Public Health Commons^™

Developing A Lifestyle Modification Tool To Prevent And Manage Elevated Blood Pressure Among African Americans, Magdalene Oziwo

Walden Dissertations and Doctoral Studies

Hypertension is a national medical problem that has been predominantly seen amongst African Americans. Within this community, hypertension has been associated with obesity, a sedentary lifestyle, and poor nutrition. It is for this reason that lifestyle modifications can be used as applied tools in the field of nursing in the prevention and management of hypertension among African American patients. This doctoral project was conducted to address the gap in nursing practice that currently exists for the African American population with regards to hypertension. The project focused on a nursing staff education program with 10 participants to promote the implementation of …

The Association Between Teen Pregnancy And Academic Performance Among Schoolgirls In The Ivory Coast, Moussokoura Ouattara Epse Assoumou

Walden Dissertations and Doctoral Studies

AbstractTeen pregnancy (TP) is a social and public health problem around the world. In developed nations, approximately 16 million girls from aged 15 to 19 years become pregnant each year, presenting health problems for the mother and fetus in addition to economic and social consequences for the communities in which they live. The purpose of this quantitative causal-comparative study, based on the theory of planned behavior, was to explore the association of academic performance and self-efficacy with TP. The research questions examined the association between the TP and the academic performance and self-efficacy while controlling for two covariates (socioeconomic status …

Experiences In An Online Learning Community, Michelle Potthoff Wylie

Walden Dissertations and Doctoral Studies

Master of public health online programs have been experiencing issues with retention and problems related to inconsistent implementation of online learning communities. This basic qualitative study aimed to understand the efficacy of online programs and the perceived impact of the implantation of online learning communities. The conceptual framework for this study is Siemens’s connectivism theory supporting different types of learning in the online environment. Two research questions guided the study: (a) How do graduate students in an online Master of Public Health program perceive the efficacy of online learning communities and (b) Which components of online learning communities do graduate …

A Quality Improvement Evaluation Of A Hospitalist Telemedicine Program, Kelly Marie Awes

Walden Dissertations and Doctoral Studies

Critical access hospitals (CAHs) encounter unique challenges in terms of providingquality resources to their community, often lacking quality measures and continuity comparable to larger regional and tertiary hospitals. One CAH in rural Minnesota implemented an overnight hospitalist telemedicine service to address concerns with provider resources and quality practice. An evaluation of quality improvement implementation was completed to address data regarding ER transfers and inpatient length of stay (LOS). Following the triple aim framework to improve patient care, population health, and decrease costs, Donabedian’s model of quality improvement was utilized. Three months of pre and postimplementation data were collected one year …

Analysis Of Malaria-Induced Anemia And Gender Differences Among Children In Nigeria, Temitope Bamgbose

Walden Dissertations and Doctoral Studies

Malaria is one of the leading causes of death among children under 5 years old in sub-Saharan Africa (SSA). Also, public health efforts on malaria prevention have been successful in many regions but remains an issue in SSA. Malaria-induced anemia (MA) is associated with health complications among children. The impact of several sociodemographic factors (age, gender, residential type, and parent’s educational level) and malaria preventive/intervention measures such as mosquito net use and malaria medication use among children under 5 years old in Nigeria were assessed to inform malaria best practices and strategies, prioritize resource allocation, and support existing literature on …

Nurse Perspectives Of Trauma-Informed Care, Lee Ann Blazejewski

Walden Dissertations and Doctoral Studies

There is growing interest in trauma-informed nursing methods to better respond to the needs of patients with histories of adverse childhood experiences and other traumatic events. Recent advances in the understanding of how trauma can negatively affect long-term health outcomes have fostered a shift towards trauma-informed care as a method to decrease patient retraumatization in nursing practice. With the implementation of trauma-informed care in many areas of healthcare and public health, several challenges have been exposed. The purpose of this study was to examine nurses’ lived experience of implementing trauma-informed care into nursing practice for the care of patients with …

Antenatal And Postnatal Care Services And Maternal Mortality In Nigeria, Lucy Evans

Walden Dissertations and Doctoral Studies

Nigeria has had a high maternal mortality rate per 100,000 live births since the 1990s. A possible contributing factor is that many Nigerian women are not aware of prenatal and postpartum pregnancy care-related services. The purpose of this study was to investigate the association between pregnancy-related care (access to antenatal services, maternal health education, and knowledge of prenatal and postpartum care) and maternal mortality in Nigeria. The theory of planned behavior forms the basis of this study. A cross-sectional quantitative study design was used to determine whether maternal mortality is influenced by pregnancy-related care. Secondary data collected by the Demographic …

Social Determinants Of Maternal And Neonatal Birth Outcomes Among Syrian Refugees In Lebanon, Mona Charbel Kiwan

Walden Dissertations and Doctoral Studies

Neonatal and maternal health indicators have been impacted due to Syrian refugees’ displacement in Lebanon and an increase in child marriage rates from 13% in pre-conflict Syria to 41%. Using the causal continuum framework, the retrospective cross-sectional study’s purpose was to examine whether there is a statistically significant association between adverse maternal and birth health outcomes among Syrian refugees in Lebanon and social determinants of health. The sample size drawn from UNHCR database included 48,083 maternal and 4,288 neonatal refugees admitted to the secondary health care in 2018. Pearson chi-square and binomial logistic regression results showed that employed, newcomers mothers …

Sociodemographic Factors Associated With Childhood Vaccination Status In Sokoto State, Nigeria, Dauda Milgwe Madubu

Walden Dissertations and Doctoral Studies

Immunization remains one of the most successful and cost-effective public health interventions worldwide. Despite the critical role of vaccines in improving childhood and maternal health, Sokoto state recorded the lowest childhood vaccination completion rate among the 37 states in Nigeria with only 5% of children aged 12-23 months having had full childhood vaccination based on data from the 2018 demographic and health survey. The factors associated with the state’s low childhood vaccination status have not been explored. The study examined the relationship between the sociodemographic factors including parents’ socioeconomic and ethnoreligious factors, place of residence, and children’s biological characteristics and …

Factors Associated With Help-Seeking Behaviors Among Persons With Serious Psychological Distress, Minn A. Oh

Walden Dissertations and Doctoral Studies

Serious psychological distress (SPD) is an important individual and public health concern, but inconsistent results exist in the literature in terms of help-seeking behaviors and health-related outcomes among persons with SPD. The purpose of this study was to address this issue and understand clinical factors, access and quality of care factors, and sociodemographic factors associated with help-seeking behaviors among adults with SPD using the California Health Interview Survey (CHIS). CHIS data were collected in 2015 as a part of a two-year cycle (2015-2016) and surveyed 42,089 adults. For multivariable analyses, logistic regression analyses were performed. Participants with chronic health conditions …

Impact Of Case Management On Childhood Lead Exposure In Marion County, Indiana, Maliki Yacouba

Walden Dissertations and Doctoral Studies

The Centers for Disease Control and Prevention recently declared that no amount of childhood blood lead level (BLL) is safe. The purpose of this quantitative study with a retrospective cohort design was to evaluate the effectiveness of case management intervention on children diagnosed with elevated BLL (EBLL; ≥ 5 μg/dL) in Marion, County, Indiana. The health belief model was used as the theoretical foundation for the study. A data set of 160 lead exposure case management records was analyzed to find whether: (a) BLL at post-case-management time significantly differ from BLL at baseline (b) BLL at post-case-management time is affected …

Relationship Between Cultural And Religious Practices And Ebola Virus In Freetown, Sierra Leone, Richmond Samuel Kpange

Walden Dissertations and Doctoral Studies

The 2014 Ebola virus epidemic in the West Coast of Africa was a historically unprecedented epidemic with a sustained spread in multiple West African nations, including Sierra Leone. The World Health Organization (WHO) classified Sierra Leone as a high Ebola-affected country as it reported the highest number of deaths (14,124) during the last Ebola outbreak compared to other Ebola-affected countries. Public health experts have given little attention to the impact of sociocultural factors on infectious diseases, especially Ebola. The purpose of this study was to ascertain whether there is a relationship between the spread of EVD and a patient’s gender, …

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 …

Medication Beliefs And Behaviors Of Hypertensive Caribbean Immigrants Living In New York City, Nadia Williams

Walden Dissertations and Doctoral Studies

Hypertension remains a worldwide health phenomenon with serious health consequences including heart attack, stroke, aneurysm, and heart failure. Beliefs about medicines have been shown to influence hypertension outcomes. Medication adherence has emerged as a vital component of hypertension control and management. However, there has been limited research which addresses beliefs about medicines and medication adherence in Blacks of Caribbean origin. The purpose of this quantitative cross-sectional study was to identify the beliefs about medications held among hypertensive Caribbean immigrants living in New York City using the Beliefs about Medicines Questionnaire to identify what factors/barriers were related to these specific medication …

The Viability Of Venture Philanthropy In A Nonprofit Organization, Melissa Lindsey Perkins

Walden Dissertations and Doctoral Studies

This case study addressed the viability of a venture philanthropy approach to augment revenue at a youth-serving nonprofit organization in the U.S. state of Connecticut. Venture philanthropy as different from an outright financial donation in that the purpose of this donation is to allow the organization to start a mission-related business. The purpose of the study was to explore the perspectives of individual donors capable of making a venture-level investment to inform organizational leaders about this revenue generation strategy. The practice-focused questions concerned what a donor may want to know prior to making a venture-level investment, to what degree donors …

Living In An Oil-Polluted Region In Nigeria As A Risk Factor In Colorectal Cancer Development, Steve Nwachi Onya

Walden Dissertations and Doctoral Studies

Due to differences in exposure to various risk factors, colorectal cancer (CRC) rates differ in regions of Nigeria. Although the people living in the Southsouth, an oil-producing region, are concerned that they are most affected, there is insufficient research to address these concerns. The purpose of this quantitative ecological study was to investigate whether living in the oil-polluted region in Nigeria is associated with an excess CRC incidence rate. The potential spatial autocorrelation of CRC incidence among the contiguous regions was also examined. The study was grounded in the ecosocial theoretical framework. Data were extracted from the Nigeria National System …

Relationship Between Cultural And Religious Practices And Ebola Virus In Freetown, Sierra Leone, Richmond Samuel Kpange

Walden Dissertations and Doctoral Studies

The 2014 Ebola virus epidemic in the West Coast of Africa was a historically unprecedented epidemic with a sustained spread in multiple West African nations, including Sierra Leone. The World Health Organization (WHO) classified Sierra Leone as a high Ebola-affected country as it reported the highest number of deaths (14,124) during the last Ebola outbreak compared to other Ebola-affected countries. Public health experts have given little attention to the impact of sociocultural factors on infectious diseases, especially Ebola. The purpose of this study was to ascertain whether there is a relationship between the spread of EVD and a patient’s gender, …

Change Fatigue, Job Satisfaction, And Organizational Commitment Among Nurses, Melissa Kapping

Walden Dissertations and Doctoral Studies

The healthcare environment is complex and ever-changing, which has a direct impact on the nurse. The effects of the constant change to the nurse may result in the development of change fatigue, which causes the loss of trust in the organization, a feeling of resentment, and a sense of apprehension while depleting the individual’s reserves. The purpose of this correlational study guided by Lazarus and Folkman’s stress and coping theory was to determine if there is a relationship between (a) job satisfaction and change fatigue and (b) organizational commitment and change fatigue in nurses who work in an outpatient clinical …

Associations Between The Use Of Bed Nets And Malaria Infection On The School Performance Of Juveniles In Ghana, Ans Bumbokuri

Walden Dissertations and Doctoral Studies

Millions of malaria cases are reported yearly in sub-Saharan Africa, events which adversely influence children’s school performance. The purpose of this quantitative, cross-sectional study was to investigate the effectiveness of major malaria control policies in reducing malaria cases as a means of improving academic performance among school children in the greater Accra region of Ghana. A secondary data set was obtained from the 2014-2016 data from the Ghana Malaria Indicator Survey (GMIS). Findings indicated that bed net use and malarial episodes in children of participant recorded a p-value of 0.43 which is a significant association between the variables. The likelihood …

Demographic Characteristics And Response Preparedness Of Employed Adults To Ebola Virus Disease In Monrovia, Liberia, Beth Ann Sexton

Walden Dissertations and Doctoral Studies

AbstractEbola virus disease (EVD) is a deadly disease with no known cure and it caused an outbreak from 2014-2016 in Western Africa. Liberia had the highest morbidity and mortality; its capital city, Monrovia, was the focus of this study. The purpose of this research was to explore the association between sociodemographic and socioeconomic factors (gender, religion, age, occupation, education, and ward) and the use of preventative hygiene measures and understanding of EVD among working Monrovian adults. This population was chosen because 97% of the Monrovian population is employed, and thus serves as a good source for future public health campaigns. …

Effect Of Insecticide-Treated Nets On Anemia In Nigerian Children, Adamu Onu

Walden Dissertations and Doctoral Studies

Childhood anemia is a significant public health problem in Nigeria and frequently coexists with malaria. The mortality associated with malaria increases when anemia is present. Insecticide-treated nets (ITNs) are a cheap and effective malaria preventive measure that can provide a protective barrier from insects. There are conflicting results from several studies on the effect of ITNs on anemia in children, with fewer studies on the effect of ITNs on anemia in Nigerian children. This study aimed to measure the effect of ITN use on anemia among children aged 6–59 months in Nigeria. The social ecological model was used as the …

Predictors Of Cancer Information Seeking Among Adults With A Family History Of Cancer, Oluwakemi Akindeju Fawole

Walden Dissertations and Doctoral Studies

Cancer is a significant cause of illness and mortality in the United States. A family history of cancer is a valuable factor for assessing disease risk and increasing cancer information-seeking behaviors for prevention. Guided by the health belief model, this quantitative study addressed the predictors of cancer information seeking behavior among adults with a family history of cancer. In this study, data from 8,473 participants in the 2017–2019 Health Information Trends Analysis Survey were analyzed using multivariate logistic regression. This analysis addressed whether there was a statistically significant difference in sociodemographic factors, measures of health status, and health care engagement …

Internet Use, Perceived Social Support, And Obesity Among African American Young Adults, Cynthia Adams

Walden Dissertations and Doctoral Studies

African Americans are disproportionately affected by obesity. Public health practitioners have an incomplete understanding of the social-environmental risk factors and how they affect obesity. The purpose of this quantitative, cross-sectional study was to explore whether internet use and perceived social support predicted obesity among African American young adults. The social cognitive theory guided this study. Secondary data were analyzed from the 2017 Behavioral Risk Factor Surveillance Survey. The sample consisted of 6,765 African American young adults age 18 to 34 and represented the U.S. population using weighted estimates. A Bonferroni correction was performed to reduce Type I error due to …

Determinants Of Substance Abuse Among Users With Mental Health Issues In Ogun State, Nigeria, Michael Olusegun Adejimi

Walden Dissertations and Doctoral Studies

In Nigeria, about 14.3 million people use drugs without physician prescription and approximately 30% of Nigerians suffer from mental illness, some of which is due to substance abuse. This study examined the associations between (a) socio-demographic factors and substance abuse among users with mental health issues in Ogun State Nigeria, (b) clinical variables and substance abuse among users with mental health issues, (c) negative life events and substance abuse among users with mental health issues, and (d) social supports and substance abuse among users with mental health issues. This study theoretical framework was based on the definition of mental health …

Perspectives Of Physicians Mandated To Complete Cultural Competence Education, Wayne Mccarthy Boatwright

Walden Dissertations and Doctoral Studies

Perspectives of Physicians Mandated to Complete Cultural Competence Educationby Wayne M. Boatwright

Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in Health Services

Walden University May 2021 Abstract Studies show that ethnic and racial disparities continue to exist in health care delivery. The economics of today’s multicultural world along with changing demographics and persistence of inequality in healthcare have challenged healthcare professionals to consider cultural competency (CC) training to assist in eliminating health disparities. The purpose of this study was to identify the perspectives of physicians who were mandated to complete CC education. …

Type Ii Diabetes Mellitus Risk Factors Among African Immigrants 20 – 45 Years Old Residing In The United States, Abu Bakar Sidique Fofanah

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus is highly prevalent among African Americans. Africans born abroad are a subset of the African American population in the U.S., but few studies have been conducted on this population, a gap this study aims to close. The incidence and prevalence of type 2 diabetes continue to rise among this population. This study explored type 2 diabetes risk factors among Africans born abroad who were 20-45 years old in the U.S. This was a retrospective and quantitative cross-sectional study involving National Health and Nutrition Examination Survey (NHANES) 2013-2014 type 2 diabetes data. The total sample size was …

Receiving Positive Hiv Test Results From Home Testing And Suicidality, Nekeisha A. Hewitt

Walden Dissertations and Doctoral Studies

Limited studies have been conducted on whether receiving a positive result from at-home HIV testing correlates with suicidality (suicidal attempt or ideation). Based on the Ajzen theory of planned behavior, this cross-sectional study comprises a surveyed convenience sample of (N = 213) HIV -positive or negative adults who either tested for HIV at home or in-clinic. The purpose of this study was to explore any association between testing positive for HIV using the HIV at-home test kit and (a) suicidal attempt and (b) suicidal ideation; also, to discover any association between (c) HIV-negative and suicidality and (d) all HIV-positives …

Association Between Bisphenols, Acrylamide, Glycidamide, Fast Food, And Obesity: An Obesogenic Perspective, Morgan Murphy

Walden Dissertations and Doctoral Studies

Endocrine disrupting chemicals (EDCs) are exogenous man-made substances that have the ability to interfere with hormone action and are believed to be a contributing factor to chronic illnesses, including but not limited to obesity. Recent studies have suggested that environmental agents (environmental obesogens), such as food additives, plasticizers, and personal care products are contributors that aid in the altering of hormone receptors and hormone mimicry. Such environmental obesogens have the potential to promote adipogenesis and fat accumulation. In this study, the social-ecological model was used to determine the factors that can influence the increased exposure to obesogenic chemicals at the …

Substance Use, Mental Health Problems And Missed Appointments By Race, Gender, And Sexual Orientation Among Hiv-Infected Individuals, Abraham Adonis Anderson

Walden Dissertations and Doctoral Studies

Human Immunodeficiency Virus (HIV) disproportionately affects African American men who have sex with men. According to the Centers for Disease Control and Prevention, in 2020 African American adult and adolescent African American men accounted for 42% (16,002) of all HIV diagnoses (37,968). Furthermore, while substance use is common among this population, in previous studies very few individuals with HIV have reported receiving substance abuse treatment or discussing substance use with HIV medical providers. The purpose of this study was to examine the differences in substance use/mental health problems by race, gender, and sexual orientation among HIV-infected individuals. This study also …

Healthcare Access For Elderly African American Type 2 Diabetics On Medicare, William Alexander Floyd

Walden Dissertations and Doctoral Studies

AbstractPrior research has shown that African Americans have less access to healthcare than do White Americans. The study’s purpose was to determine the association between race/ethnicity and quality care measures in a population of Medicare recipients with Type 2 diabetes, aged 65 75 years and over. Covariates predicted satisfaction with doctor care, compassionate doctor care, and indifferent doctor care using Andersen’s health behavior theory. The Medicare Current Beneficiary Survey (MCBS) sample consisted of 1,716 people with Type 2 diabetes, with most (76.6%) being non-Hispanic Whites, and the remainder non-Hispanic Blacks (10.8%) and Hispanics (12.6%). Race/ethnicity were associated with quality-of-care measures …