Public Health Commons^™

Prediabetes, Implementation Of Ada Practice Guidelines And Provider Perspective, Kimberlee May Manguiat-Lang

Walden Dissertations and Doctoral Studies

AbstractPrediabetes occurs before the development of diabetes in some people. Practitioners who educate people about prediabetes are not consistently using the latest evidence-based practice guidelines. The purpose of this mixed-method study was to fill a gap in the literature by providing evidence of the provider practices, attitudes and barriers when implementing American Diabetes Association (ADA) practice guidelines for the prediabetic patient. The Theory of Planned Behavior applies to evidence-based practice and the implementation of evidence-based practice guidelines. Research questions for this study focused on determining rate of compliance with ADA clinical practice guidelines from health care professionals to include providers …

Emergency Department Operational Strategies, Joyce W. Davis

Walden Dissertations and Doctoral Studies

AbstractEmergency Department Operational Strategies by Joyce W. Davis MBA/MHA, Pfeiffer University, 2011 BS, North Carolina A&T State University, 1980

Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Business Administration

Walden University December 2022

Effects Of Indoor Air Pollutants On Childhood Asthma: African American Parents’ Perspective, Marcia Maureen Haughton Lewis

Walden Dissertations and Doctoral Studies

AbstractIndoor air pollution has been implicated in many chronic health conditions, including childhood asthma, which is more prevalent among African American children. Children are more susceptible than adults to the effects of exposure to indoor air pollution; however, many parents may not be aware of the polluting impacts of products in their homes and are inadvertently placing their families at risk for adverse health outcomes. Understanding parents’ perceptions and experiences is essential for planning and developing educational programs and interventions for improving indoor environment management as part of asthma management in children. This descriptive phenomenological study aimed to explore parents’ …

Factors Associated With Accidental Drug Exposure In U.S. Adults Over 65 Years Of Age, Edwin Raj

Walden Dissertations and Doctoral Studies

Medication errors are a major public health issue and a leading cause of fatalities in the United States and globally. Older adults who rely on medications to address age-related health issues are at higher risk of medication errors. Accidental exposure to drugs is a major type of medication error that impacts older people more than other age groups. The purpose of this quantitative correlational study was to examine the association between patient gender, age group, and reporter type and accidental exposure to drugs in older people. The ecological model was used to guide the study. Logistic regression analysis was used …

Looking Upstream For Factors Influencing Mental Illness In A Low-Resource Setting, Adewole Adebola Adefalu

Walden Dissertations and Doctoral Studies

An investigation into the upstream determinants of mental disorders could provide insight into pathways by which these risk factors could relate to different groups of mental illness. The study was a quantitative inquiry using constructs within the Rothman’s sufficient and component cause framework to examine the pathways existing between upstream risk factors for schizophrenic and mood disorders. The study population was drawn from a convenience sample of clients accessing services at the psychiatry departments of a secondary mental health institution in North-Central Nigeria. The mean age of the participants in this study was 35.5years. The majority were males (53.4%), single …

Risk Factors Associated With Community-Onset Sepsis In Latino/Hispanic Adults, Joan Ivaska

Walden Dissertations and Doctoral Studies

Sepsis results in a significant public health burden globally, causing 20% of adult mortality worldwide and accounting for more than one third of deaths in hospitalized adults in the United States, making it one of the top 15 leading causes of death in the United States. Community-onset sepsis (COS) comprises nearly 80% of all sepsis cases occurring in the United States each year. Despite the widespread prevalence of COS, significant gaps in knowledge exist regarding the risk factors that lead to COS and sepsis mortality in Latino/Hispanic adults in the United States. The purpose of this secondary data study was …

Typhoid Fever Among Low-Income Women Living In Gujranwala, Pakistan., Tehmina S. Khan

Walden Dissertations and Doctoral Studies

Approximately 21 million individuals suffer from typhoid fever (TF) globally, and most outbreaks occur in Southeast Asia. The incidence of TF is high in Pakistan, particularly in low socioeconomic areas, and a new drug-resistant strain makes it difficult to control the spread of TF. There is a pressing need for up-to-date and accurate data regarding the attitudes, beliefs, and habits leading to the spread of TF infection among individuals living in low socioeconomic areas of Pakistan. This qualitative, phenomenological study was grounded in the health belief model and explored factors that influence the spread of TF among women of childbearing …

Association Between Parental Socioeconomic Status And Childhood Obesity In The Southwest Geopolitical Zone Of Nigeria, Omatsola Aboyowa Sifo

Walden Dissertations and Doctoral Studies

AbstractGlobally, childhood obesity is a major social and public health concern characterized by complications such as high cholesterol and high blood pressure. The purpose of this quantitative cross-sectional study was to examine the association between childhood obesity in children age 6–12 years and the socioeconomic status of their parents in the Southwest geopolitical zone of Nigeria. Social cognitive theory served as the theoretical framework for the study. Questionnaire data were collected from 384 parents/guardians of children age 6–12 years across three states in the Southwest geopolitical zone of Nigeria. Data were analyzed using descriptive statistics and multiple logistic regression at …

Exploring Parent Support For School-Based Health Programs To Reduce Childhood, Alaphiah Delaney Campbell Byfield

Walden Dissertations and Doctoral Studies

The rise in childhood obesity rates continues globally despite the design and implementation of social programs aimed at curtailing that phenomenon. The government of Jamaica has indicated that a whole-of-government, whole-of-society approach is needed to control obesity. The literature has shown that in Jamaica, support for being fluffy impedes progress toward addressing the problem of childhood obesity; being fluffy is considered attractive and a sign that one has a good life. Studies have shown that obese or overweight children are at risk for developing psychosocial (e.g., having low self-esteem, and underperforming academically) and medical problems (e.g., noncommunicable diseases such as …

Predictors Of Glycemic Control Among Type 2 Diabetes Mellitus Patients In Owerri, Nigeria, Jideuma Ikenna Egwim

Walden Dissertations and Doctoral Studies

Diabetes mellitus (DM) is a significant public health concern globally and in Owerri, Nigeria. The deleterious effects of diabetes have been linked to poor glycemic control. According to the International Diabetes Federation, poor glycemic control is reflected in glycosylated hemoglobin (HbA1c) levels greater than 7.0%, which are associated with substantial morbidity and mortality. Studies have shown a dramatic rise in diabetic complications in Nigeria, particularly in Owerri. However, evidence is lacking on specific risk factors associated with poor glycemic control among DM patients in Owerri. With health insurance assuming a significant position in healthcare service delivery in Nigeria, addressing this …

Intersectional Approach To Understand Condom Use Behavior Between Black And Latinos Msm And Transgender Women, Vanessa J. Mejia

Walden Dissertations and Doctoral Studies

Men who have sex with men (MSM) and transgender women has been a focus of scholars since the early 1990s. Researchers have demonstrated that individuals in these communities are at greater risk for adverse health outcomes such as sexually transmitted infections (STIs) and Human Immunodeficiency Virus (HIV). This study examined the relationship between macrosocial structural factors (i.e., housing stability) and the acceptance of risky sexual behavior (RSB) (i.e., condom use) between Black and Latino MSM, and transgender women guided by the health belief model and intersectionality theory. Using a quantitative approach, primary data were collected from MSM and transgender women …

Adverse Childhood Events And Protective Health Behaviors Among Adults With Diabetes Or Diabetes With Comorbid Heart Disease, Ciara Michelle Rukse

Walden Dissertations and Doctoral Studies

Diabetes is a prevalent and costly chronic condition that can lead to other comorbid conditions such as heart disease. Disease management is essential but can be stressful and complicated, especially for individuals who have developed maladaptive behaviors in response to exposure to adverse childhood events (ACEs), which are chronic stressors that impact physiological and psychological development. There is limited research on the potential relationship between childhood adversity and engagement in protective health behaviors among U.S. populations with diabetes or diabetes with comorbid heart disease. The ACEs pyramid was the theoretical framework of this quantitative cross-sectional study concerning morbidity and early …

African American Women’S Body Image Perceptions And The Built Environment, Andrea Denise Smith

Walden Dissertations and Doctoral Studies

African American (AA) women have a 54.8% overall obesity rate in the United States. This quantitative cross-sectional study’s aim was to determine what factors may have an impact on body image perceptions of AA women in Alabama and New Jersey. A gap in research this study addressed is sociodemographic and geographic differences that may impact obesity rates among AA women. The theoretical framework used for this study was the social cognitive theory. Secondary data were obtained from the 2018 Behavioral Risk Factor Surveillance System. Linear regression (LR) analyses results showed that none of the sociodemographic variables (education level, employment status, …

Diabetes Self-Management Education In The Urban Low Socioeconomic Status Senior Population, Heather Santa Barbara

Walden Dissertations and Doctoral Studies

This exploratory quantitative study used a survey design to address a gap in the literature concerning primary care team perceptions about diabetes care for urban low socioeconomic status seniors with diabetes. Diabetes is a chronic health problem that is often managed in primary care offices, and primary care teams are often the first source of education and support for patients. Standards of management for seniors with diabetes has changed to eliminate tight control of glucose levels, and primary care team members may have differing perceptions about diabetes care depending upon their role in the primary care team and years of …

Chronic Obstructive Pulmonary Disease 30-Day Readmission Rates In California, Illinois, And New York, Theresa Teverbaugh

Walden Dissertations and Doctoral Studies

AbstractThe Centers for Medicare and Medicaid Services (CMS) have implemented financial penalties to reduce hospital readmissions for various conditions, including chronic obstructive pulmonary disease (COPD). As a result, hospital administrators explore ways to prevent financial penalties for excessive COPD 30-day hospital readmissions. The purpose of this quantitative study was to determine if there was a correlation between hospital Medicare reimbursement, quality-of-care measures related to patient satisfaction, and 30-day readmissions rates for COPD patients in California, Illinois, and New York. The quality-of-care measures included communication with nurses, communication with doctors, the hospital staff's responsiveness, and medicine communication. The secondary data were …

Exploring The Behavioral Health Clinician Shortage At A Rural Midwestern U.S. Agency, Tracy L. Wilson

Walden Dissertations and Doctoral Studies

Behavioral health clinician shortages are a significant and ongoing problem in the United States, especially in rural areas, which have higher rates of homelessness, suicide, substance use, and violence rates than urban areas. The purpose of this qualitative case study was to explore factors contributing to the behavioral health clinician shortage in a rural midwestern U.S. public health department. The goal was to gain a better understanding of this shortage and explore strategies and solutions for recruiting and retaining behavioral health clinicians at the agency’s facilities. The Baldrige excellence framework undergirded the investigation. Data sources included interviews with three administrative …

Relationship Between Employee Engagement, Kind Of Initiatives, And Workplace Wellness Program Effectiveness, Alicia Dobrzeniecki

Walden Dissertations and Doctoral Studies

Ineffective workplace wellness programs prevent organizations from decreasing employee health and well-being costs. Workplace wellness managers lose more than $1,100 in decreased productivity each year. Grounded in the theory of planned behavior, the purpose of this quantitative correlational study was to examine the relationship between workplace wellness engagement, kind of workplace wellness initiatives, and workplace wellness program effectiveness. Data were collected from 146 workplace wellness program managers who completed the HERO scorecard. The multiple linear regression analysis results indicated the model was able to significantly predict workplace wellness program effectiveness, F(2, 143) = 85.482, p = < .001, R² = .545. Both predictors provided a significant contribution to the model, with workplace wellness engagement level (t = 8.342, p = < .001, β = .543) providing a higher contribution to the model than kind of workplace wellness initiatives (t = 4.584, p = < .001, β = .298). A key recommendation for workplace wellness program managers is to emphasize employee engagement in workplace wellness programs and choose the appropriate initiatives to ensure workplace wellness program effectiveness. The implications for positive social change include the potential for improved health and well-being within the U.S. workforce.

The Perceptions Of Adult Patients Who Experience Needle Fear During Cosmetic Injections, Julia Hoy

Walden Dissertations and Doctoral Studies

AbstractAdult patients receiving cosmetic injections frequently experience needle fear symptoms which results in patient discomfort, suffering, and poor injection outcomes. The needle fear experience contributes to a decreased quality of life and possible avoidance behaviors involving other medical treatments requiring needles. Researchers have conducted quantitative studies which explored interventions on pain reduction but there are no qualitative studies from the perspectives of adults experiencing needle fear. The purpose of this research study was to explore the perceptions of needle fear in adult patients receiving cosmetic injections in a medical office setting. The interpretative phenomenological approach was used to provide an …

Water/Sanitation, Hygiene, And Risk Factors Associated With Under-5 Mortality In Côte D’Ivoire, Ouda Kamagate

Walden Dissertations and Doctoral Studies

Despite remarkable progress in children’s survival since 1990, the global burden of the under-5 mortality rate (U5MR) remains immense. According to the World Health Organization, about 5.2 million children below 5 died in 2019, with 14,000 dying each day. Literature reveals that the lack and limitation of water, sanitation, and hygiene (WaSH) are linked to deaths in childhood. Cote d’Ivoire still lags behind expectations with 79 per 1000 live births in 2019 rather than 25 and below, so there is a need to uncover to what extent the U5MR is affected by WaSH. Through a cross-sectional design guided by the …

Risk Factors Of Infant Mortality Among Sub-Saharan Immigrants In The United States, Roland Lankah

Walden Dissertations and Doctoral Studies

While prepregnancy body mass index (BMI), gestational weight gain (GWG), and birthplace have been suggested to play a key role in predicting infant mortality outcomes, they have not been thoroughly investigated across all races/ethnicities. The purpose of this study was to examine the associations between prepregnancy BMI, GWG, birthplace as independent variables, and infant mortality as the outcome variable within the United States Sub-Saharan African Immigrants (SSAI). A quantitative cross-sectional study design grounded in the biopsychosocial model was used. Data were extracted from the 2017-2018 natality-linked birth/infant death file from the Centers for Disease Control and Prevention Wonder Database. It …

Improving Patients' Engagement And Retention In Intensive Outpatient Substance Abuse Treatment, Leo W. Lavender

Walden Dissertations and Doctoral Studies

Substance use disorder continues to be a major health crisis in the United States. Thousands of people die yearly due to substance use and related criminal activity. Substance abuse treatment is a remedy to the disorder and treatment centers admit thousands of patients yearly to address the dilemma. Throughout the years retention has been an ongoing barrier to successful treatment. This study explored significant obstacles to retention: motivation and engagement. The Baldrige Excellence Framework was utilized to assess the training, supervision, procedures, and leadership roles at an intensive outpatient substance abuse treatment center. This study utilized a qualitative approach case …

Socioeconomic And Health Impact Of Opioid Overuse On Working-Age Population In Minnesota, Colette Ngum Ngwa

Walden Dissertations and Doctoral Studies

Abstract The United States faces numerous challenges associated with the ongoing opioid crisis. Although the opioid epidemic is complex, opioid overuse affects users’ health and has a far-reaching impact on socioeconomic well-being. This study employed a quantitative cross-sectional design using secondary data from a 2018 national survey of working-age individuals ages 18 to 45. Multivariate regression analysis was used to examine the associations between opioid overuse and socioeconomic status, health status, and perceived need for substance abuse treatment. The addiction career concept and chronic illness model theory were used to analyze these correlations. The findings indicated that people with higher …

Risk Factors Associated With Type 2 Diabetes Among Adults In Alabama, Peter Okeke

Walden Dissertations and Doctoral Studies

In the 21stcentury Diabetes mellitus is recognized as one of the most important public

health challenges that carry a substantial individual and community burden.

It is necessary to do a detailed search regarding DM2 from adolescence till adulthood is in

Alabama which should aim to provide recent information. T2D is influenced by a many

factors including demographics including age, sex, income level, educational, BMI,

physical activities, etc. Identification of the associated risk factors is very important to

inform decision making by concerned bodies and T2D management. The study aimed to

examine the risk factors associated with T2D in adults aged …

Major Depressive Disorder And Perceived Everyday Discrimination Among The Jamaican Diaspora In The United States., Warren Williams

Walden Dissertations and Doctoral Studies

Overt racial discrimination in the United States has been supplanted by subtle forms of everyday discrimination known as microaggressions. Researchers have found perceived everyday discrimination (PED) to be associated with major depressive disorder (MDD) among African Americans but have often treated the African American subpopulation as a homogeneous group. The purpose of this cross-sectional study grounded in the theory of microaggression was to illuminate probable associations between microaggressions based on weight, age, gender, ethnicity, and race and lifetime MDD among the Jamaican diaspora in the United States. Secondary data from the Collaborative Psychiatric Epidemiologic Surveys were analyzed. Statistically significant associations …

Effectiveness Of Responsible Beverage Service Policies In Reducing Drunk-Driving In Maryland, Rhoda Makinde

Walden Dissertations and Doctoral Studies

In the State of Maryland and across the United States, driving under the influence (DUI) has led to a massive loss of lives and disability cases. Hence, responsible beverage service (RBS) policies and programs have been developed to prevent and control DUI incidence. This study sought to identify the effectiveness of these policies in addressing the DUI-related fatalities and injuries among young adults (18–30 years old) in the State of Maryland. Using program theory to evaluate the effectiveness of RBS policies and programs in reducing DUI, this qualitative research sampled bar patrons, club patrons, and alcohol servers/service staff in Baltimore. …

Accessibility To Vaping Products, Vaping, And Use Of Cigarettes Among Adolescents, Sherri Adeosun

Walden Dissertations and Doctoral Studies

There has been a continuous increase in the use of e-cigarettes among adolescents. The growth threatens to nullify the years of successfully reducing cigarette smoking among this age demographic. Additionally, the increase has been a concern for public healthcare workers due to the limited research on the effects of long-term use of e-cigarettes on adolescents. I investigated the possible side effects of exposure to e-cigarette advertisements and the use of e-cigarettes. Additionally, the study reviewed the relationship between the age e-cigarette use was initiated and the subsequent use of cigarettes. The conceptual framework was based on the multi-theory model and …

Parents’ Perspectives On Early Intervention For Children With Autism, Tiffany Schmidt

Walden Dissertations and Doctoral Studies

The purpose of this study was to analyze parent perspectives on early intervention services for children with autism. Research has shown a significant positive impact of early intervention on children with autism. A total of eight parents participated in this basic qualitative study guided by social cognitive theory. Participating parents were those whose child had an autism diagnosis and were receiving or had received early intervention services in Southeast Michigan. Data analysis included establishing themes and codes to organize the data into categories. Thematic analysis was applied by analyzing interview transcripts. The research questions used to collect data addressed parents’ …

Lived Experience Of Albanian Migrants Who Became Obese After Moving To The United States, Briseida Xhelaj

Walden Dissertations and Doctoral Studies

The problem of obesity is significant in the United States, and more information is needed about the factors that increase the risk for obesity among migrant populations like Albanian Americans. The purpose of this study was to discover the lived experience of Albanian migrants who became obese after moving to the United States. This study was guided by the social ecological model. The research questions were used to examine how individual, relationship, community, and societal level factors impacted lifestyle changes and obesity for Albanian American migrants after moving to the United States. This qualitative study involved the use of a …

Health Department Prevention/Education Plans And Perceived Risks Of Zika Infection, Lacey Jacques

Walden Dissertations and Doctoral Studies

AbstractZika virus is an infectious disease caused by the bite of an infected mosquito that has been linked to increased rates of microcephaly and other devastating birth defects. The existing body of knowledge has focused on the individual-level factors that influence a person’s decisions about prevention activities and risk perceptions related to Zika virus. The purpose of this study was to determine the relationship between state-level plans for prevention and education and individual-level risk perceptions. Rosenstock’s health belief model lays a foundation for why individuals make the health decisions they do and helps explain how these can be influenced for …

Perceptions Of Implicit Bias In New York City Healthcare System During Covid-19, Kiesha Jackson

Walden Dissertations and Doctoral Studies

Implicit bias has been identified as a significant problem that hinders effective healthcare delivery. The purpose of this qualitative exploratory phenomenological study was to examine whether implicit bias influenced healthcare services for African Americans with comorbidities aged 30 and over living in New York City during the COVID-19 pandemic. Current studies show healthcare disparities, revealing barriers with healthcare delivery; however, they do not disclose a patient’s lived experience qualitatively, which constituted a gap in the literature. The frameworks of the behavioral model of health services use, and social construction and policy design guided this study. Research questions addressed (a) whether …