Public Health Commons^™

Attitudes Of State Public Health Laboratory Directors Towards Iso/Iec 17025 Accreditation, Christine Kilonzo

Walden Dissertations and Doctoral Studies

The impact of ISO/IEC 17025 accreditation in state public health laboratories (SPHLs) is understudied. There is a scarcity of research on SPHLs involving behavioral intent regarding ISO/IEC 17025 accreditation. The theory of planned behavior (TPB) was utilized to evaluate SPHL directors’ attitudes towards and intent to seek or maintain ISO/IEC 17025 accreditation. To test the questions of whether the three constructs of the TPB, attitude, subjective norms and perceived behavioral control are significant predictors of intent to seek or maintain ISO/IEC 17025 accreditation, and whether there are significant differences in these constructs towards the accreditation between SPHL directors based on …

Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo

Walden Dissertations and Doctoral Studies

Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …

Type Of Union And Reproductive Health Influence On Domestic Violence In Sierra Leone, Yvonne Rowe

Walden Dissertations and Doctoral Studies

Domestic violence (DV) is one of the most hidden but prevalent public health concerns affecting women of childbearing age in Africa, despite ongoing prevention initiatives. Lack of power and control in the household is a significant precursor of DV in women, especially in sub-Saharan Africa. While poverty, gender inequality, and societal norms have been identified as directly related to DV, the factors of type of union and reproductive health choice remain unexplored. This quantitative study with a cross-sectional design assessed the relationship between the type of union, female contraceptive use, and type of DV amongst women in Sierra Leone. Anchored …

The Risk Factors For Hiv In African American Transgender Women In Connecticut, Oliver Kunda

Walden Dissertations and Doctoral Studies

AbstractThe human immunodeficiency virus (HIV) incidence rate is 70 times higher for African American transgender women than in the general population. Despite decades of outreach and intervention effort to reduce HIV incidence in the transgender community by the lesbian, gay, bi-sexual, transexual, queer, plus (LGBTQ+) community and public health organizations, the HIV prevalence rate for transgender women remains high at 38%. The purpose of this qualitative exploratory case study was to gain insights into how attitude, subjective social norms, and perceived behavioral control influence HIV risk behaviors of African American transgender women in Connecticut. Ajzen’s theory of planned behavior provided …

An Evidenced-Based Nursing Education Discharge Plan For Prescription Opioids, Josephine J. Messelmani

Walden Dissertations and Doctoral Studies

The reported number of prescription opioid overdoses justifies the need for providing patients with opioid discharge information and follow-up care as recommended. To prevent any misuse of prescription opioid drugs, it was critical for patients to receive a thorough review of their medications prior to being discharged. The purpose of the project was designed to educate nurses on the importance of delivering essential information to patients prescribed opioids. Implementation of an opioid discharge plan integrated with the teach back method increased patients’ understanding of how to properly take prescription opioids compared to the patients who did not receive opioid education …

Use Of The Hester Davis Falls Risk Assessment Scale In Medical-Surgical Patients, Gideon M. Nyakundi

Walden Dissertations and Doctoral Studies

AbstractIdentifying and containing patient falls before they happen, reporting fall occurrence, and analyzing fall causes could increase patient safety to achieve the triple aim of improved quality, reduced cost, and accessibility in healthcare. Patient falls within the medical-surgical population continue to present challenges to patients, families, hospitals, and society, despite the use of fall-related predictive analysis tools. The purpose of this quantitative study was to determine the extent to which the overall score on the Hester Davis Falls Risk Assessment Scale (HDS), comprised of patient-related factors such as medications, volume/electrolyte status, age, last known fall date, mobility, toileting needs, communication/sensory …

Knowledge And Experiences Of African American Women With Polycystic Ovary Syndrome, Kristy L. Vance

Walden Dissertations and Doctoral Studies

While polycystic ovary syndrome (PCOS) is a nationwide phenomenon, African American or Black women often have little to no information on the education and support available to manage the condition. PCOS is one of the most poorly understood disorders among patients which has led to limited resources and management. The lack of education could contribute to increased risks to many health issues for African American women with PCOS. The purpose of this basic qualitative study was to explore and examine the level of health knowledge related to PCOS among African American women living in or around the Northern Region of …

Effects Of Socioeconomic Status, Demographic Characteristics, And Education On Sarcopenic Obesity, Moruf Oladele Olaleye

Walden Dissertations and Doctoral Studies

The general problem is that although the body of research about obesity is robust, there is a lack of research addressing the problem of sarcopenic obesity. Specifically, there is a lack of research examining the statistical significance of the relationship between the independent variables of socioeconomic status, demographic characteristics, and education and the dependent variable of sarcopenic obesity. This research may advance practice and policy by lending support for developing interventions to address factors that have a statistically significant relationship with sarcopenic obesity. The purpose of this quantitative causal-comparative study was to identify independent variables among socioeconomic, demographic, and education …

Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli

Walden Dissertations and Doctoral Studies

AbstractNurses who work in the critical care unit are more likely to experience work-related stress, fatigue, understaffing, undesirable performance outcomes, and compromised workplace safety than general care nurses. Nurse managers in these units possess insights into nurses' stress-inducing challenges, in addition to managerial and administrative perspectives. Yet there is a lack of available knowledge about the experiences of critical care nurse managers in addressing nurses' work-related stress. The purpose of this study was to explore critical care nurse managers’ experiences of potential strategies to effectively address work-related stress among nurses. The job-demand resource model was the theoretical framework for the …

Relationship Between Patients Of Low Socioeconomic Status With Multiple Sclerosis And Health Care Providers, Jennifer N. Rhoads

Walden Dissertations and Doctoral Studies

Many health care initiatives seek to improve patient–provider experiences and relationships to support patient satisfaction rates and health outcomes. However, a small amount of published research has examined the perceptions of low socioeconomic status (SES) patients diagnosed with multiple sclerosis (MS) regarding their relationship with their health care provider and how these perceptions affect patient outcomes. Prioritizing communication and approachability between the health care provider and a patient can be instrumental in creating and fostering an authentic relationship. The research question for this study was designed to understand the relationship between participants of low SES who had been diagnosed with …

Suicidal Ideation Among American Indian And Alaska Natives In The United States, Lacie Lashawn Tillman

Walden Dissertations and Doctoral Studies

Suicidal ideation is a silent public health issue across the United States. Evidence suggests that suicidal ideation is a predictor of suicide attempt and completion. Suicide is a leading cause of death among American Indians and Alaska Natives (AIs/ANs) in the United States, especially among younger people. Alcohol and illicit drug use, coupled with poor social conditions, can lead to suicidal ideations—and sometimes suicide completion. Using social cognitive theory, this quantitative cross-sectional study compared variables within the 2017, 2018, and 2019 National Survey on Drug Use and Health to determine the effect that alcohol and/or illicit drug use has on …

Legislative Efforts And Community Change To Combat Female Genital Mutilation In Egypt, Maryam Berkshire

Walden Dissertations and Doctoral Studies

Female genital mutilation is recognized as a violation of human rights as it violates the bodily rights of young girls by cutting part of their bodies without their consent and leaves long term psychological, physical and sexual harm to women who were exposed to the practice. The World Health Organization estimates that 130 million girls and women are subjected to Female Genital Mutilation/Cutting (FGM/C) in African and Middle Eastern Countries. According to a UNICEF 2020 report, Egypt will not meet the SDG goal of eradicating FGM as the decrease in the practice is too slow despite the policy and community …

Spirituality, Hiv And Black/African American Women, Shawanna D. Brun

Walden Dissertations and Doctoral Studies

Despite the surmounting prevalence of human immunodeficiency virus (HIV) among Black women, few studies have been conducted to examine culturally appropriate prevention methods to reduce the occurrence of the disease. The purpose of this cross-sectional study was to explore how religion/spirituality affects the attitudes, beliefs, and self-perceptions of HIV/AIDS among 151 Black/African women, ages 25-44, in Florida, and to investigate the impact of HIV-related stigma on the attitudes, beliefs, and self-perceptions of HIV/AIDS within this population. Social cognitive theory was the framework of the study. Multiple linear regression and hierarchical regression were used to analyze the survey data. Results revealed …

Beliefs About Food Education And Healthy Food Consumption In Food Insecure Areas, Eboni Drummond

Walden Dissertations and Doctoral Studies

Many food desert residents suffer from food insecurity as a result of residing in communities where access to affordable, healthy foods is limited. This limited access can make it difficult for these residents to consume healthy foods, such as fruits and vegetables, on a consistent basis. To increase access to healthy foods, interventions such as the building of supermarkets, the introduction of mobile farmers markets or mobile produce markets, and the conversion of local corner stores into healthy corner stores are often introduced to food desert communities. However, these intervention efforts fail to focus on non-physical factors, such as the …

Opioid Types And Adolescent Prescription Opioid Misuse, Orchid George

Walden Dissertations and Doctoral Studies

AbstractAdolescent prescription opioid misuse (POM) in the United States is a significant public health issue, and there is a lack of studies investigating the association between opioid types and adolescent POM. The purpose of this quantitative cross-sectional study was to explore possible associations between a set of independent variables: opioid types, gender, religiosity, and education, and the outcome variable, POM among adolescents ages 12 to 17 in the United States. The socio-ecological model was the theoretical framework that guided the study. A sample size of 13,722 from the 2017 Substance Abuse & Mental Health Data Archive was analyzed using descriptive …

Effects Of Socioeconomic Status, Demographic Characteristics, And Education On Sarcopenic Obesity, Moruf Oladele Olaleye

Walden Dissertations and Doctoral Studies

The general problem is that although the body of research about obesity is robust, there is a lack of research addressing the problem of sarcopenic obesity. Specifically, there is a lack of research examining the statistical significance of the relationship between the independent variables of socioeconomic status, demographic characteristics, and education and the dependent variable of sarcopenic obesity. This research may advance practice and policy by lending support for developing interventions to address factors that have a statistically significant relationship with sarcopenic obesity. The purpose of this quantitative causal-comparative study was to identify independent variables among socioeconomic, demographic, and education …

Barriers To Blood Availability Within The New Orleans Area, Tishawn Michelle Francis

Walden Dissertations and Doctoral Studies

An adequate and reliable supply of blood and blood components is becoming an increasing public health concern. Over the past decade, researchers have indicated a continued decline in the collection of blood products. An insufficient blood supply may present a risk to both patients and reserves for emergencies and disasters. The purpose of this quantitative, cross-sectional study was to determine whether gender, age group, ethnicity, year, serological tests, and discard factors were associated with the availability of the donated blood supply throughout the New Orleans region. The donated blood supply chain model guided this study. Secondary data were retrieved from …

The Role Of Health And Diet In The Development Of Metabolic Syndrome Stratified By Race, Sex, And Age, Michael D. Harada

Walden Dissertations and Doctoral Studies

Obesity is now recognized as a disease in need of treatment by the medical profession and is associated with other chronic diseases including hypertension, hyperglycemia, hypertriglyceridemia, insulin-resistance, and reduced levels of high density lipoproteins. Metabolic syndrome (MetS) occurs when a combination of at least three of these chronic conditions are comorbid with each other. The purpose of this quantitative cross-sectional study was to find significant health and nutritional predictors of MetS status across race, sex, and age. The evolutionary mismatch hypothesis and health belief model provided the framework for this study. Data were collected from 2,303 participants from the 2015-2016 …

Lead Toxicity, Attention–Deficit Hyperactivity Disorder, And Gun Violence Among Young African American Men, Gwendolyn Hooker-Mcintosh

Walden Dissertations and Doctoral Studies

Violence among adolescents and young adults is a major public health concern in the United States, but it disproportionally affects African Americans. This racial disparity is especially concerning in New Orleans, Louisiana, where fatal and nonfatal shootings have been consistent since 2010 for young African American men. Also, Louisiana ranks third in the nation in prevalence of attention–deficit hyperactivity disorder (ADHD) among children. African Americans in New Orleans have lived in areas known to have greater concentrations of lead in the soil, and African American children and their parents have a lower level of awareness of lead toxicity. The purpose …

Exploring African American Single Mothers’ Experiences With Child Welfare System, Paul J. Melbourne

Walden Dissertations and Doctoral Studies

African Americans are overrepresented in the child welfare system in New York City (NYC). They face racial and ethnic bias, complex procedures, and policies that govern child welfare. The main research question for this study explored the experiences of African American single mothers with the child welfare system. This qualitative study was guided by policy feedback theory; data were gathered from 10 African American single mothers who have had experiences with child welfare investigation within the past 10 years. Participants were interviewed using semistructured questions designed to capture their experiences with the child welfare system. The data were coded for …

Cognition, Neurocognitive Disorder, Psychotropic Group Of Medication, And Fall Among Canadians Aged 65+ Years, Victoria Elaki Momoh

Walden Dissertations and Doctoral Studies

Despite the high incidence of fall among the elderly in residential care, this problem has been minimally explored and reported. This study examined the association between (cognitive performance, dementia, four groups of psychotropic medication-hypnotics, antidepressants, antianxiety medication, and antipsychotics) and fall among Canadian elderly in residential care. A multi–variate logistic regression was used for the analysis. The Social Cognitive Theory was used to interpret the findings of an analysis on 180,231 Canadian residents from 2018–2019. Cognitive performance at intact level (OR=1.114, p<0.001), cognitive performance at moderate level (OR=1.192, p<0.001), dementia diagnosis (OR=1.075, p<0.001), antipsychotics (OR=2.571, p<0.001), antidepressants (OR =1.486, p<0.001) and antianxiety prescription (OR=3.284, p<0.001) increased the odds ratio of fall. However, cognitive performance at severe level (OR=0.898, p<0.001), no dementia diagnosis (OR=0.001, p<0.001) and hypnotics prescription (OR=0.389, p<0.001) decreased the odds ratio of fall. Findings indicate that cognitive performance at the intact and moderate levels, antianxiety, antipsychotic and antidepressant medications and dementia were strong predictors of fall among the elderly in residential care in Canada. A limitation of the study was that the dataset used captured data from 7 out of 13 Canadian provinces and territories therefore, limiting external validity. The potential positive social change impact of this study is that it would guide caregivers, enhance fall prevention practices and decrease fall occurrence in this population.

Competency-Based E-Learning Module For Nurses In A Multi-Service-Line Surgical Unit, Exequiel P. Naculangan

Walden Dissertations and Doctoral Studies

Negative patient outcomes have been attributed to surgery-related complications. A gap was identified in an acute care unit in southern Texas because postoperative surgical complications were above acceptable rates. The purpose of this Doctor of Nursing Practice project was to educate staff nurses on the provision of evidence-based postsurgical care. This doctoral project was conducted to determine whether completion of a learning module would increase nurses’ level of knowledge in acute postoperative care. The project was grounded on Knowles’s adult learning theory and the Dreyfus model of skill acquisition. Learning material using competency-based education was developed using the analyze, design, …

Role Of Hypertension In Low-Birth-Weight Racial Disparities Among Virginian Women, Ashli Owen

Walden Dissertations and Doctoral Studies

Low birth weight (LBW) is a leading cause of infant mortality globally, but it disproportionately burdens the Black community in the United States, with a rate twice that of White women. Further, hypertensive disorders of pregnancy (HDsP) increase LBW incidence. The purpose of the study was to assess the association between HDsP and LBW, maternal race and LBW, and the moderation effect of HDsP on race and LBW on Black and White women in Virginia. The theoretical framework for this study was based on the lifecourse health development model, which states that health should be viewed as an outcome of …

Associations Of Fast-Food Zoning Policy And Cardiovascular Disease In African American Communities, Starrlett Pena-Johnson

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) remains a major public health concern, causing one in every four deaths in the United States. Despite availability of effective disease management, African Americans bear the burden of incidence and mortality as CVD prevails as the primary cause of disparities in life expectancy, stroke, and heart failure. This cross-sectional study investigated fast-food restaurant (FFR) availability and socioeconomic status (SES; income, occupation, and education) to predict CVD risk scores in African Americans residing in Jackson, Mississippi. The social construction of target populations theory was used to inform this study. Using hierarchical multiple linear regression, a secondary data analysis …

Association Of The Use Of Combination Therapy Self-Management Of Prediabetes And Type-2 Diabetes Mellitus In Adults, Celestina Reed

Walden Dissertations and Doctoral Studies

Diabetes is a long-lasting chronic health condition that encompasses three types: Type 1, Type 2, and gestational diabetes. The disease affects how the body breaks down food into energy. It is an insulin-deficient disease and causes heart disease, vision loss, and kidney disease. Investigators of the Centers for Disease Control and Prevention and the American Diabetes Association evaluated patient treatment preferences to determine the upsurge in patient health-related quality of life (HRQOL) and optimum health. The literature revealed that patients' preferences consisted of therapies and achievable goal setting using the health belief model (HBM) framework. This quantitative research aimed to …

Health Educator Experience: Recommendations For Physical Activity For Mental Health In Women, Patricia Schneider

Walden Dissertations and Doctoral Studies

Mental health issues, specifically anxiety and depression, continue to be a public health crisis in the United States. Despite the established therapies of pharmacology and cognitive behavioral therapy, not all patients seek or find relief using these methods. Therefore, other treatment strategies need to be studied. The purpose of this basic qualitative study was to understand the experiences of health educators who use physical activity as a strategy for anxiety and depression management among middle-aged women as well as their own attitudes, norms, and perceived behavioral controls. The theory of planned behavior (TPB) was leveraged as the theoretical foundation for …

Services For Homeless Veterans: A Study Of Access To Benefits, Sheryl Maddox Williams

Walden Dissertations and Doctoral Studies

AbstractHomelessness among veterans in the United States is a multifaceted social and health concern that has continued to increase despite immense efforts to minimize and eliminate this issue. Numerous organizations have dedicated resources; however, many veterans do not use benefits and resources that are available to them, and homelessness remains a health and social concern. The purpose of this study was to explore and describe how individual and interpersonal barriers, community factors, organizational structure, and existing policies for assistance are perceived by support staff that work with veterans with mental disorders who are homeless or at risk of becoming homeless. …

Gestational Weight Gain, Level Of Education, And Infant Mortality Among African American Women, George Lee Amanambu

Walden Dissertations and Doctoral Studies

Abstract

African American (AA) women in Mississippi have a higher burden of infant mortality, especially those with low income and educational levels, as compared to other regions of the country. However, it is unknown if abnormal gestation weight gain (GWG) is contributing to this increased burden. This quantitative cross-sectional study examined the association between GWG (25-35lbs), level of education, income, and infant mortality among AA women with normal prepregnancy body weight who were between 30 to 47 years old in the state of Mississippi from 2016 to 2018. Biopsychosocial and ecosocial models were used as the theoretical foundation to design …

Factors That Determine Utilization Of The Canadian School-Based Human Papilloma Virus Vaccine Programs, Diane Gloria Brown

Walden Dissertations and Doctoral Studies

Human Papilloma Virus (HPV) is the most common sexually transmitted infection in the world and is the known causative agent of many HPV-associated cancers in both males and females. HPV vaccination rates in Canada are significantly lower than other developed countries and this finding is poorly understood as Canadian adolescents have access to free-of-charge HPV vaccines through school-based vaccination programs. This quantitative descriptive study used an online survey to collect data from 992 eligible respondents. This study identified predisposing, enabling, and need factors characterized by the Andersen behavioral model of health services use which facilitate or impede the use of …

Secondary Data Analysis Of The Association Of Screen Time With Selected Health Behaviors, Kellany Cadogan Noland

Walden Dissertations and Doctoral Studies

The noticeable disparity in youth access of preventive healthcare and youth’s tendency towards excessive screen time have been linked to poor health outcomes. This issue prompted the current study, which had three core purposes: to identify associations between screen time and selected health behaviors, to identify target sociocultural and personal determinants of youth health, and to provide evidence to prompt innovation in promoting youth health via screen-based strategies. The social cognitive theory provided a context for triadic reciprocity between youth personal factors, environmental factors, and behaviors. A quantitative secondary analysis was completed using SPSS-27 to identify whether there was an …