pressure. The purpose of this quantitative research was to describe the extent of association between those who were exposed to combat deployment, were 40 or older, and were overweight or obese and had elevated blood pressure for U.S. military personnel who deployed to an area of declared combat between 2012 and 2017. The conceptual basis of this research was best represented by the determinants of health model. Chi-square correlation revealed that being older (equal to or …


Managing Post-Traumatic Stress Disorder In Emergency Personnel: A Qualitative Case Study, Jason Lee Brooks Jan 2019

Managing Post-Traumatic Stress Disorder In Emergency Personnel: A Qualitative Case Study, Jason Lee Brooks

Walden Dissertations and Doctoral Studies

The material in current emergency medical services (EMS) curricula is insufficient to prepare prehospital emergency medical care personnel recognize the signs and symptoms of post-traumatic stress disorder (PTSD) within their workforce. Prehospital emergency textbooks focus on treating patients affected with PTSD, but there is very little included about how EMS professionals may also be affected. Moreover, supervisors and managers of EMS agencies receive very little education on workforce PTSD in their personnel. The purpose of this study was to understand the educational preparation of EMS supervisors in order to develop a PTSD-awareness course. The research question investigated the educational preparation …


Meanings Of Preconception Health To Overweight Women In An Economically Depressed County, Valeria Ninette Balogh Jan 2019

Meanings Of Preconception Health To Overweight Women In An Economically Depressed County, Valeria Ninette Balogh

Walden Dissertations and Doctoral Studies

The intention-behavior gap between receiving professional health information and transitioning to improved health behaviors prior to conception is not well understood. In order to improve preconception health across the board, a more integrative understanding of the problem must present itself. This study combined elements from the theory of planned behavior, self-determination theory, and the bioecological model of human development as it's foundation. Qualitative phenomenology and semistructured face-to-face interviews were used to gain a deeper understanding of the ways in which nine overweight and obese women described preconception intentions and beliefs and the bioecological experiences leading to those beliefs. Interpretation of …


The Experience Of Older Homeless Females With Type 2 Diabetes, Joan Jacqueline Downes Jan 2019

The Experience Of Older Homeless Females With Type 2 Diabetes, Joan Jacqueline Downes

Walden Dissertations and Doctoral Studies

The purpose of this phenomenological study was to explore the experience of older homeless females who have type 2 diabetes mellitus. Women who have stable housing often find it difficult to manage their diabetes; for those who are homeless, managing the disease is even more difficult. This chronic disease has impacted people all over the world and decreased their quality of life. However, people who are homeless may be at a higher risk of this stressful illness. Managing glycemic levels is a crucial factor in decreasing the adverse results in type 2 diabetes. In this study, face-to-face interviews were conducted …


Factors Associated With Pesticide Resistance In Culex Mosquitoes, Jude Akpan Jan 2019

Factors Associated With Pesticide Resistance In Culex Mosquitoes, Jude Akpan

Walden Dissertations and Doctoral Studies

In recent years mosquito-borne diseases have reemerged, largely because of pesticide resistance. The mosquitoes develop resistance to pesticides because of broad and repeated uses of pesticides. Preventing the development of pesticide resistance requires proper understanding of the environmental factors potentially associated with the development of the resistance. The purpose of this study was to investigate the environmental factors associated with the resistance to pesticides by the Culex mosquitoes. This correlational study included the analysis of archived data samples (N = 29,794) from the Field Cage Tests results conducted between 2013 and 2017 by a large county public health department. The …


Merging Pay-For-Performance And Technology To Impact Patient Outcomes, Daaiyah Nimat Akram Jan 2019

Merging Pay-For-Performance And Technology To Impact Patient Outcomes, Daaiyah Nimat Akram

Walden Dissertations and Doctoral Studies

Pay-for-performance (P4P) programs improve the effectiveness, quality, and overall value of healthcare. In today's world of advanced technology and changing trends, physician organizations hesitate to adopt P4P program methodology. A gap in the literature was identified, as there were no guides found that explained how to implement P4P initiatives that improved quality of care. The purpose of this study was to gain a better understand-ing of P4P, and the phenomenology of practice theory was applied to obtain different perspectives about P4P programs and how incorporating technology improved quality of health provisions. Basic qualitative methodology was used, and semistructured telephone interviews …


Perceptions Of Economic, Health, And Environmental Effects Of Hydraulic Fracturing In Indiana, Juliana Bayowa Jan 2019

Perceptions Of Economic, Health, And Environmental Effects Of Hydraulic Fracturing In Indiana, Juliana Bayowa

Walden Dissertations and Doctoral Studies

Effects of hydraulic fracturing (HF) have become a controversial public health issue in the United States. The purpose of this qualitative case study was to explore community members' perceptions of economic, health, and environmental effects of HF in Gibson County, Indiana. The conceptual framework was adapted from the health belief model and was named the HF health impact belief model (HFHIBM). Data were collected from stratified purposeful non-randomly selected 32 Gibson community members, using semi structured questionnaires, complete observations, and existing documents. Stratification was based on factors influencing perception, such as, gender, race, level of education, age or technology exposure, …


Emotional Intelligence And Sociodemographic Status In Associate Degree Nursing Students, Melanie Renee Benington Jan 2019

Emotional Intelligence And Sociodemographic Status In Associate Degree Nursing Students, Melanie Renee Benington

Walden Dissertations and Doctoral Studies

Emotional intelligence (EI) is essential for providing quality and competent care in the nursing profession. Because nurses need to be competent in EI, it is important to determine if inherent factors and academic performance contribute to the development of EI. The purpose of this study, guided by the 4-branch ability model of EI by Mayer and Salovey, was to examine the relationship of EI levels and academic performance, gender, and ethnic background in associate degree nursing (ADN) students who attended a community college. Using convenience sampling, 110 ADN students completed the Schutte Self-Report Emotional Intelligence Test and sociodemographic data. Data …