Public Health Commons^™

Impact Of Food Insecurity On The Management Of Illness In Wayne County, Ohio, Bernadette Coleen Paul

Walden Dissertations and Doctoral Studies

The incidence of food insecurity coupled with poor management of illnesses poses a

public health challenge. Poor adherence to medication regimens is a contributor to poor

health outcomes, especially among the socioeconomically disadvantaged. Food insecurity

is a global health and nutrition problem that affects approximately 50 million people in

the United States. The number of food-insecure households in the United States has

increased by 12% since 1995, and so has the burden of management of illnesses. The cost

of healthcare has risen from 5% of the Gross Domestic Product (GDP) in 1960 to 20% of

the GDP currently. This quantitative …

Experiences And Perceptions Of Staff Providing Substance Use Disorder Treatment For Adolescents, Connie Jean Rendleman

Walden Dissertations and Doctoral Studies

Substance Use Disorder (SUD) is associated with high mortality rates and remains a public health concern in the United States. Although, numerous interventions are offered for adolescents struggling with substance misuse, minimal research is available on the effectiveness of treatments to reduce recidivism. Researching the most effective treatment offered to adolescents is crucial to treatment adherence and recovery. The purpose of this study is to determine the most effective SUD treatment for adolescent patients by exploring the perceptions and experiences of treatment therapists providing treatment. The trans-theoretical model was used with elements of the social cognitive theory as a guide …

The Self-Perceived Cultural Competency Of Hiv Interventionists, Tonya Herring

Walden Dissertations and Doctoral Studies

Despite significant research and inroads with the human immunodeficiency virus (HIV), disparities in HIV infection continue to widen for African American (AA) men who have sex with men (MSM). In recent times, cultural competence has been receiving increased attention as a possible factor to enhance the quality of health messaging and lessening HIV disparities. However, there is a dearth of research specifically dedicated to AA MSM and culturally competent HIV health messages. To address this gap, this qualitative research was designed to investigate the self-perceived cultural competency among HIV counselors. The theoretical framework for the project was the PEN-3 cultural …

Vitamin D Receptor Gene Polymorphisms Knowledge And Breast Cancer In Texas, Ejike Roland Egwuekwe

Walden Dissertations and Doctoral Studies

Breast cancer is a world health problem and is a leading cause of cancer-related death among women in the United States. However, breast cancer risks were reported to be reduced through exposure to Vitamin D through its Receptors identified as the p53 target gene. The purpose of this study was to assess the associations between VDR gene polymorphisms knowledge/awareness and decisions to reduce breast cancer risks and likelihood of mammogram screening among women in Texas. Data from survey were used. Roy adaptation model was the theoretical framework that guided this quasi- experimental, quantitative research. The dependent variables were decisions to …

Pregnant African American Women Breastfeeding Intentions, Beliefs, Attitudes And Perspectives, Janelle S. Mcclain, Phd

Walden Dissertations and Doctoral Studies

Breastfeeding is the best infant feeding source of nutrition for infants in their early stages of development. However, there is a fundamental gap in the number of African American women that initiate breastfeeding compared to White, Asian, and Hispanic mothers. Social cognitive theory was used to explore the breastfeeding intentions, beliefs, perceived barriers, and perceptions on breastfeeding through a basic qualitative research method. To capture the essence of the lived experiences of African American pregnant women, a purposeful sample of 13 African American pregnant women were invited to participate in the study. Two focus groups discussions pertaining to breastfeeding intentions …

Measuring Effects Of Childhood Adversity On Resilience Level Of Army Veterans, Stephanie Rausch

Walden Dissertations and Doctoral Studies

Veteran suicide is a public health issue that requires more research to understand the multidimensional factors, such as resilience, that lead someone to suicide. Adverse childhood events (ACEs), such as poverty and abuse, have affected how resilience is developed. This study examined the association between childhood factors of socioeconomic status, parental discipline, and being a military child, and adult resiliency level. Dienstbier's theory of mental toughness framed the study, which posits that a child who experiences mild ACEs and has time to recover between events, will be more resilient than children who experience serious ACEs, and children who experience little …

The Effect Of Maternity Care Practices On The Duration Of Breastfeeding, Lisette Rodriguez

Walden Dissertations and Doctoral Studies

The natural practice of breastfeeding has been strongly noted as one of the most cost-effective, health promoting, disease-prevention strategies of the 21st century. Although primary health organizations recommend exclusive breastfeeding for the first 6 months of life with added complementary foods and continued breastfeeding up to 2 years of age or longer, many mothers do not breastfeed their infants for the recommendation length of time. Applied policies and health practices, such as those described under the 10 Steps to Successful Breastfeeding and The International Code of Marketing of Breast Milk Substitutes, have been noted as contributing factors that can considerably …

The Association Between Leapfrog's Healthcare Organizational Grades And 30-Day Mortality Rates, Steven Michael Armstrong

Walden Dissertations and Doctoral Studies

U.S. healthcare consumers have access to various provider ratings from several organizations that are meant to assist in selecting their healthcare providers. Leapfrog Hospital Safety Grades is one such rating system that professes to allow consumers the ability to select the best hospital for their care. However, since consumers ranking mortality risk as their most important concern, it is essential to determine if Leapfrog grades align with consumer expectations. Andersen's Phase-4 behavioral model of healthcare utilization was used as the foundation for understanding healthcare consumer preferences. This study was designed to determine if Leapfrog grades are predictive of CMS 30-day …

Incentive Size Alignment With Accountable Care Organization Performance, Kristie D. Racca

Walden Dissertations and Doctoral Studies

Changes to the country's health care political landscape in 2012 resulted in the development of federal programs aimed at containing costs and improving the quality of care delivered. Accountable Care Organizations (ACO) emerged linking performance to rewards. Guided by Conrad's value-based performance incentive theory as the theoretical foundation, the purpose of this quantitative study was to determine the relationship between financial incentive size and ACO performance measures. The research questions examined the predictive relationship of incentive size and acute care readmission rates, emergency department (ED) visits, and per capita spending of the ACO Medicare Shared Savings Program population. The study …

Oral Health Literacy And Oral Hygiene Habits In A Kentucky Appalachian Community, Katie D. Schill

Walden Dissertations and Doctoral Studies

This study sought to identify the level of oral health literacy held by people who live in transitional and distressed Kentucky Appalachian areas and if this effects how often they are using oral hygiene techniques. Data were also collected to describe the attitudes Kentucky Appalachian adults hold toward oral hygiene and oral health status. Current documentation shows that poor oral health remains a public health threat in this population despite efforts such as school-based sealant programs and increased dental insurance coverage. This study followed a quantitative design and 99 participants were polled using a survey specifically developed for this study's …

Leptin Level Variance In Adults With And Without Cancer, Vilisa Chatman-Terry

Walden Dissertations and Doctoral Studies

Abstract

In 2018, health statistics revealed that, despite the many preventive measures established,

cancer was the second leading cause of death in the United States and the leading cause

of death in 22 states, exceeded only by heart disease. With obesity/leptin levels reaching

pandemic levels worldwide, and cancer having a well-known association with obesity,

both chronic diseases represent a large proportion of public health challenges. Guided by

the social ecological model, the purpose of this cross-sectional, quantitative study was to

examine if a significant difference exists in leptin levels among adults with different

types of obesity-associated and common cancers and …

Implementing Aromatherapy For Falls Reduction In The Inpatient Hospice Population, Kimberly Kay Pistek

Walden Dissertations and Doctoral Studies

Falls among the elderly is a health concern affecting multiple patients annually. Hospice patients and those with multiple comorbidities are at the greatest risk of falling and sustaining injuries from falls. Aromatherapy has been used for reducing multiple symptoms as well as for decreasing falls. The practice-focused question explored whether an education program on using aromatherapy for fall prevention would increase knowledge of this intervention for an interdisciplinary group of hospice staff. The design was developed using Knowles's theory of andragogy and Bloom's taxonomy. Thirteen staff members from the same facility participated in the education program. The program was targeted …

Cultural Health Beliefs And Influenza Vaccination Among Caribbean-Born Students, Dona S. Walcott

Walden Dissertations and Doctoral Studies

This purpose of this quantitative study was to examine health beliefs among Caribbean-born university students regarding acceptance or rejection of influenza vaccination among populations at institutions of higher education. In addition, acculturation was addressed as a factor affecting cultural health beliefs. A survey was completed by 98 students enrolled at Florida International University during the spring 2018 semester. Linear regression was used to analyze whether cultural health beliefs and acculturation were predictive of beliefs about influenza vaccination and beliefs about perceived barriers to influenza vaccination. The study findings showed cultural health beliefs of the students were statistically significant predictors of …

Poverty, Demographics, And Hepatitis C Infection In The National Health And Nutrition Examination Survey, Wilson J. Washington Jr

Walden Dissertations and Doctoral Studies

Hepatitis (HCV) is a communicable disease that impacts many Americans. The scholarly literature lacked the knowledge pertaining to the relationships between poverty and HCV diagnosis and prescription for HCV medication. The purpose of the study was to measure the magnitude and statistical significance of these relationships, as modeled by the health belief model and public health surveillance and action framework. Specifically, the study was designed to determine whether there is a statistically significant relationship between living below the poverty line and being diagnosed with HCV, as well as living being below the poverty line and being prescribed HCV medication. A …

Improving Early Mobilization In Acute Stroke Patients Through Best Practice Education, Angela Christine Middleton

Walden Dissertations and Doctoral Studies

Nonadherence to best practice guidelines in early mobilization in acute stroke increases the time from admission to mobilization and may increase residual long-term stroke effects. Early mobilization following an acute stroke is known to decrease long-term and secondary disability. The purpose of this project was to decrease the time from admission to mobilization in the acute stroke patient population by improving knowledge of best-practice guidelines in early mobility using an educational intervention for advanced practice nurse practitioners, physicians, and registered nurses. The practice-focused question for this project asked whether a staff educational program based on best-practice guidelines would decrease the …

Parents' Knowledge Of Child-Passenger Safety And Child-Passenger Restraint Usage, Amanda Cadore

Walden Dissertations and Doctoral Studies

Although occupant protection laws exist, limited research has been conducted on how current child passenger safety (CPS) issues and CPS marketing strategies relate to child passenger safety seat (CPSS) usage. The purpose of this cross-sectional study was to analyze the relationship between parents' perception and knowledge of CPS issues and CPSS usage rates. The diffusion of innovation and the social marketing theories provided the frameworks for this study. The overall research question for the study examined the correlation between parents' knowledge of CPS issues and CPSS usage. Data (participants' surveys, car seat check-up information, and observational statistics) were collected from …

Relationship Between Adolescent Perception Of Harm, Electronic Cigarette Use, And Texas Antitobacco Campaigns, Candace Rasheedah Campbell

Walden Dissertations and Doctoral Studies

The increase in use of e-cigarettes in adolescents is a major public health concern that must be addressed. Research studies showed some e-cigarettes contained varying amounts of nicotine and sever cancer-causing chemicals. The purpose of this quantitative, cross-sectional study was to assess the perception of harm (dependent variable) from using e-cigarettes and being exposed to state and school-based antitobacco programs (independent variable) and to determine if the association was modified by socioeconomic status or area of residence. Attitude-social influence-self-efficacy theory was the chosen theory for research and suggests that attitude, social influence, and self-efficacy variables can be persuaded via specific …

Feeding Practices And Nutritional Status Of Infants In Northwest Nigeria, Michael Enyi Enwere

Walden Dissertations and Doctoral Studies

Infants and young children in the Northwest province of Nigeria are susceptible to malnutrition. Inappropriate and inadequate breastfeeding and complementary feeding result in stunting, underweight, and wasting. The purpose of this cross-sectional study was to examine current feeding practices of infants not older than 2 years and their nutritional status in Northwest Nigeria. The theory of planned behavior was adopted in this research. With a total sample size of 3,861, multiple linear regression was adopted as a predictive analysis to delineate the correlation between two or more independent variables and one continuous dependent variable. Also, adopted was an independent t …

Cited And Underprepared; The Call For Improved Emergency Preparedness In Ltc Facilities, Dawn M. Ide

Walden Dissertations and Doctoral Studies

This research investigated the connection between the Medicare star rating system and E-tags on emergency preparedness of nursing homes for disasters in Hampton Roads, Virginia. Emergency preparedness in nursing homes has been a topic of growing interest within the past decade. Hampton Roads, Virginia, has a history of natural disasters including hurricanes and flooding, which necessitates a proper and efficient emergency preparedness plan in nursing home facilities. The primary purpose of this research was to review the secondary Centers for Medicare and Medicaid Services (CMS) data regarding the star rating system and E-tag surveys of each of the 37 nursing …

Racial Disparities, Fragmentation Of Care, And Adverse Outcomes Associated With Ectopic Pregnancy, Angela Rosa Jourdain

Walden Dissertations and Doctoral Studies

Ectopic pregnancy (EP) is a rare condition that occurs in 1% of all pregnancies. However, women of lower socioeconomic status (SES) and ethnic minority groups are at greater risk of adverse outcomes associated with EP than White women. The purpose of this study was to examine data from the 2014 National Inpatient Sample to identify predictors of complications from EP in 2,626 females ages 15-44 in the United States. The theoretical framework used to guide this study was the theory of fundamental causes to explain why the association between SES and mortality has persisted despite progressive advances in the diseases …

Staff Education: Hypertension Management For Adults In Primary Care Settings, Doris Adediwura Obaze

Walden Dissertations and Doctoral Studies

Management of hypertension and its complications requires health care providers to

understand the reason for developing the disease. Complications of hypertension (HTN)

are more prevalent when patient interventions are not consistently performed by staff. A

gap in staff knowledge regarding the management of patients with HTN was noted at an

outpatient clinic in the southwestern United States. A staff education project based on

the Eighth Joint National Committee (JNC-8) guidelines for HTN management was

developed to address the gap in knowledge. This DNP project sought to understand the

impact of an evidence-based staff education program in improving the knowledge of …

Utilizing Food Safety Knowledge In Comprehensive Patient Care Among Harlem Hospital Physicians, Sean Alexander Shivers

Walden Dissertations and Doctoral Studies

According to the World Health Organization (WHO), people throughout the world become sick every year from consuming contaminated foods, which impacts countries’ socioeconomic development, straining their healthcare system, travel and tourism, and foreign trade markets. To help alleviate the impact foodborne illness (FBI) has on society, scholars suggest physicians incorporate food safety in their standard work practice. The purpose of this study was to determine if Harlem Hospital physicians utilized food safety knowledge in comprehensive patient care with a diagnosis of FBI, in addition to how physicians passed this food safety information onto the patient. A qualitative methodology using an …

Mothers' Parenting Discipline Style And Their Early Puberty Daughters' Engagement In High-Risk Behaviors, Yvette C. White

Walden Dissertations and Doctoral Studies

Some early puberty girls engage in high-risk externalizing behaviors such as early sexual activity, delinquent behavior, and disruptive behaviors. Harsh parenting experienced by girls who develop early has been associated with delinquent and disruptive behaviors. The purpose of this quantitative correlational study was to examine predictive relationships between the style of parental discipline by mothers of early puberty girls and the likelihood and frequency of the girls' engagement in high-risk behaviors. Parenting style theory, including the authoritarian, authoritative, and permissive style of parenting, served as the theoretical foundation for the study. Survey data were collected from 28 mothers who identified …

Factors Associated With Maternal Mortality In Greater Accra Ghana 2016: Case-Control Study, Edmund Sekyi Eghan

Walden Dissertations and Doctoral Studies

Maternal mortality is a critical area of concern globally, despite the availability of accessible preventive measures. The role of sociodemographic and service delivery factors in maternal mortality in the Accra Metropolitan Area of Ghana are important to examine. As part of the United Nations (UN) Millennium Campaign, the UN implemented 8 Millennium Development Goals (MDGs); maternal mortality reduction by 75% between 1990 and 2015 was among the fundamental MDGs to be achieved by 2015. The purpose of this case-control study was to use secondary data to assess the relationships between sociodemographic variables, service delivery factors, and maternal mortality among 8,171 …

Factors That Influence Physical Activity Among African American Mothers At Recreation Centers, Nichole Leigh Glover

Walden Dissertations and Doctoral Studies

Physical activity is a critical factor in preventing obesity and other chronic illnesses. African American women experience higher rates of physical inactivity than the general population. As a key figure in the family, African American mothers should model healthy behaviors to the family, especially their children. This qualitative study explored the physical activity attitudes of African American mothers who frequently visit a recreation center in the Columbus, Ohio, area. The research questions focused on the possible barriers and motivators for physical activity engagement. The theory of planned behavior, which emphasizes behaviors, intentions, and attitudes when exploring health behaviors, guided the …

Influence Of Low Rate Of Reporting Of Adverse Events Following Immunization On Immunization Dropout, Samuel Errie Yenyi

Walden Dissertations and Doctoral Studies

Immunization protects millions of children. Yet, many children drop out of immunization in Jigawa State of north Nigeria. This cross-sectional quantitative correlational study based on the Health Belief Model was designed to determine whether the dropout from routine immunization (RI) was influenced by low rate of reporting of adverse events following immunization (AEFI) to health facilities by caregivers. Primary data was collected from 307 caregivers with dropout children using structured interviewer-administered questionnaire. The data were analyzed using logistic regression and descriptive statistics. The results showed that 61.3% of the children had AEFI and dropped out. Rate of reporting of AEFI …

"Exploring Telehealth Feasibility For Hiv Status In Individuals Aged 17 To 34 In Southwestern Nigeria", Michael Funso Olaniyi

Walden Dissertations and Doctoral Studies

Abstract

The use of smart phones among young people in Southwestern Nigeria has grown since the early 1990'€™s while traditional healthcare access had continued to deteriorate. HIV care centers have been concentrated in large cities, but earlier studies had shown higher prevalence of HIV in rural areas that constituted a larger portion of the population. However, existing studies had not adequately explored the use of mobile phones to supplement traditional healthcare access. The purpose of this study was to assess the feasibility of telehealth for healthcare access among individuals aged 17-34 with positive HIV status and those at high risk …

Hazardous Waste Site Proximity And Type 2 Diabetes: From Youths To Adults, Theresa Ann Johnson

Walden Dissertations and Doctoral Studies

Type 2 diabetes has reached epidemic proportions in adults and youths. Persistent organic pollutants and endocrine-disrupting chemicals (EDCs), such as pesticides, dioxins, and organochlorines, are omnipresent and persist in the environment with potential for human exposure via contaminated air, waterways, soil, and human food supply. EDCs have been correlated with diabetes incidence and risks. Residential proximity to hazardous waste sites (HWS) has been correlated with increased hospital admission rates for diabetes. The study used a sample population (N = 1,724), ages ≥ 12 years from the 2005-2012 Continuous NHANES and HWS data from the National Priorities List of Superfund Sites. …

Mother Feeding Style And Health Outcomes Of Children, Marie Youngblood

Walden Dissertations and Doctoral Studies

Childhood and adolescent obesity are pervasive among single mother households. Obesity causes many health risks including psychological/emotional illnesses. The purpose of this secondary analysis study was to examine the association between the parental feeding styles of single mothers and the degree that ethnicity moderates the rates of childhood obesity. Data from the National Longitudinal Survey of Youth were used with a total of 1,630 children in the study for a total of 842 minorities (African American and Hispanic American); 788 participates were not minorities (European American) with an average body mass indent of 15.9. Using the cross-sectional design, the quantitative …

Geospatial Analysis Of Care And Mortality In The 2014 Liberia Ebola Outbreak, Marion Carlton Kinkade

Walden Dissertations and Doctoral Studies

The Ebola outbreak in West Africa in 2014 to 2016 had more than 28,000 suspected, probable, and confirmed cases. It was the largest Ebola outbreak in history. Of the 28,000 cases in the three Ebola-affected countries, Liberia had 10,000 cases with almost 5,000 deaths. The Ebola Virus Disease (EVD) entered Liberia along the border of Guinea and moved to the capital city of Monrovia where the virus spread. Ebola Treatment Units (ETUs) were constructed throughout the response in locations where there were available facilities versus distance to care challenges. This study examined the association of distance from villages to ETUs …