Public Health Commons^™

The Adequacy And Perceived Impact Of Nigeria's Health Policy, Kennedy Magoma Ongwae

Walden Dissertations and Doctoral Studies

From 2004 to 2015, the health sector in Nigeria was substantially underfunded despite the existence of a federal health policy committing 15% of the national budget to health care financing. The purpose of this narrative and phenomenological study was to explore the nature and significance of economic claims made in this policy. The central research question examined the extent to which these economic claims were perceived to be realistic, attainable, and successful in meeting their intended policy objectives and impact. The study's conceptual framework combined Kingdon's ambiguity and multiple streams theory, Roe's narrative policy analysis, and Skocpol's policy feedback theory. …

Paths To Tier 1 Genomics Implementation: A Survey Of Chronic Disease Directors, Amy Ponte

Walden Dissertations and Doctoral Studies

Although evidence is currently available for population-based genetic screening and testing of individuals and their family members for certain hereditary chronic disease conditions (Tier 1), few states have integrated these genomic applications into chronic disease prevention programs. State and territorial chronic disease directors (CDDs) could provide the leadership needed to deliver these applications in more states. The purpose of this study was to determine whether an association exists between current chronic disease genomics funding or specific state genomic activities and the level of knowledge and interests in genomics by these directors. Rogers's diffusion of innovations (DIT) theory was used to …

The Role Of Inflammatory Biological Markers In Novel Pharmacotherapies For Populations With Depression, Stacey Boyer

Walden Dissertations and Doctoral Studies

Current interventional pharmaceutical therapies targeted for depression are not adequate to achieve sufficient remission following treatment. Researchers explored inflammatory biomarkers as a way of understanding why treatment for depression is effective for some and not others. The purpose of this secondary data analysis study was to determine if there was a relationship between inflammatory biomarkers and treatment efficacy in persons diagnosed with depression who have demonstrated a previous lack of remission. Using the immune-cytokine paradigm of depression (POD) allowed depression to be viewed as multifaceted and a potential signal of chronic immune system activation. This secondary data analysis included findings …

Influences Of Provider-Patient Communication On Health Literacy And Public Policy Relevant Outcomes, Rachel Carla Cartwright-Vanzant

Walden Dissertations and Doctoral Studies

Several artifacts of federal policy address the connection between health literacy of patients and health outcomes. These laws include The Plain Writing Act, Health Information Technology for Economic and Clinical Health, and the Health Insurance Portability and Accountability Act. Even with this policy structure, little is known about how nurses' knowledge of health literacy may influence patient understanding of medical information and health outcomes. Using Knowles' principles of effective communication, the purpose of this mixed-methods study was to concurrently examine the relationship between nurse knowledge of health literacy and communication techniques used by nurses to identify any causal relationships in …

The Impact Of Palliative Care On Health Status In Hiv-Positive Children, Aabid Abdulmajid Ahmed

Walden Dissertations and Doctoral Studies

HIV-positive children in sub-Saharan Africa have numerous challenges to overcome. These challenges increase psychosocial stress as well as symptom burden including fatigue, weight loss, pain, and mental changes. The symptoms may persist even after initiation of antiretroviral therapy, so such children need additional care. Palliative care lays emphasis on holistic patient-centered care, including physical, psychological, social, and spiritual symptoms, alongside antiretroviral therapy. There is limited data on the impact of integrating palliative care with standard HIV care and treatment in children. The purpose of this study was to fill the gap in the literature by investigating the impact of palliative …

Sexual Harassment Experience, Psychological Climate, And Sex Effect On Perception Of Safety, Kenneth C. Barker

Walden Dissertations and Doctoral Studies

Sexual harassment has significant adverse psychological and physical effects on employees and can negatively impact the workplace, and overall business operations. A gap in current research was identified concerning whether the employee's sex affects employee's perceived workplace sexual harassment climate, sexual harassment experience, and perceived safety from sexual harassment. This study examined the effects of employee workplace sexual harassment experience and perception of workplace sexual harassment psychological climate on employee's perceived safety from sexual harassment moderated by sex. Results showed that perceived workplace sexual harassment climate and employee workplace sexual harassment experience were both significant predictors of perceived safety from …

Emergency Medical Service Career Longevity: Impact Of Alignment Between Preemployment Expectations And Postemployment Perceptions, Michael Joseph Belotto

Walden Dissertations and Doctoral Studies

The purpose of this qualitative study was to investigate whether there were differences between the preconceived notions of emergency medical technicians and paramedics prior to entering the profession and their notions of the vocation after facing the realities of the job. The contribution of alignment or misalignment to job satisfaction and the intention to leave the profession was also further investigated. This research is important as there currently is a gap in the literature pertaining to the factors affecting career longevity of emergency medical service (EMS) professionals. The degree of fit between individual and occupational characteristics guided this phenomenological study …

Impact Of The Childcare Setting And Caregiver Education On Toddler Language Environment, Snejana Nihtianova

Walden Dissertations and Doctoral Studies

Young children's early language development is strongly related to their school performance, and slow language growth may predict later academic problems. The link between the language quality and amount of speech that children hear and their language development is well documented; however, the factors that impact variability in linguistic input are not well understood. The purpose of this quantitative study was to assess the association between childcare settings and childcare provider education level and toddlers' language environment. The study sample consisted of 29 Bulgarian children. The study used a new technology called Language Environment Analysis, which is the preferred method …

Income, Education, Age, And Physical Activity Among Physically Disabled African American Women, Sherèè Johnson Johnson

Walden Dissertations and Doctoral Studies

This study was designed to identify possible risk factors about physical activity in middle-aged disabled African American women (AAW) aged 45 to 64 years. Disabled middle-aged AAW has a disproportionate prevalence of obesity and chronic illness than nondisabled women. Most disabled middle-aged AAW leads a sedentary lifestyle, and they do not meet the recommended physical activity (PA) guidelines. Little is known about this group, and a social ecological model was used to explain PA patterns. Data were extracted from the 2009 Behavioral Risk Factor Surveillance System (N = 1,599) for women who responded yes to indicate that they needed specialized …

The Molecular Epidemiology Of Tuberculosis In South Carolina, 2005-2011: Estimates Of Recent Transmission And Risk Factors For Genotype Clustering, Amy Kathleen Roach

Walden Dissertations and Doctoral Studies

Because tuberculosis (TB) is a public health threat that continues to elude elimination in the United States, there is a need to identify contributing factors that may have implications for targeted control measures. Molecular studies of genetic clustering are crucial for pinpointing these contributing factors. It is for this reason this study was conducted. This was a non-experimental, cross-sectional population-based molecular epidemiological study of TB in SC from 2005 to 2011. Its purpose was to estimate the proportion of TB that may be due to recently acquired infection and to determine the risk factors associated with the genetic clustering of …

Relationship Between Caregivers' Quality Of Life And Childhood Tuberculosis In Nigeria, Haruna Ismaila Adamu

Walden Dissertations and Doctoral Studies

In Nigeria, childhood tuberculosis (TB), a debilitating and deadly disease, is highly prevalent and case reporting is poor due to weak health systems. Globally, children account for at least 10 percent of the TB burden, yet they remain neglected in TB prevention and control efforts. Research studies integrating family and community-centered strategies have been recommended by stakeholders to address the paucity of current local prevention and management strategies for childhood TB. This observational cross-sectional study explored the relationship between caregivers' quality of life (QOL), gender, and socioeconomic status (SES) and the incidence of TB in children aged 0-14 years. Using …

Health Portal Functionality And The Use Of Patient-Centered Technology, Anita Joyce Simmons

Walden Dissertations and Doctoral Studies

Health portals are dedicated web pages for medical practices to provide patients access to their electronic health records. The problem identified in this quality improvement project was that the health portal in the urgent care setting had not been available to staff nor patients. To provide leadership with information related to opening the portal, the first purpose of the project was to assess staff and patients' perceived use, ease of use, attitude toward using, and intention to use the portal. The second purpose was to evaluate the portal education materials for the top 5 urgent care diagnoses: diabetes, hypertension, asthma, …

American Indians' Perceptions Of Obesity And Its Effects On Healthy Lifestyles, Morgan J. Foster

Walden Dissertations and Doctoral Studies

A disproportionate number of American Indians are overweight or obese and have a higher risk of other health concerns compared to the general United States population. Researchers conducting anthropometric studies have found that American Indians have higher body mass indices and worse health than most of the general United States population. There is, however, a gap in the literature regarding American Indians' perceptions, beliefs, opinions, and attitudes of obesity and its effects on their health. The purpose of this qualitative study was to determine whether American Indians view obesity as a major health concern. Focus groups and key-informant interviews were …

Predictors Of Mastectomy In Male Breast Cancer, Esther Opara

Walden Dissertations and Doctoral Studies

Male breast cancer (MBC) is rare, and research on the predictors of MBC has been limited because of inadequate funding in and outside of the United States. One goal of this study was to eradicate the stereotyping of breast cancer as a female disease. The emergence of medical technology and education to benefit the public will help to ensure greater health awareness at the individual, community, and global levels. The purpose of this study was to understand the influence of the predictors of age; race (Black, White, and Other); and grade of cancer (I, II, or III) on the outcome …

An Integrated Approach To Malaria Prevention And Control In Rural Cameroon, Naomi Chuiwo Azunie

Walden Dissertations and Doctoral Studies

Malaria is a life-threatening parasitic disease spread to humans through bites of an infected mosquito. In rural Cameroon, malaria is one of the major causes of morbidity and mortality. Several studies have examined the use of various malaria preventive tools; however, there is insufficient literature available on use of an integrated approach to prevent and control malaria in rural Cameroon. The aim of this study was to provide information necessary for bridging the gap in understanding the proper use of insecticide treated nets (ITNs) and antimalarial drugs and the roles of education and socioeconomic status in malaria prevention and control …

Hiv Prevalence Determinants Among Young People In Zimbabwe: Sexual Practices Analysis, Joyce Caroline Mphaya

Walden Dissertations and Doctoral Studies

A decline in Human Immunodeficiency Virus (HIV) prevalence rates have been observed among females ages 15 to 19 years and 20 to 24 years in Zimbabwe between 2005 and 2010. However, for males 15 to 19 years, rising trends were observed, whereas for males ages 20 to 24 years, rates fluctuated between 2005 and 2011. The purpose of this cross-sectional study was to examine relationships between sexual behaviors and practices and HIV prevalence among young males and females ages 15 to 24 years in Zimbabwe. Guided by constructs of proximate determinants framework, extracted data from two National Demographic Health surveys …

Sickle Cell Trait And Genetic Counseling, Tricia Salmon Anderson

Walden Dissertations and Doctoral Studies

Sickle cell trait (SCT) is a very prevalent disorder in the United States, especially among African Americans or people of African descent. However, even with the prevalence of the disorder, there are no standardized guidelines for providing patients with information about SCT and the implications of the disorder at physicals and well-check visits. The purpose of this evidence-based project was to increase awareness for African American patients 18-44 years old in the practice setting about SCT and to provide options for testing and genetic counseling. Kotter's contemporary change theory was used as a guide to implement the new practice approach. …

Culturally Competent Nutrition Counseling And Health Outcomes Of Patients On Emergency Dialysis, Edlyn Geraldine Bustamante

Walden Dissertations and Doctoral Studies

Undocumented end stage renal disease (ESRD) patients in the United States only have access to emergency dialysis. To compensate for the lack of regular dialysis these patients must follow strict renal dietary restrictions. However, nutrition counseling by a dietitian is not part of the renal management of patients on emergency dialysis. The purpose of this quantitative quasi-experimental treatment-control study was to assess how the application of nutritional counseling that is both culturally and linguistically competent affects dialysis frequency and biochemical lab values such as serum potassium, phosphorus, and vitamin D of patients in emergency dialysis. The study was grounded on …

U.S. Young Adults Stds, Risk Perception, Risk Behaviors, And Health Information Seeking, Amanda Robison-Chadwell

Walden Dissertations and Doctoral Studies

Sexually transmitted diseases (STD) are preventable conditions for which treatment failure (specifically in gonorrhea) is becoming problematic. U.S. young adults (20-29 years) have high rates of STD incidence and prevention of these diseases, but reaching them to provide primary prevention educations is challenging due to low perceived susceptibility to infection and lack of knowledge about how young adults seek health information. The purpose of this quantitative survey study was to assess the association between perceived susceptibility to STDs, sexual risk behavior, and the acquisition of health information as it pertains to sexual health topics in young adults. The Health Belief …

Improving Fall Prevention Strategies In An Acute-Care Setting, Sylvia B. Boye-Doe

Walden Dissertations and Doctoral Studies

Falls with or without injuries among the elderly have become a public health concern, with falls among adults age 65 years and older increasing every year. Nurses play a role in ensuring patient safety by following fall prevention guidelines. The purpose of this evidence-based study was to implement the RE-AIM evaluation tool to determine the impact of the Safe Five program on staff compliance with the program; patients' awareness of the need for falls prevention; and falls among older adults, ages 65 years and older, admitted to an acute care nursing unit. The literature supports implementing a falls prevention program …

Nutrition Services, Viral Suppression, Cd4, And Retention In Ryan White Program Participants, Theresa Jumento

Walden Dissertations and Doctoral Studies

The Ryan White HIV/AIDS Program (RWHAP) provides HIV-related medical and support services for uninsured and underinsured people living with HIV (PLWH) in the United States. In addition to HIV-related medical care, the program provides medical nutrition therapy and food assistance. The role of nutrition in the health of PLWH is well-documented, especially in resource poor areas; however, the role of medical nutrition therapy and food assistance provided through the RWHAP in resource rich areas is not well documented. This study addressed the association between the nutrition services of food assistance and medical nutrition therapy and the HIV-related health outcomes of …

Impacts Of Observing Live Open Heart Surgery On Young Adults' Health Behaviors, Muhammad Musa Qarizadah

Walden Dissertations and Doctoral Studies

Having a heart healthy lifestyle at a younger age is beneficial in reducing the risk of coronary heart disease (CHD) in adulthood and various health education programs for CHD prevention exist to persuade young adults to adopt a heart healthy lifestyle. Little is known, however, about the influence of watching live open heart surgery on young adults' adoption of a heart healthy lifestyle. To address that gap in knowledge, this study was conducted at a health facility in Virginia where students came to observe live open heart surgery. The purpose of the study was to understand whether watching live open …

Perceptions Of Community-Based Participatory Research From Community And Academic Members, Ivonne G. Kanko

Walden Dissertations and Doctoral Studies

Community-based participatory research (CBPR) is an increasingly popular form of public health research. However, little is known about the application of CBPR and the levels of involvement for partners in specific phases of the partnership. This phenomenological study addressed the application of CBPR from the perspectives of 7 academic researchers and 6 community members experienced in CBPR. Arnstein's ladder of citizenship participation and the community coalition action theory provided the framework for the study. Semi-structured interviews addressed participants' levels of involvement in the CBPR process, as well as challenges, concerns, successes, and recommendations for improvement. Interview transcripts were analyzed by …

Evaluation Of Automated Reminders To Reduce Sepsis Mortality Rates, Maria M. Lindo

Walden Dissertations and Doctoral Studies

Sepsis is still a leading cause of death in the United States despite extensive research and modern advancement in technology. Early recognition of sepsis and timely management strategies are important for effective reduction of sepsis-related morbidity and mortality. Guided by the logic model, the purpose of this project was to evaluate the effectiveness of electronic reminders in enhancing clinical decision-making among 30 nurses in 3 medical-surgical units. The practice-focused question addressed the effectiveness of electronic reminders for early recognition and initiation of goal-directed treatment of sepsis in hospitalized patients on medical-surgical units in an effort to reduce sepsis mortality rates. …

Identifying Communication Barriers And Trust Issues Of Black Women Seeking Preventive Health Services In Houston, Texas, Melissa E. Shelton

Walden Dissertations and Doctoral Studies

Black women mortality rates are perceived to be impacted by communication barriers, trust issues, and the lack of quality preventive health services. The purpose of this phenomenological study was to explore communication barriers and trust issues perceived by Black women when seeking preventive health services. HMB was used to identify public attitudes around receiving preventive health services and to construct each question based on perceived susceptibility and perceived severity of communication barriers and trust issues. An ecological model of the communication process was used as a framework to identify fundamental relationships between the Black female patients and health care providers. …

10,000 Step Challenge For Bedside Registered Nurses Working 12 Hour Shifts, Katherine Louise Schnebly

Walden Dissertations and Doctoral Studies

Obesity is a pandemic that directly affects chronic health problems and mortality. Researchers have shown that more than 54% of nurses are obese. The increasing rate of obesity among nurses and the long hours they work make healthy lifestyles, including daily physical activity, difficult. Tracking daily activity using a pedometer or fitness application has shown improved awareness and sustainability of daily physical activity. This project was an investigation of the daily steps of bedside nurses working a 12-hour shift, and their subsequent awareness of their daily physical activity. Pender's Health Promotion Model was used to consider motivating factors for improving …

Workers' Perceptions Of The Effect Of Three-Tier Shift Schedules On Community Functioning, Jillian Leigh Wallace

Walden Dissertations and Doctoral Studies

Shift work is commonplace in many fields that require around-the-clock employee coverage. There is ample evidence that two-tier shift work can detrimentally affect health and functioning. The purpose of this study was to understand the impact of three-tier shift schedules on physical and mental health and community functioning, a concept which refers to activities and behaviors performed by individuals or groups within a system. This study used a qualitative phenomenological design, and community functioning and recovery theory were central to the conceptual framework. In-depth interviews were used to explore the perceptions of three-tier shift workers on their functioning, relationships, mental …

Behavioral Activation For Smoking Cessation And Mood Management Following A Cardiac Event: Results Of A Pilot Randomized Controlled Trial, Andrew M. Busch, Erin M. Tooley, Shira Dunsiger

Arts & Sciences Faculty Publications

Background: Smoking cessation following hospitalization for Acute Coronary Syndrome (ACS) significantly reduces subsequent mortality. Depressed mood is a major barrier to cessation post-ACS. Although existing counseling treatments address smoking and depression independently in ACS patients, no integrated treatment addresses both. We developed an integrated treatment combining gold standard cessation counseling with behavioral activation-based mood management; Behavioral Activation Treatment for Cardiac Smokers (BAT-CS). The purpose of this pilot randomized controlled trial was to test feasibility, acceptability, and preliminary efficacy of BAT-CS vs. Standard of Care (SC).

Methods: Participants were recruited during hospitalization for ACS and were randomly assigned to BAT-CS or …

Burnout Or Depression: Both Individual And Social Issue, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In view of the profound problems attached to the construct of burnout, we recommended that occupational health specialists focus on (job-related) depression rather than burnout to help workers more effectively. Epstein and Privitera (April 8, 1398) rejected our recommendation on the grounds that burnout is not a “purely individual syndrome”. Problematically, Epstein and Privitera attributed to us an idea that is not ours. In these authors’ view, equating burnout with depression is synonymous with mistakenly individualising a social problem. For two reasons, the argument that depression cannot replace burnout because burnout is a social problem whereas depression is an individual …

‘Burnout Syndrome’: From Nosological Indeterminacy To Epidemiological Nonsense, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

All in all, Imo’s review is undermined by the very research it relies on. We recommend that researchers interested in burnout begin at the beginning, that is to say, by establishing a reasoned, clinically-founded (differential) diagnosis for their entity of interest. As long as investigators do not complete the required groundwork for establishing a diagnosis and remain unable to distinguish a case of burnout from either a noncase or an existing disorder, conclusions regarding the prevalence of burnout will be nonsense. To close this comment, we note that an immediately available solution for effectively monitoring and protecting physicians’ occupational health …