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Walden Dissertations and Doctoral Studies

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Prescribing Hiv Prep And The Need For Education Among Care Providers, Martin Kokou Logo Jan 2016

Prescribing Hiv Prep And The Need For Education Among Care Providers, Martin Kokou Logo

Walden Dissertations and Doctoral Studies

Preexposure prophylaxis (PrEP) is an innovative biomedical approach that has been used over the past 6 years to avert the spread of human immunodeficiency virus (HIV). Under-prescribing of PrEP could increase the probability of HIV exposure among serodiscordant couples/partners and those who do not practice safe sex. Previous PrEP research has not assessed the association between awareness of PrEP, years of experience of providers, provider types, and the frequency of PrEP prescription among physicians. Precaution adoption model framed this study, which aimed to evaluate the bond between the independent variables relating to awareness of PrEP, years of experience, and provider …

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Veterans' Perceptions Of Military Stigma And The Shame Associated With Combat-Related Posttraumatic Stress, Alexander J. Buelna Jan 2016

Veterans' Perceptions Of Military Stigma And The Shame Associated With Combat-Related Posttraumatic Stress, Alexander J. Buelna

Walden Dissertations and Doctoral Studies

Military stigma is a heavy burden of social stigma internalized by veterans who are diagnosed with posttraumatic stress disorder (PTSD) during post-deployment psychological screening. PTSD is classified as a mental disorder associated with widespread reluctance to seek medical assistance. Among military veterans who suffer from combat-related posttraumatic stress (PTS), military stigma is considered a widespread problem. The purpose of this phenomenological study was to explore veterans' perceptions of various aspects of military stigma, including post-deployment psychological screening, the diagnosis of PTSD, and factors associated with reluctance to seek medical assistance for PTS. In-depth interviews were conducted with a convenience sample …

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Differences In Treatment-Seeking And Treatment-Adherence Factors For Tuberculosis In Armenian Versus Non-Armenian Populations Of Los Angeles County, Tanya Marie Ferguson Jan 2016

Differences In Treatment-Seeking And Treatment-Adherence Factors For Tuberculosis In Armenian Versus Non-Armenian Populations Of Los Angeles County, Tanya Marie Ferguson

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) is a deadly, yet curable, infectious disease that continues to be a global health threat. Armenia suffers from rising TB incidence and mortality rates. Armenians living in Los Angeles (LA) County, where TB incidence is higher than national averages, is the second largest Armenian community in the world; therefore implications are that many TB cases are attributed to this group. Using the social ecological model as a theoretical framework, this concurrent, mixed-methods study compared Armenians to non-Armenians in LA County about their knowledge of TB and perceived barriers to seeking and adhering to treatment. Bivariate chi-square analysis from …

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African American Single Mothers' Perceptions Of Physical Activity, Sheryl Lynn Richard Jan 2016

African American Single Mothers' Perceptions Of Physical Activity, Sheryl Lynn Richard

Walden Dissertations and Doctoral Studies

Insufficient physical activity detracts from healthy living and has a disparate impact on African American women and their female children. The extensive body of prior research addressing preventable chronic disease and other consequences of insufficient physical activity includes limited information specific to African American single mothers. The purpose of this descriptive phenomenological study was to gain an understanding of African American single mothers' perceptions of physical activity. Specifically investigated were African American women's familial influences and potential effects of these influences on their children's health behaviors. The health belief model served as the theoretical framework for this study and provided …

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Oral Health Status And Oral Hygiene Knowledge, Attitudes, And Practices Of Jail Inmates, April Lee Wendling Jan 2016

Oral Health Status And Oral Hygiene Knowledge, Attitudes, And Practices Of Jail Inmates, April Lee Wendling

Walden Dissertations and Doctoral Studies

The oral health and hygiene of incarcerated populations, both in the United States and globally, is known to be poorer than that of the general population. This study examined the prevalence of dental caries and periodontal disease and the relationships between oral health status and the oral health knowledge, attitudes, and practices of jail inmates housed in a large metropolitan jail located in the midwestern United States. This cross-sectional study collected data from 100 inmates using a 21-item closed-ended questionnaire in addition to oral examinations conducted by the jail's dentist to determine the extent of dental caries and periodontal disease …

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Improving Self-Management In Patients With Chronic Conditions, Jeryl Yvette Horton Jan 2016

Improving Self-Management In Patients With Chronic Conditions, Jeryl Yvette Horton

Walden Dissertations and Doctoral Studies

Care Coordination Home Telehealth (CCHT) maintains a positive impact on the delivery of patient care in the primary care clinic at the Department of Veterans Administration Medical Center (VAMC). This quality improvement initiative targets patients with chronic conditions such as diabetes, hypertension, heart failure, and chronic obstructive pulmonary disease. These patient are frequently seen in the emergency room, and are often admitted to the hospital, where they saturate the outpatient clinics' waiting room with multiple walk-ins. CCHT has, to some extent, reduced walk-ins, emergency room visits, and hospitalization while minimizing the strain on access to care at the VAMC. Sustaining …

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Parents Perception Of Safety In Pennsylvania And Children's Activity And Weight, Linda C. Carr Jan 2016

Parents Perception Of Safety In Pennsylvania And Children's Activity And Weight, Linda C. Carr

Walden Dissertations and Doctoral Studies

Physical activity is associated with many health benefits to include weight management, lower risk for chronic diseases, and improved mental health and self esteem. The built environment has been linked to lower physical activity levels and overweight and obesity in children living in low income communities but the exact causes need further investigation. The purpose of this quantitative, cross sectional study was to examine the association between parents' perception of safety and body mass index (BMI) percentile and children's physical activity/ inactivity levels and children's BMI as measured by the National Survey of Children's Health (2011/12 NSCH). The sample consisted …

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Poverty, Food Insecurity, And Obesity Among Urban And Rural Populations, Tameka Ivory Walls Jan 2016

Poverty, Food Insecurity, And Obesity Among Urban And Rural Populations, Tameka Ivory Walls

Walden Dissertations and Doctoral Studies

Over 17 million food-insecure households are associated with increasing obesity rates across the United States. Although food insecurity and obesity are distinct social concerns, the two are linked and may be influenced by poverty and geographic location. Public health authorities and state leaders responsible for the health and nutrition of rural populations in particular would benefit from this information. The purpose of this quantitative cross-sectional study was to examine whether poverty mediated the relationship between food insecurity and obesity among urban and rural adults. The study was guided by the poverty, food insecurity, and obesity conceptual framework. The study addressed …

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Socioeconomic Status As A Predictor Of Chronic Obstructive Pulmonary Disease, Hilaire Saint-Pierre Jan 2016

Socioeconomic Status As A Predictor Of Chronic Obstructive Pulmonary Disease, Hilaire Saint-Pierre

Walden Dissertations and Doctoral Studies

While epidemiological research has generated new knowledge about the treatment and prevention of chronic obstructive pulmonary disease (COPD) through smoking secession, the socioeconomic status (SES) of people with the disease has been under investigated. Thus, the purpose of this study was to determine the predictability of association between SES and COPD. This study was based on the ecological theory, which states that health and disease may have multiple underlying factors. This study was a secondary analysis of archived data from the Inter-University Consortium for Political and Social Research (ICPSR). The dataset was collected for the National Survey of Midlife Development …

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The Association Of Smoking With Low Back Pain In Adult Americans: Analysis Of The 2012 National Health Interview Survey, Bart Green Jan 2016

The Association Of Smoking With Low Back Pain In Adult Americans: Analysis Of The 2012 National Health Interview Survey, Bart Green

Walden Dissertations and Doctoral Studies

Back pain is a chronic disease epidemic and the most common chronic painful condition in Americans. It is associated with human suffering and enormous financial and social burdens. Smoking is a prevalent and harmful health behavior and is the greatest modifiable risk factor for many chronic diseases. Cigarette smoking is associated with back pain, but there is little research on this relationship among adults in the United States. Using biopsychosocial theory, this study examined (a) the prevalence of back pain (dependent variable) among smokers, former smokers, and never smokers (independent variable), and (b) the influence of age, sex, race, body …

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Methylmercury Exposure Via Canned Tuna Fish Consumption And Breast Cancer, Jennifer Bodenrader Jan 2016

Methylmercury Exposure Via Canned Tuna Fish Consumption And Breast Cancer, Jennifer Bodenrader

Walden Dissertations and Doctoral Studies

Widespread consumption of canned tuna fish since the 1950s may explain some of the increase in breast cancer prevalence in the United States and Europe. Although canned tuna is the primary source of human exposure to methylmercury, its role as an estrogen activating metalloestrogen has been overlooked in the etiology and incidence of breast cancer. Carcinogenic theory asserts that increased exposure to estrogen elevates the risk of breast cancer. The purpose of this population-based, case control study was to examine the association between canned tuna consumption, total blood mercury, and breast cancer in the NHANES 2003-2006 surveys. A multivariable logistic …

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Insecticide Treated Nets As An Effective Malaria Control Strategy In Liberia, Taiyee Nelson Quenneh Jan 2016

Insecticide Treated Nets As An Effective Malaria Control Strategy In Liberia, Taiyee Nelson Quenneh

Walden Dissertations and Doctoral Studies

Malaria is a vector-borne disease that presents the most persistent and serious public health burden in Liberia. Numerous studies have examined the relationship between ITN use and malaria prevalence. However, little research has explored the effectiveness of ITNs in controlling malaria among children in postwar Liberia. The aim of this study was to examine the association between ITN ownership, parental economic status, ITN installation support, and malaria prevalence among children. This was a quantitative cross-sectional study guided by the health belief model. The study used secondary data from the 2011 Liberia Malaria Indicator Survey. Chi-square for association and Logistic regression …

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The Ability To Purchase Organic Food Items Among Participants Of The Women, Infants, And Children Program In Los Angeles County, Brenna Colleen Doran Jan 2016

The Ability To Purchase Organic Food Items Among Participants Of The Women, Infants, And Children Program In Los Angeles County, Brenna Colleen Doran

Walden Dissertations and Doctoral Studies

Lack of accessibility to healthy foods is a factor associated with the increase in obesity, diabetes, and other negative health consequences. While programs such as WIC (Women, Infants, and Children) provide supplemental nutritional access to healthy foods, few organic food items are included in the WIC authorized food list. Government programs and policy makers that provide to the most vulnerable populations are concerned about equal availability of healthy foods. The purpose of this study was to compare variability and cost of organic food items in 24 large chain grocery stores located in high- and low-income areas. The theoretical concepts of …

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Diagnosing Fibromyalgia: Using A Diagnostic Screening Tool In Primary Care, Lilo Fink Jan 2016

Diagnosing Fibromyalgia: Using A Diagnostic Screening Tool In Primary Care, Lilo Fink

Walden Dissertations and Doctoral Studies

Fibromyalgia (FMS) goes undiagnosed in as many as 3 out of 4 people who have the disease. Primary care providers (PCPs) are the first to evaluate patients; therefore, PCPs need to be able to recognize FMS, implement initial treatment, and refer for further consultation. The Fibromyalgia Diagnostic Screening Tool (FDST), a validated instrument to identify FMS, can improve the speed and accuracy of FMS diagnosis. The purpose of this project was to familiarize PCPS with the FDST, evaluate their receptiveness to the tool, and train them in its use. The Leventhal, Diefenbach, and Levanthal, common sense model of illness provided …

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Evaluation Of Active And Passive Neonatal Tetanus Surveillance Systems In Katsina State, Nigeria, Shafique Sani Nass Jan 2016

Evaluation Of Active And Passive Neonatal Tetanus Surveillance Systems In Katsina State, Nigeria, Shafique Sani Nass

Walden Dissertations and Doctoral Studies

The incidence and mortality rates of neonatal tetanus (NNT) remain underreported in Nigeria. This cross-sectional study was guided by the Mosley and Chen's model for the elements of child survival in developing countries. The goals of the study were twofold: (a) to compare the NNT prevalence and the mortality rates from the existing surveillance system and active surveillance of health facility records in 7 selected health facilities from 2010 to 2014 in Katsina state, Nigeria and (b) to assess the associations between selected NNT risk factors, number of maternal tetanus toxoid injections, frequency of antenatal visits, place of delivery, and …

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Socioeconomic Responsibility And Its Effect On Hypertension Among West African Immigrants In The United States, Chryss Arekhandia Okonofua Jan 2016

Socioeconomic Responsibility And Its Effect On Hypertension Among West African Immigrants In The United States, Chryss Arekhandia Okonofua

Walden Dissertations and Doctoral Studies

Native-born African Americans (NBAA) bear a disproportionate burden of the effect of hypertension (HTN) in comparison to other racial groups in the United States. West African immigrants (Foreign-born African Americans) appear to carry a heavier burden than the NBAA in the United States. Using the social support theory as a guide, this study examined the association between the need to meet socioeconomic responsibility of financial and familial obligations (SERFFO) and perceived stress and the increased likelihood of HTN among West African immigrants, aged 25-54 years, in the United States. In this quantitative, cross-sectional design, self-reported data were collected from a …

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Experiences Of Black Msm At An Hbcu Regarding Stigma And Hiv Risk Behavior, Natasha Harden Jeter Jan 2016

Experiences Of Black Msm At An Hbcu Regarding Stigma And Hiv Risk Behavior, Natasha Harden Jeter

Walden Dissertations and Doctoral Studies

Black men who have sex with men (MSM) on Historically Black College/University (HBCU) campuses face a unique set of challenges. In addition to being disproportionately affected by HIV, Black MSM are impacted by risk behavior, stigma, and environmental policies and practices that adversely influence their experiences. The purpose of this study was to explore the experiences of Black MSM at a HBCU and how stigma, culture, social practices and the collegiate environment impact HIV risk-taking behavior. Utilizing the ecological framework and qualitative analysis, the behaviors of 13 Black MSM on a HBCU campus were examined. Personal interviews and risk assessment …

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Impact Of Simulation Training On Novice Nurses, Sheila Marjean Moore Jan 2016

Impact Of Simulation Training On Novice Nurses, Sheila Marjean Moore

Walden Dissertations and Doctoral Studies

In 1999, the Institute of Medicine released its report on building a safer health system. Since then, safety in patient care has become a paramount interest. Given the growing support for increasing patient safety, simulation training has become a common part of novice nurses' orientation program. This simulation training is designed to mimic situations in the acute care setting where novice nurses can practice in a patient safe environment. In this DNP project, a stroke simulation scenario and supporting patient chart was developed as an addition to a novice nurses' orientation program. The National League for Nursing simulation template was …

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Emergency Room Utilization Of Participants With Mental Health Conditions Enrolled In Health Home Services, Amanda Duff Jan 2016

Emergency Room Utilization Of Participants With Mental Health Conditions Enrolled In Health Home Services, Amanda Duff

Walden Dissertations and Doctoral Studies

Large numbers of individuals utilize the ER each year for mental health reasons. The health home agency in this study was designed under the Affordable Care Act with the intention of increasing patient self-management thus decreasing high-cost service utilization. The effectiveness of health homes in reducing mental health-related ER visits has remained unexplored. In this study, the relationship between participation in this program and ER utilization was examined, using the theoretical framework of the Health Belief Model. The sample of 128 health home participants with documented mental health conditions was selected using systematic random sampling. A one-way, repeated-measures t-test and …

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Transcriptome Analysis Of Vaccine Responses To Francisella Tularensis Or Venezuelan Equine Encephalitis Virus, Rebecca Ann Erwin-Cohen Jan 2016

Transcriptome Analysis Of Vaccine Responses To Francisella Tularensis Or Venezuelan Equine Encephalitis Virus, Rebecca Ann Erwin-Cohen

Walden Dissertations and Doctoral Studies

The lack of vaccines for emerging and re-emerging diseases highlights technical gaps and indicates a need for innovative approaches to produce new vaccines. Vaccines may be improved by knowledge of host responses to vaccination, disease pathogenesis, and the effect of age and genetics on vaccine outcome. This study's purpose was to quantitatively assess the molecular epidemiology of Francisella tularensis (Ft) and Venezuelan Equine Encephalitis Virus (VEEV). Study results support the Epidemiology Nexus model which holds that association of changes in gene expression to vaccination facilitate understanding the mechanisms of immune development and link public health and disease epidemiology. My research …

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Parental Perceptions Of Childhood Overweight And Obesity In Four-Year-Olds In Northeastern North Carolina, Crystal Keyes Terry Jan 2016

Parental Perceptions Of Childhood Overweight And Obesity In Four-Year-Olds In Northeastern North Carolina, Crystal Keyes Terry

Walden Dissertations and Doctoral Studies

Childhood obesity has increased due to factors such as more television time, less outside play, parents' lack of education about nutritious meals, and eating more fast food versus home cooked meals. Research has been performed on many school-aged children; however, there is a gap in research as it pertains to preschool children. Preschool age learning is when children are most receptive to habit-forming activities. The purpose of this transcendental phenomenological study was to assess the parental perceptions of 11 preschool parents in rural Northeastern North Carolina of 4-year-old children who have been told by a health care professional that their …

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Determinants Of Obesity Among Deaf And Hard Of Hearing Adults, Lindsay Buchko Jan 2016

Determinants Of Obesity Among Deaf And Hard Of Hearing Adults, Lindsay Buchko

Walden Dissertations and Doctoral Studies

Trends of obesity increased over the last 3 decades with the obesity rate doubling from 1980 to 2010. People with disability are more likely to experience health disparities including obesity compared to the general population. Yet research on the determinants of obesity such as self-efficacy, hearing levels, and deaf acculturation styles among those who are deaf or hard of hearing (HoH) is limited. This cross-sectional study, using the social cognitive theory framework, examined BMI and self-efficacy differences between deaf/HoH adults and hearing adults, aged 20 years and older. This study also examined the associations between BMI or self-efficacy and factors …

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Time To Diagnosis Of Second Primary Cancers Among Patients With Breast Cancer, Edward Okezie Irobi Jan 2016

Time To Diagnosis Of Second Primary Cancers Among Patients With Breast Cancer, Edward Okezie Irobi

Walden Dissertations and Doctoral Studies

Many breast cancer diagnoses and second cancers are associated with BRCA gene mutations. Early detection of cancer is necessary to improve health outcomes, particularly with second cancers. Little is known about the influence of risk factors on time to diagnosis of second primary cancers after diagnosis with BRCA-related breast cancer. The purpose of this cohort study was to examine the risk of diagnosis of second primary cancers among women diagnosed with breast cancer after adjusting for BRCA status, age, and ethnicity. The study was guided by the empirical evidence supporting the mechanism of action in the mutation of BRCA leading …

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Perceived Barriers To Oral Health Care Access For Massachusetts' Underserved Parents, Doudelyne Cenafils-Brutus Jan 2016

Perceived Barriers To Oral Health Care Access For Massachusetts' Underserved Parents, Doudelyne Cenafils-Brutus

Walden Dissertations and Doctoral Studies

Poor oral care is detrimental to the overall health of the population. In the United States, oral health diseases affect millions of individuals, especially children and adolescents. Guided by the health belief model, the purpose of this study was to identify parents' perceived barriers to oral health care access among their 5- to 10-year-old children. A phenomenological approach was used to gather data and thematically analyze interview data from 20 parents who were recruited from a health center in the northeastern United States. All participants had at least one child between 5-10 years old and all identified as under-served. Data …

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Knowledge, Attitudes, And Beliefs About Preconception Care Among American Adolescent Females, Lynette Collins Collins Jan 2016

Knowledge, Attitudes, And Beliefs About Preconception Care Among American Adolescent Females, Lynette Collins Collins

Walden Dissertations and Doctoral Studies

Despite an initiative to provide preconception care (PCC) and reproductive life planning (RLP) for all women of childbearing age, many women, especially those with low incomes, are not receiving it. As a result, there continues to be a high rate of infant morbidity and mortality in this population. Furthermore, low income adolescent females have not been adequately studied regarding this phenomenon. The purpose of this phenomenological study was to explore low income adolescent females' knowledge, attitudes, and beliefs about PCC and RLP in order to serve them more effectively. Five low income adolescent females, aged 18 to 21, were recruited …

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Delaying First Pregnancies: Canadian Women's Knowledge And Perception Of The Consequences, Deborah Haynes Jan 2016

Delaying First Pregnancies: Canadian Women's Knowledge And Perception Of The Consequences, Deborah Haynes

Walden Dissertations and Doctoral Studies

Many women aged 20-30 are postponing their first pregnancies until their mid 30s and beyond, which has resulted in compressed childbearing years and/or infertility. Little is known about the knowledge and understanding that Canadian women of advanced age (age 35-45) possess of their reproductive capacity. This phenomenological study sought to explore these women's knowledge and perception of their reproductive capacity in relation to the timing of first pregnancy. Research questions using the constructs of Ajzen's theory of planned behavior were developed to explore how the behavioral, normative, and control beliefs of women's childbearing behaviors were based on their perceptions of …

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Disparities In Arkansas Mandated Immunization Coverage Among Natural Home And Foster-Care Adolescents, Jerome Essono Ngundue Jan 2016

Disparities In Arkansas Mandated Immunization Coverage Among Natural Home And Foster-Care Adolescents, Jerome Essono Ngundue

Walden Dissertations and Doctoral Studies

Anecdotal evidence indicated vaccine coverage disparities among foster-care (FCA) and natural-home adolescents (NHA). Arkansas laws require 5 vaccines for school entry (FVSE) to prevent 9 common childhood diseases. The study problem was that Pulaski County, Arkansas adolescent birth cohort (PCABC) immunization rates were low compared to U.S. adolescents for these FVSE. This study examined the extent to which (1) PCABC immunization rates were significantly different from those estimated for U.S. adolescents in 2006–2008, (2) NHA and FCA immunization rates were different in 2003– 2008; (3) sociodemographic variables mediate associations between home of residence (HOR), NHA or FCA, and up to …

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Interrelationships Of Colorism, Violence, And Sexual Behaviors Among Southern African American Women., Phaedra Christensen Jan 2016

Interrelationships Of Colorism, Violence, And Sexual Behaviors Among Southern African American Women., Phaedra Christensen

Walden Dissertations and Doctoral Studies

Two significant public health concerns that threaten both the physical and mental health of African-American women are Intimate Partner Violence (IPV) and Human Immunodeficiency Virus (HIV). African-American women (AAW) in the south carry the greatest burden of HIV and disproportionately represent the region with an incidence of 71% for new HIV infections, and elevated rates of morbidity and mortality. In 2013, the murder rate among AAW was 2.5 times higher than it was among Caucasian women. Most of the published studies that explored the association between IPV and HIV had mixed populations, did not explore topics unique to AAs, or …

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The Effect Of Federal Reporting Regulations On Hospital Investment In Community Building, Dorothy Magasis Escobar Jan 2016

The Effect Of Federal Reporting Regulations On Hospital Investment In Community Building, Dorothy Magasis Escobar

Walden Dissertations and Doctoral Studies

The role of hospitals as partners in community health improvement is changing, especially for nonprofit hospitals receiving tax exemptions in exchange for providing benefits to the community. There are examples of reported health improvement activities funded through hospitals' charitable donations, but there's a gap in the literature on the effect of policy and legislation on hospitals' investments in community building activities that address the social determinants of health. Grounded in eco-social theory, this quantitative, correlational study compared secondary data from CA's nonprofit hospitals' annual 2009 and 2012 reports to determine what, if any, changes have occurred in the hospitals' investments …

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Risk Factors For Hypertension Among African-Born Immigrants In The United States, John Ojih Jan 2016

Risk Factors For Hypertension Among African-Born Immigrants In The United States, John Ojih

Walden Dissertations and Doctoral Studies

Essential hypertension (HTN) has been and continues to be a serious public health problem across the globe, particularly among Black races, with an estimated morbidity rate of over 1 billion people and an estimated mortality rate of 9.4 million people worldwide. Essential HTN can lead to a host of chronic diseases including cardiovascular disease (CVD), stroke, myocardial infarction, brain damage, kidney failure, and retinopathy. The main purpose of this quantitative, descriptive, nonexperimental study was to investigate the association of physical inactivity, length of stay in the United States, immigrants' health status, and food security as risk indicators in the development …

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