Public Health Commons^™

Factors Associated With Electronic Cigarette Use Among Adolescents In Texas, Christie Anuli Okonkwo

Walden Dissertations and Doctoral Studies

The use of electronic cigarettes among adolescents has remained a major public health concern. Reports have shown that the adolescent brain is still growing and can be affected by nicotine and cancer-causing chemicals contained in e-cigarettes. The rising trend of e-cigarette use by adolescents has reportedly reached an epidemic, and there is a knowledge gap in the factors associated with this behavior and the provision of appropriate interventions for the at-risk population. The purpose of this quantitative, cross-sectional study was to investigate the association between sociodemographic factors and the tendency of Texas adolescents to use e-cigarettes. This study was a …

The Combined Impact Of Race And Education On Obesity Among U.S. Adults By Fidelis Okoye, Fidelis Chidi Okoye

Walden Dissertations and Doctoral Studies

Walden University

College of Health Professions

This is to certify that the doctoral dissertation by

Fidelis Okoye

has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made.

Review Committee Dr. Vasileios Margaritis, Committee Chairperson, Public Health Faculty Dr. Srikanta Banerjee, Committee Member, Public Health Faculty Dr. James Rohrer, University Reviewer, Public Health Faculty

Chief Academic Officer and ProvostSue Subocz, Ph.D.

Walden University2021

AbstractThe Combined Impact of Race and Education on Obesity Among U.S. Adults by Fidelis Okoye

MA, Walden University, 2009BS, Marygrove College, 2001

Dissertation …

An Examination Of The Absence Of A Comprehensive Smokefree Law In Georgia On College And University Campuses, Nakki Price

Walden Dissertations and Doctoral Studies

AbstractCigarette smoking is the number one preventable cause of death and disability in the United States. Although there are policies that govern the use of tobacco products, there are jurisdictions that do not employ these policies. Comprehensive smokefree laws govern private-sector entities and prohibit smoking in public places, specifically restaurants, bars, and workplaces. While states have the authority to implement these laws, some include exceptions that limit the intention of the law. Colleges and universities are specific communities for learning and serve as housing for students and an employer for the greater community. There is a gap in the literature …

Sociodemographic And Pregnancy Risk Factors Associated With Place Of Delivery Among Northern Nigerian Women, Daniel Ali

Walden Dissertations and Doctoral Studies

AbstractOne out of every 13 women in Nigeria die during childbirth. In Nigeria, over 60% of deliveries that take place at home were attended to by an unskilled person. This study involved using Thaddeus and Maine’s three delays model to determine the influence of sociodemographic factors (woman’s age, woman’s residence [rural/urban], woman’s and husband’s education level, husband’s occupation, household wealth), pregnancy risk factors (antenatal care usage, wanted pregnancy, and birth order) on the choice of place of delivery amongst women of reproductive age (15-49 years) in Northern Nigeria. This quantitative cross-sectional study used the National Demographic Health Survey of 2018. …

Domestic Abuse Against Men In Kenya, Catherine W. Kigaya

Walden Dissertations and Doctoral Studies

Domestic violence, also known as intimate partner violence (IPV), is prevalent globally and causes severe physical, psychological, and social harm to victims. The purpose of this quantitative cross-sectional study was to highlight the predictors of physical and sexual IPV among men in Kenya and examine the influence of media in seeking help. These factors were explored through the lens of the socio-ecological model and the social learning theory. The 2014 Demographic Health Survey archival data obtained through in-depth interviews were used to answer the research questions. Dependent variables were physical abuse, sexual abuse, and seeking help while independent variables were …

Nigerian Pensioners’ Knowledge, Attitudes, And Beliefs About Type 2 Diabetes, Nnawuihe Ugochukwu Nwosu

Walden Dissertations and Doctoral Studies

AbstractDiabetes is one of the leading killer diseases globally, and it is on the rise, especially in developing countries like Nigeria. The high prevalence of undiagnosed Type 2 diabetes in developing African countries has been attributed to a lack of knowledge and awareness about the disease, unbelief in modern healthcare efficacy, and limited healthcare services access. The purpose of this study was to explore the knowledge, attitudes, and beliefs about Type 2 diabetes among pensioners in Nigeria. A qualitative phenomenological research design was used for the study. The constructs of the health belief model formed the study’s theoretical framework. Data …

A Study Of Public Awareness About The Threat Of Earthquakes, Mike Allen

Walden Dissertations and Doctoral Studies

Noticeably absent from the existing literature was a correlation study which would have gauged individual awareness for earthquakes. The literature search provided one quantifiable narrative that correlated college education with awareness about earthquakes; the study found that college graduates scored higher points on the awareness test for earthquakes than their counterparts who had no college education. The research question for this study examined the possible correlations between personal characteristics and awareness about earthquakes. A survey was developed and used to find hypothesized correlations between public awareness and a number of variables such as age, gender, education, income, and professional leadership. …

Why African American Men Diagnosed With Chronic Obstructive Pulmonary Disease Continue To Smoke, Vashonda Laniece Allen

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this research was to explore why some African American men diagnosed with chronic obstructive pulmonary disease (COPD) continue smoking following their diagnosis. The theory of planned behavior (TPB) guided the development of this research. The research questions were developed to understand the attitudes, behavioral intentions, subjective norms, social norms, perceived power, and perceived behavioral control that influence their continuing or quitting smoking based on the TPB model. The study’s research method was qualitative. A pilot study, using the same criteria as the main study, confirmed the reliability of the interview guide. Participants were informed about the study …

Understanding Female Somali Noncollege Graduate Immigrant’S Experiences With Cervical Cancer Screening Services, Rachel Anyu Anyu-Lainjo

Walden Dissertations and Doctoral Studies

AbstractHealthcare disparities exist in cervical cancer screening worldwide particularly in women of East African descent compared to non-African women. Previous research has investigated the reasons for low participation in cervical cancer screening among Blacks, minorities, and immigrant populations. Limited research has focused on immigrant women in the United States of America, specifically immigrants from Somalia who currently live in St. Cloud, Minnesota. The purpose of this qualitative study was to understand the perception of Somali immigrant women ages 25 - 45 years who have not earned a college degree and their lived experiences with cervical cancer screening. Two conceptual frameworks …

Sociodemographic Factors, Socioeconomic Factors, And Teenage Pregnancy Outcomes In Guyana, Karen Roslyn Cummings

Walden Dissertations and Doctoral Studies

Teenage pregnancy, a global phenomenon is associated with adverse pregnancy outcomes, owing to the mother’s individual factors, location, education attainment, and service accessibility. Globally, 16 million babies are born to teenage mothers annually. In Guyana, there is a paucity of information on factors associated with teenage pregnancy rate which stands at 74 per 1,000, and its outcomes. Archived data from the 2014 UNICEF Multiple Indicator Cluster Survey 5 (MICS5) was used to identify and examine relationships between the sociodemographic, socio-economic factors, and teenage pregnancy outcomes in Guyana. This quantitative cross-sectional review approach guided by the Bronfenbrenner theoretical framework analyzed data …

Subclinical Stress On Obesity Among Obese African American Women, Dr. Nosakhare Osasu Idehen

Walden Dissertations and Doctoral Studies

AbstractObesity is a complex disease linked to genetics, health behaviors, upstream social determinants of health, and psychosocial stress. Obesity-related chronic diseases and opportunity cost significantly impact individuals and communities. Current prevention policies focus on diet and exercise without demonstrating the benefits of stress coping strategies in obesity management. Subclinical racial minority and gender stress heighten hypervigilance, psychological overload, poor stress coping strategies, inflammation, and obesity. Subclinical stress varies with race and gender, and it is higher in African American (AA) women. The purpose of this qualitative study was to explore the lived experience of subclinical racial minority and gender stress …

Hpv Vaccination Rates Among Males In Minority Populations, Andrew Lemke

Walden Dissertations and Doctoral Studies

Ethnic minorities are less likely to be vaccinated in comparison to White individuals. As a result, Blacks have one of the highest rates of human papillomavirus (HPV)-related complications. The purpose of the quantitative study was to identify significant factors predicting initiation of HPV vaccination in Black male adolescents. The study was based on the constructs of Ajzen’s theory of planned behavior and used a cross-sectional design that involved weighted data from the 2018 National Immunization Survey (n=395,067) conducted by the Centers for Disease Control and Prevention. The research questions were based on how factors such as fear, family involvement, sexual …

Addressing Cardiovascular Disease Among Populations Disproportionately Impacted In The United States, Michael Leron Sells

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) causes the most deaths in the United States and is disproportionately impacting certain groups more than others. A gap in the research exists when focusing on national data for those who bear the highest burden of CVD amongst people with hypertension when cardiovascular morbidity and mortality are examined. There is also a need to investigate the relationships between key indicators for CVD health disparities in people with hypertension. The purpose of this quantitative study is to investigate the cumulative effect of key health disparities indicators such as race, age, gender, education, and income using national-level surveillance data …

Retention, Viral Suppression, And Care Models In Hiv Positive Children And Adolescents In Cameroon, Eveline Mboh Khan

Walden Dissertations and Doctoral Studies

Human Immunodeficiency Virus (HIV) remains a significant public health problem in Sub-Saharan Africa with poor treatment outcomes in children and adolescents (C&As). There is a lack of information on the effects of various HIV care models (Child and Adolescent Friendly Clinic model and Support Group model) on retention in care and Viral Suppression (VS) in Cameroon. This study was carried out to identify the care model with the best outcomes for C&As, inform national scale-up strategies, resource prioritization, and contribute to the existing literature. A quantitative retrospective cohort review approach guided by the social cognitive theory was used to analyze …

An Interpretive Qualitative Study Of Idaho Head Start Families Facing Food Insecurity, Sherry Deiter

Walden Dissertations and Doctoral Studies

The purpose of this basic interpretive qualitative study was to examine food insecurity among Idaho Head Start enrolled families, focusing on barriers and deterrents to accessing available nutrition assistance programs. The social-ecological model (SEM) was used as the theoretical foundation for this study. Based on this model, the research questions were designed to explore experiences of participants related to individual, interpersonal, community, organizational, policy, and educational factors that influenced food insecurity. Parents who had children enrolled in Idaho Head Start programs that met purposeful sampling criteria were recruited for the study. A total of 11 parents, all who had experiences …

Evaluating Integrated Treatment On Recidivism For Female Offenders In Criminal Justice System, Oyin T. Popoola

Walden Dissertations and Doctoral Studies

The burden of co-occurring disorders (CODs) among offenders in the criminal justice system (CJS) in the United States, particularly among the female population, is threatening the communities. About 80% of women in the CJS were diagnosed and treated for CODs, and 63% tend to be rearrested. The study examined the possible influence of CODs, integrated treatment of CODs, and gender, on recidivism while controlling for other demographic factors. The study was based on the conceptual framework of integrated dual disorder treatment (IDDT) and feminist criminology theory. Cross-sectional quantitative study design was applied on a secondary dataset from the 2017 Treatment …

Sexual Orientation, Body Mass Index, And Methamphetamine Use Among Chicago Youth, Nileshkumar Panchal

Walden Dissertations and Doctoral Studies

Drug use and obesity are two of the most challenging health-related issues that young people face. Obesity, substance abuse, and drug addiction lead to brain dysfunction, which can decrease the quality of life and academic performance as well as increase the vulnerability of developing chronic diseases. To date, there has been little research to determine whether sexual orientation influences the relationship between body mass index (BMI) and methamphetamine use. Focusing on youth, the relationship between BMI, methamphetamine use, and sexual orientation were examined in this study through secondary data analysis of the Youth Risk Behavioral Surveillance System in Chicago. Guided …

African American Maternal Mortality In The United States: A Quantitative Analysis Of Chronic Disease And Maternal Deaths, Glory Inyang

Walden Dissertations and Doctoral Studies

African American women have higher rates of chronic disease including diabetes and cardiovascular related disease compared to White women and are 3 to 4 times more likely to die during childbirth, more than any other ethnic group in the United States. . When African American women become pregnant these conditions may influence their maternal health outcomes. This study aimed to determine difference in pregnancy related death associated with chronic conditions between African American women and White women. Based on secondary/archival data from the Center for Disease Control and Preventions' 2017 National Center for Health Statistics Mortality Multiple Cause Files a …

The Caregiver Advise Record And Enable (Care) Act And Compassion Fatigue In The United States, Karen Marie Johnson

Walden Dissertations and Doctoral Studies

The transition from hospital to home can be complicated, leaving family caregivers in stressful situations that they may not know how to handle. The burden that is placed on these individuals has led researchers to focus on the public health implications of caregiving in hopes of identifying at-risk caregivers. This quantitative analysis identified what relationships exist between caregiver compassion fatigue among family caregivers and training or education received per the Caregiver Advise Record and Enable (CARE) Act and if education influences readmission rates. A purposive sample of 385 family caregivers participated in this study. The Care Transitions Measure (CTM-15), the …

Tetanus Immunity Among Adults In The Democratic Republic Of The Congo, Sue K. Gerber

Walden Dissertations and Doctoral Studies

Although tetanus is not a contagious disease, it can be deadly for people who are exposed and do

not have protective immunity against tetanus, which can be acquired only through vaccination.

Most studies on adult tetanus protective immunity are from high-income countries; limited

studies occur in Africa, and none has been reported from the Democratic Republic of the Congo

(DRC). This study sought to determine protective immunity against tetanus among adults in

DRC in relation to their age, sex, place of residence, and for women, antenatal care. The primary

purpose of this observational cross-sectional study using a nested serosurvey within …

Meat Intake And Prostate Cancer In African American Men, Uchenna Njoku

Walden Dissertations and Doctoral Studies

African American men have more prostate cancer and are more than twice as likely to die of the disease as Caucasian men, and the reasons for this racial disparity have not been clarified. Identifying lifestyle and dietary risk factors of prostate cancer is an important public health issue. Studies on the association between meat intake and prostate cancer risk have produced inconsistent results. The purpose of this cross-sectional quantitative study was to determine whether there is an association between total meat intake and total prostate cancer risk among African American men when controlling for age, income, educational level, physical activity, …

Behavioral, Demographic, And Clinical Determinants Of Hiv Serostatus In Zambian Women, Debebe Masresha Gebreyohannes

Walden Dissertations and Doctoral Studies

The rate of human immunodeficiency virus (HIV) infection shows a diminishing trend at the global level while it shows increasing in intensity of mortality, morbidity, and burden in Sub-Saharan Africa. The intertwined behavioral, demographic, and clinical determinants fueled the incidence of infections in Zambian women. The purpose of this study was to determine the association between demographic, behavioral, and clinical determinants with HIV serostatus in Zambian women. With the conceptual framework of the World Health Organization’s Commission for Social Determinants of Health (CSDH) and quantitative method of MANOVA, this study examined Zambian Demographic Health Survey data for Zambian women of …

Impact Of Education On Hiv Testing Among African American Women In The United States, Florence Matimbah Mbangowah

Walden Dissertations and Doctoral Studies

Improved and increased human immunodeficiency virus (HIV) testing among African American women in the United States could facilitate early detection of the virus. The purpose of this cross-sectional quantitative study was to determine if there was a significant association between HIV testing participation and education level (i.e., high school, college, post-college level) based on access to healthcare after accounting for insurance, income, employment, marital status, English language proficiency, and vision quality. The integrated theory of health behavior change, the theoretical framework used for this research, proposes that changes in health behavior can be improved by various factors such as fostering …

Sociopolitical Determinants Of Parental Acceptance Of Childhood Vaccination In Abuja, Nigeria, Lawrence Madu Ohammah

Walden Dissertations and Doctoral Studies

Despite the efficacy of vaccines, some parents still reject vaccination of their children, resulting in low vaccination coverage, a greater burden of vaccine-preventable diseases, and high infant mortality. The purpose of this study was to investigate the sociopolitical determinants of vaccination status among children, aged 0-24 months, and identify the factors that drive vaccine hesitancy. The social ecological model served as the theoretical framework. The study research design was a quantitative cross-sectional survey. An interviewer-administered questionnaire was used to collect primary data from parents and caregivers in 384 randomly selected households from 48 settlements in the Abuja Municipal Area Council. …

Hiv Positive African American Women’S Lived Experiences And Clinical Outcomes, Christie Olejemeh

Walden Dissertations and Doctoral Studies

African American (AA) women are disproportionately affected by HIV/AIDS. The infection rate for AA women continues to increase, and literature lacks information specifically on education for AA women regarding viral suppression at diagnosis. The purpose of the study was to understand the lived experiences of AA women living with HIV in the District of Columbia, particularly how they acquired knowledge of viral suppression. To understand their experiences with antiretroviral medications, viral suppression, discrimination, and stigma, this qualitative study applied a hermeneutic phenomenological approach. The theories of resilience and empowerment were applied. Ten HIV positive AA women living in the District …

Guidelines For Chronic Back Pain: An Education Module For Health Providers, Ron Pascual

Walden Dissertations and Doctoral Studies

Effective chronic back pain management and patient self-care guidelines are necessary for healthcare providers treating patients with complaints of low back pain (LBP). The purpose of this doctoral project was to provide an evidence-based educational program aimed at improving the knowledge and skills of healthcare professionals regarding the Center for Disease Control (CDC) and American Chronic Pain Association (ACPA) guidelines, emphasizing alternative pain management treatments. The staff education project was supported by the biomedical pain model and chronic care model. A panel of 3 experts including the clinic’s board-certified anesthesiologist and pain management specialist, clinical manager, and leading medical director …

Exploring Health Literacy In The Acute Care Setting In A Rural Border Region, Shiloh Williams

Walden Dissertations and Doctoral Studies

Health literacy is important to ensuring patients have the necessary knowledge and skills needed to actively participate as a member of their own healthcare team. Patients with low health literacy are at increased risk for poor outcomes and limited participation in decisions affecting their health or treatment plan. Using the Social Ecological Model (SEM) as a framework, the purpose of this study was to determine the relationship between medical-surgical registered nurses, medical-surgical patients and the registered nurse’s (RN) assessment of their patient’s health literacy of those who live in a rural-border region. The study’s sample consisted of 84 pairs of …

Risk Factors For Polysubstance Abuse: A National Secondary Data Analysis Study, Dakota Mcmurray

Walden Dissertations and Doctoral Studies

Substance abuse is a serious public health problem in the United States and globally. Abuse of more than one substance is considered polysubstance abuse and can cause more harm than abuse of only one substance. Polysubstance abuse compounds the problems of addiction because of the variety of substances that may be used and the resulting side effects. This quantitative cross-sectional secondary data analysis, guided by the socio-ecological theory, assessed patient characteristics and how predictive they were for polysubstance abuse. The study sample of 986 patients was analyzed by binomial logistic regression to assess the association between patient-related factors and polysubstance …

Use Of Managerial Epidemiology By Healthcare Leaders In Ambulatory Settings, Chantelle Schenning

Walden Dissertations and Doctoral Studies

Despite many health reforms, the United States continues to struggle with limited healthcare access, exponential healthcare costs, and poor quality of care. Overcoming these challenges requires healthcare leaders’ effective navigation of industry transformation towards population health and a shift in patient volume to ambulatory healthcare settings. Research has demonstrated that the use of managerial epidemiology, an application of epidemiology tools and principles to management decision-making within healthcare organizations, can better serve the health of the population and could improve the triple aim of inadequate access, high costs, and poor quality. However, the adoption of this practice is weak and its …

Effectiveness Of An Educational Intervention To Reduce Preanalytical Specimen Errors, Carol Ann Lineberry

Walden Dissertations and Doctoral Studies

A rejected blood specimen can be very costly to a hospital as well as to the patient. Many errors occur in the preanalytical phase in which nurses and assistive personnel are often involved because they are usually not trained to do so. This staff education project was designed to decrease the number of laboratory rejections of blood specimens in a local hospital setting. Knowles’s adult learning theory was combined with the knowledge translation framework, proposed by Fredericks, Martorella, and Catallo, so that evidence-based changes in practice could occur more readily. There is a 20-minute in-service educational intervention followed by an …