Public Health Commons^™

Perceptions Of Cameroonian Women Regarding Cervical Cancer Prevention, Anna Nkapsah Nji

Walden Dissertations and Doctoral Studies

Women in Cameroon as well as those residing in the Maryland-Washington Metropolitan area and the Diasporas suffer a disproportionate rate of cervical cancer morbidity and mortality due to the vast disproportion in the distribution of healthcare services. The widespread human papillomavirus (HPV) vaccination holds promise for helping to attenuate the disproportion in cervical cancer screening and prevention services. Literature from other countries including Cameroon suggests that barriers to the uptake of cervical cancer screening include: culture, religion, the psychological impact of embarrassment, the influence of husbands, cost, discomfort, and vulnerability. The purpose of this study was to gain an understanding …

Socioeconomic Status-Related Inequities On Maternal Health Services: Trends, Associations, And Outcomes, Nibretie Gobezie Workneh

Walden Dissertations and Doctoral Studies

Maternal Mortality Rate (MMR) in Ethiopia remains one of the highest in the world due in part to very limited use of maternal health services. However, the underlying factors for limited use of the services and hence the high MMR are not well known. The purpose of this study was to identify factors associated with use of maternal health services and maternal health risks, to analyze inequity patterns between use of maternal health services and maternal health risks, and to measure the magnitude and trends in inequity. Behavioral-cultural and structural theories of health inequalities were used to frame the study. …

Hiv Risk Perceptions Of Hiv-Infected Adults Ages 30 To 49 Years In Atlanta, Georgia, Esther Nduta Mune-Ashford

Walden Dissertations and Doctoral Studies

More than 49,081 people were diagnosed with HIV in the United States in 2011. Of those 49,081 HIV-infected persons, 1 in 6 was not aware of being HIV positive. In 2011, Georgia had the 5th highest number of HIV diagnoses among the 50 U.S. states. This phenomenological study aimed to understand the lived experiences of HIV-infected adults, ages 30 to 49 years in Atlanta, Georgia, by understanding their perceptions of risk prior to contracting HIV. The health belief model was used to guide this study because it explains and predicts health-related behaviors and it has been used in previous studies …

Public Health Leaders' Perceptions Of And Attitudes Concerning Eating Disorders, Karin L. Lightfoot

Walden Dissertations and Doctoral Studies

Eating disorders are associated with high mortality rates. Most eating disorder prevention research is conducted within the fields of psychology and psychiatry, not in public health. This gap in public health research can lead to insufficient attention to the root causes of eating disorders and minimal upstream prevention efforts. The purpose of this phenomenological study was to identify public health leaders' perceptions of and attitudes concerning eating disorders as a public health issue. Objectification theory was used to describe how societal expectations have created an environment in which people's self-worth is based on their outward physical appearance. Ecological theory was …

Relationship Between Family Income And Obesity Among African American Adults, Charles Dadzie Boison

Walden Dissertations and Doctoral Studies

Obesity is a chronic disease that is caused by a number of factors such as diet, genetics, physical inactivity, and poor dietary habits. This research focused on how income affects obesity among a target population in the African American community in Durham, North Carolina (NC). It has been noted that chronic diseases that are diet-related, for example, obesity, diabetes, hypertension, and high cholesterol, affect African Americans disproportionately, especially those who earn low income. Some studies have also reported that those who make higher income have higher rates of obesity. This inconsistency and gap in the literature prompted research on this …

Comparison Of Thyroid Disease Mortality Between Urban And Rural Populations In Southwest Georgia, Donyale Bouie Childs

Walden Dissertations and Doctoral Studies

Twenty million people in the United States have some form of thyroid disease. In 2014, there were 62,980 new cases of thyroid cancer and 1,890 deaths. Water source is a known risk factor for thyroid disease. Pollutants that are known to alter thyroid function can find their way into water sources. The effect of various water sources on thyroid- related mortality has not been determined in the state of Georgia. The purpose of this correlational study was to investigate whether invasive thyroid disease mortality differs between urban participants who drank municipal water and rural participants who drank untreated water in …

The Connection Between Wellness Programs And Employee Job Satisfaction In Higher Education, Donel J. Richemond

Walden Dissertations and Doctoral Studies

Job dissatisfaction is becoming a fundamental concern for employers. Employee engagement makes an organization more productive and can reduce absenteeism. The purpose of this quantitative study was to examine the relationship between employer-sponsored wellness-program participation and job satisfaction among for-profit college and university leaders. Data collection involved an online survey of 400 faculty members' from for-profit universities in the United States contacted using the Job Satisfaction Survey; 103 participants completed the survey. The theoretical framework was the need-satisfaction theory, which includes the factors that promote job satisfaction and job dissatisfaction. The results came from a multiple regression analysis that indicated …

Social Demography Of Health Seeking Experiences Among Transgender African Americans, Alicia Cutrice Fritz

Walden Dissertations and Doctoral Studies

Access to and receipt of health care is an essential human right; however, transgender people often have negative health seeking experiences that give way to the many health disparities seen in the transgender community. Using the social ecological model, this study determined, through multiple logistic regressions, that correlations existed between socioeconomic, health behaviors, and sociocultural variables and 6 measures of health seeking experiences among transgender African Americans. Secondary data from the 2010 National Transgender Discrimination Survey were used, yielding a sample size of 253 transgender African Americans. Those in the African American transgender community at most risk for negative health …

Evaluation Of Low Immunization Coverage Among The Amish Population In Rural Ohio, Christine Marie Kettunen

Walden Dissertations and Doctoral Studies

Amish communities have persistently low childhood immunization rates. Prior to this study, reasons for low rates had not been clearly identified. Researchers have speculated that access to health care, religious factors, and fear might be reasons that Amish parents refuse childhood immunizations, but more empirical evidence was warranted.The purpose of this study was to gather that empirical evidence regarding the knowledge, attitudes, opinions, and beliefs of Amish parents residing in Ashtabula County Ohio, an additional purpose was to examine how these factors influence timely immunizations of Amish children. The theoretical framework was the PEN-3-Cultural Model, focusing on cultural influences, beliefs, …

Perspectives Of Young Adults Toward Tobacco Use, Caroline Oluwatosin Omoalako-Adesanya

Walden Dissertations and Doctoral Studies

Conditions related to tobacco use constitute the single most preventable cause of death in the United States. Approximately 443,000 U.S. adults die each year from smoking-related illnesses. During young adulthood, social and behavioral changes occur; experimentation with tobacco products such as cigarettes is common and may lead to a habit of smoking. A gap was identified in the literature on the perceived impact of family communication on young adults' decisions regarding smoking. The purpose of this descriptive phenomenological study was to address this gap by gathering information on the perspectives of young adults toward tobacco use. Fifteen young adults aged …

Best Practices For Controlling Tuberculosis - Training In Correctional Facilities: A Mixed Methods Evaluation, Ellen Reynolds Murray

Walden Dissertations and Doctoral Studies

According to the literature, identifying and treating tuberculosis (TB) in correctional facilities have been problematic for the inmates and also for the communities into which inmates are released. The importance of training those who can identify this disease early into incarceration is vital to halt the transmission. Although some training has been done by public health authorities for corrections, there is little to no evaluation of such training. The aim of this mixed methods retrospective study was to evaluate the effectiveness of a training to control TB in correctional facilities. The Southeastern National Tuberculosis Center (SNTC) conducted 12 trainings between …

Influence Of Patient Engagement Protocol On Health Outcomes And Medication Adherence Of Patients With Metabolic Syndrome, Angela H. Mcconnell

Walden Dissertations and Doctoral Studies

August 2016

Management of metabolic syndrome (MetS) may be enhanced by promoting patient engagement. Training health care providers in the conceptual and practical application of integrative patient centered care tools may promote patient lifestyle behaviors for better management of MetS. The purpose of this quantitative quasi-experimental study was to assess the impact of training providers in integrative patient centered care for patients with MetS. The biopsychosocial construct provided the conceptual framework for the study. Two groups of physicians were included; one received training in an integrative model (IM) while the second received no training and provided usual care (UC). Following …

An Ecological Perspective On Pertussis, Jody Ruth Goard

Walden Dissertations and Doctoral Studies

In 2012, 48,277 cases of pertussis were diagnosed in the United States. Pertussis, otherwise known as whooping cough, is a highly contagious, often debilitating, sometimes deadly, vaccine-preventable disease with an increasing incidence and death rate in the U.S, which may be due to vaccine exemptions. The purpose of this project was to determine if a relationship exists between immunization policies and immunization exemption rates, immunization exemption rates and pertussis rates, and immunization policies and pertussis rates in each state. Bronfenbrenner's bio-ecological framework was used to guide the project. Publically available data from the Centers for Disease Control and Prevention (CDC), …

Prolonged Exposure To Non-School Related Media Use And Violence Among Urban Youth, Cindy Davis

Walden Dissertations and Doctoral Studies

Youth violence is a pervasive and ongoing public health concern. Based on the paradigm of resilience, the purpose of this quantitative study was to test the relationship between prolonged (3 or more hours) of non-school related media use and youth violence. Secondary data from the Centers for Disease Control and Prevention (CDC) were utilized for this study. Logistic and multiple regression models were used to test whether exposure to prolonged non-school related media (video games and TV) use was associated with violent behavior, and whether there was a relationship between prolonged exposure to non-school related media use and electronic bullying …

The Effect Of Dietary Fruits & Vegetable Consumption And Physical Activity On Obesity In African American Adolescent Females., Tanisha Brooks

Walden Dissertations and Doctoral Studies

Obesity is epidemic among Black adolescent females, and adolescent obesity often leads to adult obesity. Previous research suggests that there may be an interaction between physical activity and dietary fruit and vegetable intake on body mass index (BMI) in obese adolescent females in general, but it was unclear whether the same pattern is evident in Black adolescent females, who, on average, tend to have low levels of physical activity and fruit and vegetable intake. Bandura's social learning theory implies the possibility that adolescent females might model their behaviors on the behavior of others in their high school years, including physical …

Maternal Characteristics And Childhood Immunization Series Completion Rates Among Children 2-Years-Old, Merlene Ramnon

Walden Dissertations and Doctoral Studies

Delays in childhood immunization may have adverse health implications. In the United States, childhood immunization among children who are below 3 years of age continues to be below Healthy People 2020 targets for some vaccines such as DTaP, PCV, HIB, Hep A, Rotavirus, and Hep B birth dose. The purpose of this study was to examine the association between maternal characteristics and childhood immunization series completion rates among children 2 years of age. The social learning theory and self-efficacy theory provided the theoretical foundation for the study. Data from the Florida Department of Health Immunization Surveys were used. ANOVA and …

Teen Dating Violence: Co-Occurrence With Bullying Among African American Teens In South Florida, Rosemarie Hemmings

Walden Dissertations and Doctoral Studies

Teen dating violence and bullying are major public health concerns but are preventable. Both dating violence and bullying occur within similar social context and the prevalence of teen dating violence was highest for African American teens as reported on the 2011 Youth Risk Behavior Survey (YRBS). Social learning theory provides a foundation for understanding and changing behavior related to dating violence victimization and bully victimization. The research questions focused on relationships between bully and teen dating violence victimization when controlling for race/ethnicity, gender, substance abuse, age, and age of first sexual intercourse. Additionally, the potential mediating variable of spending time …

The Impact Of The Sentinel Initiative And Faers Surveillance System On Consumer Safety, Sonia Batra

Walden Dissertations and Doctoral Studies

The U.S. Food and Drug Administration (FDA) uses the FDA Adverse Event Reporting System (FAERS) to monitor adverse events resulting from pharmaceutical drug use. However, this system has limitations such as not allowing real-time data collection. To address these limitations, the FDA launched the Sentinel Initiative in 2008. This comparative case study was conducted to describe perceptions of investigating the efficacy of the Sentinel Initiative compared with the FAERS. The study was based on the theory of preemption as it emphasized the need for efficient means for providing unquestionable proof that consumers suffered adverse drug effects. The sample included interivews …

Correlates Of Influenza Vaccination Uptake Among Older Adults, Cheryl Hilliman

Walden Dissertations and Doctoral Studies

Seasonal influenza is associated with signiï¬?cant morbidity and mortality among older adults, aged 65 and older. Since vaccination is the single most effective preventive measure against seasonal influenza, clinicians and senior citizen center administrators need a better understanding of the perceptions of older adults concerning the reason for poor influenza vaccine uptake. The purpose of this study was to identify perceived factors that may be associated with poor influenza vaccination uptake among older adults. The health belief model (HBM) guided the study. The research questions examined perceptions predicting the odds of influenza vaccination uptake among older adults. This quantitative cross-sectional …

Assessment Of Her2-Neu In Breast Cancer Lines Upon Differential Exposures To Xenoestrogens, Abha Aggarwal

Walden Dissertations and Doctoral Studies

Synthetic xenoestrogens have differential estrogenic properties. Research has shown that exposures to xenoestrogens could promote breast cancer by disrupting normal function of the human epidermal growth factor receptor 2 (Her2) gene. Although animal models demonstrated a connection between xenoestrogen exposure and Her2 activity, no study using human cells has systematically examined their carcinogenic potential influencing the Her2 gene expression. Furthermore, breast cancer cells are phenotypically disparate (ER+, Her2+), with some phenotypes (Her2+), leading to more aggressive disease. This study aimed to dosimetrically assess the carcinogenic potential of commonly used xenoestrogens influencing Her2 gene expression, and delineate cellular phenotypes at greater …

Human Trafficking: The Health Of Men Forced Into Labor Trafficking In The United States, Christina Omole

Walden Dissertations and Doctoral Studies

Human trafficking is a criminal act that occurs globally. It affects both women and men, but most studies have focused on female victims; few have explored trafficked men or their related health issues. Though there are many forms of trafficking, it is believed that most male victims are trafficked as forced labor. Using gender schema theory as a framework, this quantitative study examined archival data to identify the types of trafficking men are subjected to, their health ailments, and how these differ from the health ailments of trafficked women. Archival data from 124 individuals subjected to human trafficking in Florida …

An Exploration Of A State Mandated Health Education Program, Patricia Lyons

Walden Dissertations and Doctoral Studies

Shaken baby syndrome (SBS) is one of the most violent forms of physical child abuse. In 2007, the State of Ohio enacted a health education mandate known as Claire's law. Claire's law requires all birthing hospitals to provide SBS education to mothers prior to their discharge. This law is the result of public demand and advocacy initiatives; however, it was not clear how the mandate was developed or whether or not the mandate and subsequent educational programs have had an impact on efforts to prevent SBS. The purpose of this qualitative case study was to explore the state of Ohio's …

Nigerian Women's Empowerment Status And Its Influence On Access To Reproductive Health Services, Temi Aregbesola

Walden Dissertations and Doctoral Studies

Nigeria is a patriarchal society, which puts women in subordinate positions that may prompt gender-based discrimination. While evidence of this phenomenon has been investigated in Nigeria and other African countries, no such investigation has been conducted with immigrant and first-generation Nigerian women in the United States. The purpose of this study was to examine the role of a Nigerian woman's perceived empowerment and status on her willingness to access reproductive health services. The research questions examined views of Nigerian traditional beliefs' influence on status and how attitudes around traditional beliefs relate to access to reproductive health services and/or knowledge. Data …

The Effect Of Personal Beliefs And Perceptions On Influenza Vaccination Uptake Among Older Adults, Rani Sujatha Athota

Walden Dissertations and Doctoral Studies

Despite a 90% fatality rate and high risk of complications from influenza infection, vaccination coverage remains lower among African American (AA) and Hispanic American (HA) older adults. Health care professionals, families, and older adults are concerned with improving vaccination uptake. The purpose of this study was to examine differences among older adult AA and HA compared to European Americans (EA) on how their personal beliefs and perceptions affect vaccination uptake. The health belief model guided this study. The study research design was a quantitative cross-sectional analysis of the 2009 National H1N1 Flu Survey. Weighed prevalence of vaccine uptake indicated all …

Donor Coordination And Health Aid Effectiveness In The Nigerian Health Sector, Ifeoma Edna Uduji

Walden Dissertations and Doctoral Studies

Development partners and donors increasingly acknowledge the importance of coordinating their activities to achieve the outcome of the official development assistance to developing countries. Although stakeholders have recognized the importance of harmonizing donors and development partners' efforts in the Nigerian health sector, little research has addressed the influence of coordination on the health aid effectiveness. This qualitative case study determined the influence of coordination among the donors and development partners involved in the HIV/AIDS, malaria, and nutrition program on the outcome of these programs in Nigeria. Data were collected through interviews with 22 program officers participating in the health programs …

The Socioeconomic And Cultural Impact Of Sickle Cell Disease In Nigeria, Jejelola Owotomo

Walden Dissertations and Doctoral Studies

Sickle cell disease (SCD) is a genetic health condition that has continued to increase globally. SCD is prevalent in developing countries like Nigeria with 20 to 30% of the population living with SCD. The aim of this study was to explore the effect of the socioeconomic and cultural factors that affect the quality of life (QOL) of individuals with SCD in Nigeria. The framework for the study is secondary prevention. Secondary prevention allows for opportunities to improve QOL amongst people living with SCD focusing on the health beliefs, and socioeconomic wellbeing. A phenomenological approach was used to collect in-depth data …

The Underuse Of Hospice Care In The African American Military Beneficiary Population, Wanda Castleberry Richards

Walden Dissertations and Doctoral Studies

Hospice services provide a holistic approach to end-of-life care to terminally ill patients though there is some evidence to suggest that African American military beneficiary populations may not access hospice care as often as expected. The purpose of this nonexperimental study was to evaluate reasons for the low use of hospice care among the terminally diagnosed members of this population, between the ages of 18 and 64. Kolcaba's comfort theory provided the theoretical framework for this study. The research explored whether a statistically significant difference exist among African Americans military beneficiaries population as compared to non-Hispanic Whites pertaining to their …

Sexual Health Education Policy: Influences On Implementation Of Sexual Health Education Programs, Renata Denise Ellington

Walden Dissertations and Doctoral Studies

High school youth in Grades 9-12 who are in public schools without comprehensive sexual health education (CSHED) are more likely to engage in high-risk sexual behaviors and have higher rates of HIV and sexually transmitted diseases than are their peers in schools with CSHED. The purpose of this correlational study was to explore the statistical relationship between the consistent implementation of CSHED, before and after the enactment of the Chicago Public Schools' (CPS) sexual health education policy, and the sexual risk behaviors of Chicago high school youth in Grades 9-12. The study was based on Antonovsky's salutogenic model of health …

Methicillin-Resistant Staphylococcus Aureus Infections In The Eight Service Planning Areas Of Los Angeles County, Ildiko Roxane Bocskay

Walden Dissertations and Doctoral Studies

Methicillin-resistant staphylococcus aureus (MRSA) has become resistant to antibiotics. The purpose of this quantitative, retrospective cohort study was to examine the relationship between length of hospitalization and invasive MRSA infection rates among different racial and ethnic groups in the 8 service planning areas (SPAs) of Los Angeles County. Cane, O'Connor, and Michie's theoretical domain framework was used. Secondary data from the Healthcare-Associated (HA) Infections Program of the California Department of Public Health were analyzed. For the first research question, a Pearson correlation analysis was conducted to assess the relationships between length of hospitalization and invasive HA-MRSA infection rates and counts. …

Risk Of Maternal Smoking On Breastfed Infants And The Development Of Otitis Media, Judith C. Ogbonna

Walden Dissertations and Doctoral Studies

Despite advances in health promotion through efforts to reduce tobacco smoking, tobacco-related health conditions have continued to be significant. Exposure to secondhand smoke has been identified as a health risk also in addition to infant health risks related to maternal smoking. In contrast, breastfeeding has been found to promote infant health and is strongly encouraged. Despite literature supporting both of these statements, the combined effects of both breastfeeding and maternal smoking on infant wellbeing have not been delineated. Otitis media represents a common health problem among infants and young children. Tobacco exposure has been shown to increase its incidence while …