Public Health Commons^™

Effect Of Reduced-Fee Dental Hygiene Treatment And Oral Health Perceptions Among Socioeconomically Deprived Persons, Janeime Necole Asbury

Walden Dissertations and Doctoral Studies

Access to oral health care remains problematic for millions of Americans. Factors such as socioeconomic status, age, race, and lack of dental insurance benefits inhibit the ability of many to obtain preventative oral health care. The aim of this study was to explore the effect of preventive oral health treatment and education at reduced-fee dental hygiene facilities on the oral health behaviors and perceptions of socioeconomically deprived persons within the state of Georgia. This study was based on the health belief model constructs. A convenience sample of 102 participants was recruited from the individuals who visited two dental hygiene colleges …

Gestational Age, Birth Weight, And Incidence Of Adult Type 2 Diabetes Among Southeast Alaska Natives, Renee Elaine Crawford

Walden Dissertations and Doctoral Studies

American Indian and Alaska Native adults are 2.6 times more likely to have adult onset diabetes resulting from higher weight at birth. Pregnant women, providers, and Indian Health Service administrators may benefit from timely information during pregnancy to intervene and prevent Type 2 diabetes. The purpose of this study was to examine the role of birth weight in the development of Type 2 diabetes among Southeast Alaska (SEA) Natives. Guided by the socioecological model, this study examined the extent to which birth weight and gestational age predict the incidence of Type 2 diabetes. The study used a quantitative research design …

Self-Efficacy And Self-Management Assessments On Hispanic Patients With Diabetes, Yesenia Dejesus

Walden Dissertations and Doctoral Studies

Hispanics are at increased risk for diabetes and are 40% more likely to die from the condition than are non-Hispanic Caucasians. The purpose of this project was to determine the effects of diabetes education conducted in Spanish by bilingual staff on the self-management and self-efficacy of a sample of 50 volunteer adult Hispanic clinic patients with diabetes. The education intervention incorporated the American Diabetes Association's Diabetes Self-Management Education program materials. Bandura's self-efficacy theory was selected as the theoretical support for the project that relied on self-management education of the patients to improve their self-efficacy to undertake the interventions necessary to …

Wellness Intervention As A Quality Of Life Predictor In Mentally Ill Veterans, Tosha Lashon Ellis

Walden Dissertations and Doctoral Studies

Veterans with serious mental illness (SMI) are at high risk of developing conditions such as insulin resistance, obesity, and smoking, which may lead to chronic medical problems. As a result, the morbidity and mortality of people with SMI are high compared to the general population. It appears that integrated care improves the wellbeing of veterans; however, there is a gap in the literature on wellness-based interventions for veterans with SMI. The purpose of this cross-sectional study was to evaluate the association between a wellness intervention for veterans and their perceived quality of life (QOL). Social cognitive theory was the theoretical …

The Lived Experiences Of Hiv+ Community Health Workers Serving Hiv+ Clients, Phronie Lynn Jackson

Walden Dissertations and Doctoral Studies

Numerous studies have focused on the effectiveness of community health worker (CHW) programs in producing positive health behaviors and health outcomes for the clients CHWs serve; however, there has been a gap in the literature regarding how the health of HIV + CHWs is impacted by their jobs. A phenomenological design was used to gain insight into the lived experiences of HIV+ CHWs (HIVCHW) who provided services to HIV positive clients. Fifteen HIVCHW were recruited using criteria and snowball techniques. Data were collected via audio recorded personal interviews regarding respondents' perceptions of their work and how it impacted their own …

Heroes Or Victims: The Lived Experiences Of Women On Female Genital Mutilation/Cutting In Northwestern Nigeria, Sarah Kasham Philips

Walden Dissertations and Doctoral Studies

The custom of female genital mutilation/cutting (FGM/C) is a traditional practice inimical to women's health with profound implications. There is a gap in the literature on the lived experiences of women who have undergone FGM/C and their statuses within their communities. Guided by the social cognitive theory and the ecological model, this qualitative study aimed at explicating the attitudes and perceptions of women in the northwest region of Nigeria towards the practice of FGM/C, to illuminate how the women view themselves in their society and the inspiration for the continued practice of FGM/C. Interview and observation data were gathered from …

Health Care Provider Perceptions Of High Blood Pressure Screening For Asymptomatic African American Teens, Juanita Braxton

Walden Dissertations and Doctoral Studies

Health care provider perceptions of typical practices play a significant role in evaluating the efficacy of screening and diagnosis of teen high blood pressure in African Americans. African American adults are more likely to develop high blood pressure than are any other ethnic group; however, there is a gap in the literature concerning high blood pressure in teens. Approximately 1 to 5 of every 100 children has high blood pressure. This purpose of this phenomenological study was to explore the perspectives of health care providers on high blood pressure screening and diagnosis of African American asymptomatic teens. The health belief …

The Relationship Between Health Risk And Workplace Productivity In Saudi Arabia, Sarah Lorraine Hayman

Walden Dissertations and Doctoral Studies

Rising worldwide rates of noncommunicable diseases (NCDs) in the Middle East, principally Saudi Arabia, have put an increasing load on the health system and employers. Middle Eastern organizations have been slow to develop targeted health programs, which include an emphasis on employee productivity. The purpose of this study was to determine the relationship, if any, between employee lifestyle and workplace productivity. Productivity is the amount of work produced based on the time and cost required to do so. The underlying theoretical foundations of this research were the socioecological health model and the human capital model. The quantitative, ex post facto …

Hospital Preparedness: Effects Of Designated Preparedness Coordinators On Hospital Preparedness For Special Hazard Classes, Rodney Sinelair Jones

Walden Dissertations and Doctoral Studies

Since 9/11, little statistical rigor has been placed on identifying the correlates of hospital preparedness. This quantitative study explores the research question: Is there a correlation between the employment of a designated hospital preparedness coordinator and the reported level of preparedness for: (a) general preparedness; (b) chemical, biological, radiological, and nuclear (CBRN) events; (c) pandemic disease outbreaks; (d) mass casualty events; and (e) internal infrastructure failure, as assessed by an online survey. Alternative analysis was conducted to assess the relationship between access to resources and the 5 dependent variables. Using complexity theory as the theoretical framework, point biserial correlation and …

Perception Of Nutrition And Utilization Of Healthy Food Ideas When Making Food Choices., Judy Pilgrim-Hector

Walden Dissertations and Doctoral Studies

The availability of nutrition information is an important aspect of health care and equally important is access to cultural and theoretical nutrition evidence to increase awareness on ways to manage a diet in ethnic communities. The problem was the shortage of culturally appropriate nutrition data to educate Caribbean immigrants. The purpose of the study was to acquire culturally profound nutrition information on Caribbean immigrants' distinctive philosophical perception on nutrition and food choices. A phenomenological approach was used to examine ways in which the participants integrate nutrition facts when making food choices. The theory of reasoned action was the main conceptual …

Hiv/Aids-Related Stigma And Discrimination Toward Women Living With Hiv/Aids In Enugu, Nigeria, Chinyere Fidelia Nnajiofor

Walden Dissertations and Doctoral Studies

HIV/AIDS-related stigma and discrimination (S&D), lack of social support, poverty, and gender inequalities have been identified as factors in the increased prevalence rate of HIV transmission in Enugu, Nigeria, especially among women ages 15 to 49 years. Despite the funding of reduction programs, HIV/AIDS-related S&D remain a major driving force in the increased rate of new HIV cases in Enugu. This study addressed a perceived need for behavioral change intervention approaches that span all societal factors to reduce the HIV infection rate in Enugu Nigeria. The study was guided by Goffman's (1963) social S&D theory. The sample was composed of …

Nigerian Cancer Survivors' Perceptions Of Care Received From Health Care Professionals, Olusegun Akinsuli

Walden Dissertations and Doctoral Studies

Cancer patients worldwide receive care from multidisciplinary teams, and patients

sometimes have little or no knowledge about the different treatment options available, making communication with their care providers an important influence in how they perceive their care. Patient satisfaction with care is an important factor in determining survivorship. The increasing prevalence of cancer worldwide has become a huge public health issue. The World Health Organization has warned that the potential gains from combatting infectious diseases in Nigeria might be lost because of the increasing prevalence of cancer. The purpose of this grounded theory study was to obtain the perceptions of …

Perceptions Of Employed People With Narcolepsy, Chantelle L. Jones

Walden Dissertations and Doctoral Studies

Many companies have used perceptions of their employees to understand how sleep disorders affect their working environment. Sleep disorders have had an undesirable effect on employee performance and often result in employee modifications to accommodate their condition in the workplace. Though information is available concerning employees' experiences pertinent to working with sleep disorders, research focusing on how employees with narcolepsy perceive their work environment appears to be missing from the literature. The purpose of this study was to gain understanding of perceptions of employees with narcolepsy about their work environment and strategies that may influence others to promote positive health …

Experiences Of Heterosexual Couples Who Undergo Hiv Counseling And Testing In Nakuru-Kenya, Stephen Kinyua Mucheke

Walden Dissertations and Doctoral Studies

The increase in new human immunodeficiency virus (HIV) infections among heterosexual couples in Africa may reverse the gains made by HIV prevention programs. HIV screening among such couples remains low and understudied.This qualitative study focused on the motivations for HIV screening among heterosexual couples. The primary research goal was to examine the lived experiences of heterosexual couples who were screened for HIV and received their results in Nakuru-Kenya. The health belief model (HBM) served as the theoretical framework and as a basis for the secondary questions which sought to explore the participants' perceptions on HIV based on the constructs of …

Bone Health Education For Osteoporosis Risk Reduction In Premenopausal Women: A Quality Improvement Project, Gloria Nichols Nichols

Walden Dissertations and Doctoral Studies

In the United States, about 8.5 million women live with osteoporosis. Osteoporosis is a debilitating systemic skeletal disorder characterized by low bone mass and reduced bone mineral density that occurs with the loss of estrogen. The mortality rate for this group is about 3 to 4 times higher than other women and as many as 1 in 3 experience a fracture. Guided by the Health Belief Model, this project evaluated how a bone health fact sheet impacts knowledge about osteoporosis and self-efficacy for preventative behavioral change in premenopausal women (age 40-58 years). The project also evaluated if an electronic medical …

Effectiveness Of Cognitive Screening For Heart Failure Patients, Comfort Nkengla

Walden Dissertations and Doctoral Studies

Cognitive impairment is commonly seen in the elderly population. It is unclear if cognitive deficit in heart failure (HF) patients is a primary factor for higher hospital readmission rates in this population. The Centers for Medicare and Medicaid Services have established strict guidelines for reimbursement on readmissions that occur within 30 days. It is imperative that organizations identify and rectify issues that impact readmissions. The aim of this project was to determine if there is a reduction in HF readmission after patients are screened for cognitive impairment. Orem's self-care model guided the project by providing a framework of inquiry regarding …

Relationship Between Nurse Training And Physical Restraints In Nursing Homes, Terah Tessier

Walden Dissertations and Doctoral Studies

According to the Centers for Medicare and Medicaid Services (CMS), approximately 1.3 million U.S. residents are residing in nursing homes. CMS enforced regulations in the Nursing Home Reform Act. Training in the use of restraints in nursing homes is monitored through the CMS standards. The purpose of this study was to determine whether there was a correlation between training standards of health care practitioners and their use of restraints in nursing homes based on the patterns of citations by RNs and CNAs. Data were collected from Kansas, Louisiana, and Ohio within the CMS Nursing Home Data Compendium. The key research …

African Americans' Understanding Of The Provisions Of The Affordable Care Act, Ewang Theo Epie-Alobwede

Walden Dissertations and Doctoral Studies

African Americans as a group tend to have numerous health issues, and by the time they seek healthcare, the conditions often advance into more serious ailments. Researchers have shown that cultural distrust of the U.S. healthcare system coupled with some discriminatory practices has hindered African Americans seeking care and taking full advantage of the healthcare system. With the introduction of the Patient Protection and Affordable Care Act (ACA), there is some confusion about the application of the law, resulting in many intended beneficiaries misinterpreting it, and not accessing quality healthcare. This interpretive phenomenological study explored how African Americans in the …

Perceptions Of Stroke Risks Among West African Male Immigrants In San Diego, Lawrence Agi

Walden Dissertations and Doctoral Studies

The incidence and knowledge of the risk factors of stroke across ethnic groups in the United States have been examined in multiple studies. However, it is not well known if the foreign-born African immigrants who constitute about 4% of the U.S. immigrant population are at a higher risk of the incidence of stroke than are other nonimmigrant population in the U. S. This ethnographic study explored the perceptions of Anglophone African male immigrants residing in San Diego on the risk factors of stroke. The theoretical framework for this study included the health belief model and the health promotion model. Data …

Incidence And Factors Associated With Nonalcoholic Fatty Liver Disease Among Patients With Rheumatoid Arthritis, Ani K. John

Walden Dissertations and Doctoral Studies

Nonalcoholic fatty liver disease (NAFLD) has become one of the most common hepatic diseases worldwide, making the diagnosis and management of NAFLD an emerging public health issue. Theories associated with NAFLD surmise that inflammation may be the root cause, along with the complex interplay of other chronic conditions such as obesity, metabolic syndrome, diabetes, dyslipidemia, and cardiovascular disease (CVD). It is unknown if other inflammatory conditions such as rheumatoid arthritis (RA), along with the use of methotrexate (MTX), might confer increased risk for NAFLD. Longitudinal data collected from a retrospective cohort of 17,481 adult RA patients in the United States …

Obesity Among Women In Rural Kenya: Knowledge, Beliefs, And Perceptions., Ann Mugo

Walden Dissertations and Doctoral Studies

Obesity or being overweight is a prevalent health concern around the world. Despite the growing problem in developing countries such as Kenya, there is scant literature available on obesity or being overweight among women in rural Kenya. This research study provides information necessary for bridging the gap in understanding the perceptions, beliefs, and knowledge of obesity among women in rural Kenya. This study used the social cognitive theory (SCT) framework to assist in understanding the impact of obesity or being overweight among women living in rural Kenya. Participants were women aged 20 to 45 recruited from a local church in …

Factors Associated With Primary And Secondary Sexual Transmission Of Hiv In Concurrent Relationships In Kenya, Daphne Parker

Walden Dissertations and Doctoral Studies

This phenomenological study was designed to understand the lived experiences of a purposive sample of 9 participants from local villages in Nairobi, Kenya, who had sexual behaviors that contributed to higher HIV risk exposure. Past studies have provided information about the increased rates of HIV infection; however, little has been done to identify the solutions for minimizing the negative impact of HIV among concurrent partnerships. The study investigated the role of high risk cultural practices among participants in married and cohabitating unions. The conceptual framework of the study was gender and power theory, which addresses the complex sexual relationships between …

Complexity Of Prostate Cancer Diagnosis In African American Men In The United States, Adam B. Sumlin

Walden Dissertations and Doctoral Studies

Researchers have identified higher incidence rates and mortality rates among African American men (AAM) diagnosed with prostate cancer than they have among urban African American men. This quantitative descriptive study was conducted to measure the association between advanced stage and grade of prostate cancer, demographic location, and prostate specific antigen (PSA) levels over a 5-year period in AAM and European American men (EAM) in rural versus urban communities. This study addressed 4 research questions concerning cancer grade, cancer stage, age, geographic location, PSA level, and the impact that each of these variables had on prostate cancer diagnosis in AAM in …

Chiropractic Student Infection Control Practices And Methicillin-Resistant Staphylococcus Aureus Skin Infections, Jonathon Todd Egan

Walden Dissertations and Doctoral Studies

Chiropractic training involves many hours of skin contact, and chiropractors have manual contact with millions of patients annually, but chiropractic has only had professional clinical hygiene guidance since 2010. Methicillin-resistant Staphylococcus aureus (MRSA) is the most common cause of cultured skin and soft tissue infection (SSTI) in the United States. Using the epidemiologic triad of person, place, and time as a framework, this quantitative, cross-sectional study obtained the first assessment of MRSA SSTI incidence among chiropractic students and its association with infection control behaviors (hand and table hygiene, sharing gowns, and sharing lotion) and initiation of patient care. The study …

Acculturation, Inflammation, And Depression Among Hispanic Adults In The United States, Kristin Marie Marano

Walden Dissertations and Doctoral Studies

Disparities exist in the recognition and treatment of depression among Hispanics in the United States, creating a social, ethical, economic, and public health burden. This study was designed to generate an improved understanding of the causes of and/or contributors to depression within this population. It was specifically designed to 1) assess the prevalence and severity of depression among Hispanic adults in the United States relative to adults of other race/ethnicities in the United States; 2) clarify the inconsistent results in the literature concerning the relationship between acculturation and depression among Hispanic adults in the United States; and 3) fill a …

Associations Between Healthcare Facility Types And Healthcare-Associated Infections, Aretha D. Miller

Walden Dissertations and Doctoral Studies

Healthcare-Associated Infections (HAIs) continue to be an epidemiological issue burdening patients and public health systems worldwide. The purpose of this study was to determine if specific healthcare facility types (Acute Care Hospitals, Long Term Acute Care Hospitals, and Inpatient Rehabilitation Facilities) were associated with particular categories of HAIs: Ventilator-Associated Pneumonias (VAPs), Central Line-Associated Bloodstream Infections (CLABSIs), and Catheter-Associated Urinary Tract Infections (CAUTIs). The theoretical framework for this study was the environmental determinants of infectious disease framework. A single research question focused on whether an association existed among the specified health care facility types and HAIs. Three independent categorical variables were …

Asthma Determinants, Health Care Utilization, And Control Among Women In Puerto Rico, Maria Calixta Ortiz-Rivera

Walden Dissertations and Doctoral Studies

Active asthma and asthma-related health care utilization are higher among adult females than they are among adult males in Puerto Rico. The purpose of this study was to examine the determinants of the risk of active asthma and associated health care utilization and asthma control among women in Puerto Rico. Guided by the Andersen behavioral model, the study included data from the Asthma Call-Back Survey (ACBS) during 2011 and 2012 in Puerto Rico. The associations between active asthma and behavioral, demographic, and environmental factors were assessed using logistic regression. The relationship between asthma-related health care utilization and predisposing, enabling, and …

Use Of Maternal Health Services And Pregnancy Outcomes In Nigeria, Abubakar Sadiq Umar

Walden Dissertations and Doctoral Studies

Maternal health services (MHS) provide primary, secondary, and tertiary levels of prevention to achieve better pregnancy outcomes. However, use of prenatal and natal services among Nigerian women has been ranked among the lowest in the world and, consequently, the country is among the 10 countries with the highest maternal mortality ratio. Moreover, nationwide community-based studies on the use of maternal health services in Nigeria are limited. To address this gap, this quantitative, cross-sectional study analyzed the 2008 Nigerian Demographic and Health Survey (NDHS) data to identify whether Nigerian women's biological, cultural, and socioeconomic characteristics are associated with their use of …

Analyzing Interrelationships Between Food Safety Practices And Inspections Among Food Staff In Manitoba, Kirandeep Kaur Brar

Walden Dissertations and Doctoral Studies

The incidence and prevalence of food safety practices among food staff working in food establishments in Manitoba is underrepresented and has not been adequately reviewed and researched. Uncertified food staff are at higher risk of not following food safety practices that can cause contamination of food and result in foodborne illness. The purpose of this quantitative study was to determine the prevalence of food safety practices among food staff in Manitoba and to determine the relationship between food safety certification and routine health inspections. Pender's health promotion model and Bandura's social cognitive theory were used to explain the relationships and …

What Are The Perspectives Of Osteoporosis Screening Among Black Women?, Angela Alsberry Wilkins

Walden Dissertations and Doctoral Studies

Osteoporosis is a serious disease which often brings pain, disability, hospitalization, and even death. An increasing number of studies have been conducted on the prevention and treatment of osteoporosis in White women, yet a paucity of research exists to explain disparities in screening and treatment of osteoporosis in Black women. This narrative study describes the perspectives of Black women regarding individual barriers to osteoporosis screening. The purpose of this study was to better understand the perspectives of Black women regarding prevention of and screening for osteoporosis. Selections included purposive, criterion sampling of 10 Black women who were 50 years and …