Public Health Commons^™

Factors Affecting Cervical Cancer Screening Among Dominican Women Living In The United States, Cybil Bonhomme

Walden Dissertations and Doctoral Studies

The highest incidence and mortality rates of cervical cancer are seen among minority women groups in the United States. Hispanic women have the highest rate of cervical cancer, contributing to the 2nd highest mortality rate of the disease. Researchers have examined the lower rates of cervical cancer screening among Hispanic women, as compared with other groups of U.S. women, but researchers have not examined cervical cancer screening practices, specifically for U.S. Dominican women. The purpose of this study was to examine the correlation between compliance with cervical cancer screening and major influences including acculturation, socioeconomic status, immigration status, and usual …

Reducing Morbidity: Establishing A Relationship Between Perioperative Normothermia And Colon Surgical Site Infections, Nychie Dotson

Walden Dissertations and Doctoral Studies

Healthcare-associated infections (HAIs) are an emerging public health threat. Every day in the United States, HAIs impact 1 in 31 hospitalized patients. Surgical site infections (SSIs) account for over 40% of all reported HAIs and have an increased risk for morbidity and mortality. Surgery associated with colon procedures present an increased risk for infection, morbidity, and mortality. There has been vast work to prevent colon SSIs; however, there remain areas for improvement and exploration. The main research question evaluated the relationship between maintaining perioperative normothermia and colon SSIs. Secondary research questions explored additional risk factors to include age, gender, obesity, …

Fertility Treatments Of Women In Nigeria: Using Long Versus Short Protocols, Michael Egwu

Walden Dissertations and Doctoral Studies

A global estimate indicates that over 70 million heterosexual married couples live with the burden of infertility, and Nigeria accounts for about 30%. Although protocols exist, it appears there are no standardized treatment guidelines for practicing fertility experts in Nigeria. This study, therefore, aimed to determine which protocol provides a better outcome across a given population of infertile women in Nigeria as a method to move towards developing standardized treatment guidelines. The study was grounded using the Patient-Centered Care Treatment Model, and the method of inquiry was a retrospective, cross-sectional, quantitative, and nonexperimental technique, and the influence of the patient’s …

A Provider Education Program Addressing Barriers To Diabetic Patients’ Self-Care, Henrietta O. Emokidi

Walden Dissertations and Doctoral Studies

Diabetes is the leading cause of death among American Indian/Alaskan Natives and the 7th leading cause of death in the United States. Type 2 diabetes (T2DM) affects 9% of the U.S. population and costs the United States an estimated $245 billion annually. The purpose of this project was to identify patients’ concerns related to their disease and to develop an education program for providers to address these concerns. The project was framed using Orem’s theory of self-care and the middle-range theory of self-care of chronic illness. Five providers in an underserved clinic in Alaska conducted assessments during a primary care …

Perceptions, Practices, And Risk Factors Associated With Typhoid Fever In Nimo Village, Nigeria, George Ilouno

Walden Dissertations and Doctoral Studies

Typhoid fever is a bacterial disease transmitted by the fecal-oral route. In Nigeria, the condition is life threatening and endemic. It affects communities such as Nimo that have limited water, sanitation, and hygiene infrastructure. Previous researchers focused on sanitation and hygienic conditions that contribute to the disease such as household-level hygiene and food and water contamination, including handling practices. However, there is limited knowledge on how the environmental behavior and living conditions of eating and sleeping on a floor harboring fecal materials affect typhoid fever prevalence. The purpose of this qualitative phenomenological study was to explore the perception of the …

Promotion Of Lifestyle Changes By Community Pharmacists Among Adults With Hypertension In Nigeria, Olanike Olawunmi Kehinde

Walden Dissertations and Doctoral Studies

The growing prevalence of hypertension is a global public health problem. Lifestyle modification is the first-line best practice for the management of hypertension, however there is not enough focus on healthcare professionals’ competencies in managing hypertension in Nigeria. The perspectives of Community Pharmacists (CPs) about promotion of lifestyle modification (PLM) among adults with hypertension have not been explored in Nigeria though they play an essential role in healthcare in the community. This phenomenological study was conducted to document the experiences of CPs about PLM by using in-depth interviews. Social cognitive theory and the health promotion model were used as frameworks …

Factors Contributing To Community-Associated Carbapenem Resistant Enterobacteriaceae Infections In The United States, Zabrina Lockett

Walden Dissertations and Doctoral Studies

Carbapenem-resistant Enterobacteriaceae (CRE) health care acquired infections are a serious public health threat due to a high mortality rate, economic burden, and depletion of last resort CRE antimicrobials. CRE infections have emerged as community-associated type infections in the United States. For CRE to now have that type of potential is cause for immediate and extensive action. The prevalence of CRE infection cases that were reported as community-associated CRE and health care acquired CRE by examining specific clinical characteristics between 4 selected states that were reported to respective state health departments and the Centers for Disease Control were explored in this …

Microcystins And Liver Disease Mortality, Insights From An Ecological Study, Rajesh Tirpaul Melaram

Walden Dissertations and Doctoral Studies

Microcystins (MCs) are toxic secondary metabolites produced by freshwater cyanobacteria. Algal bloom subsidence can stimulate MC release, which can impair liver function if orally exposed to in large doses. The purpose of this retrospective, U.S. ecological study was to determine if MC exposure represented an environmental risk factor for liver disease mortality using a socioecological approach. A longitudinal ecological substudy investigated the association between average total MCs in Lake Washington and Lake Manatee and age-adjusted chronic liver disease (CLD)/cirrhosis death rates in Brevard County and Manatee County, Florida (FL). A prediction model of total MCs was deduced by quantifying levels …

Decreasing Hiv Stigmatization For Care Of Young Men Of Color Who Have Sex With Men, Alethea Arnett Miller

Walden Dissertations and Doctoral Studies

HIV-related stigma from healthcare provider attitudes, beliefs, perceptions, or misconceptions has been a barrier to healthcare delivery. This project was conducted to examine whether an HIV-related stigma education provided to healthcare clinic staff with a focus on advance practice registered nurses can improve knowledge and empathy toward young men of color who have sex with men (MSM), which can lead to improved overall quality of healthcare through increased health behaviors and retention in care. An educational intervention was conducted utilizing a blended-learning environment focused on social cognitive theory to influence social behavior change among healthcare professionals, increasing their exposure, knowledge, …

The Correlation Between Unemployment Rate, Gdp Per Capita, And Adult Obesity Prevalence In Developed Economies. Evidence From Oecd Member Countries., Uche Noel O'Martins

Walden Dissertations and Doctoral Studies

Adult obesity continues to be endemic in developed countries; at least 1 in every 5 people in developed economies is obese. In line with the theory of social suffering, socioeconomic factors may be correlated with the increasing prevalence of adult obesity. The purpose of this study was to investigate the correlation between socioeconomic factors and adult obesity prevalence rate in developed countries using Organization for Economic Co-operation and Development (OECD) member countries as a case study. In this study, the correlation between 2 independent variables - unemployment rate and Gross Domestic Product (GDP) per capita - and the dependent variable …

Childhood Blood Lead Levels And Adolescent Crime Rates In The United States, Jude Juiye Soweh

Walden Dissertations and Doctoral Studies

Juvenile violent crime rates in the United States have been on a continuous decline since 1996. Despite this decrease, youth violence as well as racial differences in crime rates continues to be a public health issue in the United States. Researchers have linked externalization behavior in children to factors including genetics, parental upbringing, abuse, school environment, and media exposure but have not fully considered the relationship between early childhood lead contamination and youth violence. This was an ecologic study of the relationship between early childhood blood lead levels (BLLs; ≥ 10µg/dL before 2012 or ≥ 5µg/dL after 2012) and crime …

The Role Of Self-Mutilation Behaviors Among Adolescents Who Are Depressed, Patricia Wilkins

Walden Dissertations and Doctoral Studies

Adolescents who are depressed may self-injure themselves. Common methods for non-suicidal self-injury are cutting and burning the skin of one’s own body. Multiple confounding factors of age, gender, race and socio-economic status could lead one to engage in intentional or unintentional self-mutilation acts. The current body of literature on adolescent mental health demonstrates limited understanding of how racial and ethnic identity factors contributes to depression, self-injurious behavior, and suicide. This quantitative study determined if there was a relationship between depression and prevalence of adolescent self-mutilation. The social ecological theory was used to study the intersection of social determinants of depression …

Effectiveness Of A Standardized Fall Assessment Tool In Reducing Falls Among Elder Home Health Clients, Terica M. Woods

Walden Dissertations and Doctoral Studies

Because of the physiological changes that occur with the normal aging process, falls tend to have more serious consequences in individuals age 65 and older. The purpose of this systematic review of literature was to analyze studies that addressed the impact of a multifactorial fall risk assessment tool on decreasing falls in the elderly home health patient population following hospitalization. The conceptual model for this project was Roper, Logan, and Tierney’s activity of daily living model. A narrative analysis was used to analyze 16 selected articles from the CINAHL, ProQuest and MEDLINE databases. Results indicated that implementing fall assessment tools …

Antibiotic Stewardship And The Quality Of Life For Residents Over 65 Years, Reshma Beharry-Guest

Walden Dissertations and Doctoral Studies

Antibiotics were often over-prescribed in long term care facilities (LTCFs) and antibiotic stewardship guidelines, established by the CDC were not followed. The nursing home administrator was responsible for the quality of care for the residents and ensured that the facility met and/or exceeded the CMS antibiotic stewardship standard of care. The purpose of this quantitative study was to analyze operational secondary data collected from a Texas LTCF regarding antibiotic utilization for male and female residents over 65 years. The theoretical framework of the social cognitive theory was applicable for quality improvement in the LTCF setting. The data analysis showed that …

Health Literacy And Diabetes Among Refugee Women Residing In Arizona, Aline Nina Indatwa

Walden Dissertations and Doctoral Studies

There is limited research available linking health literacy and diabetes knowledge to poor health outcomes among refugees. The aim of this study was to determine the levels of health literacy and diabetes knowledge and examine whether different factors (age, education, employment status, number of years lived with diabetes and length of stay since resettlement) are associated with health literacy and diabetes knowledge. A cross-sectional study was performed among 82 refugee women with a known diagnosis of diabetes and residing in Maricopa County, Arizona. A modified two part questionnaire (self-reported health literacy extracted from the European Health Literacy Questionnaire [HLS-EU-Q16] and …

Physicians’ Perceptions Of Facilitators And Barriers In Electronic Health Record Education, Alice Keene Martin

Walden Dissertations and Doctoral Studies

A significant focus in health care is quality documentation to lower patient safety risks. The local problem at a healthcare organization in the northeastern United States is that some physicians are falling short with quality documentation of patient care in athenaNet, a cloud-based electronic health record (EHR). This qualitative case study was conducted to explore physicians' perceptions of the facilitators and barriers that impact the educational process for quality documentation in EHRs. Attention also focused on identifying physicians' recommendations for enhancing the educational process for quality documentation. Knowles’ adult learning theory served as the conceptual framework. Purposeful sampling was used …

Familial Caregivers’ Perceptions Of Alcohol Use Among Mature Adults Residing In Assisted Living Communities, Lemeshia Meshana Agee Chambers

Walden Dissertations and Doctoral Studies

Research suggests that alcohol abuse is among the 8 primary causes of death for mature adults, which includes individuals age 65 and older. Alcohol use is a growing, unaddressed, public health concern among this referent population. Additionally, as mature adults enter the retirement phase of their lives, many of them transition to residing in assisted living communities. The purpose of this study was to explore mature adults’ alcohol use in assisted living communities and how such use, as perceived by the familial caregivers, affected the mature adults’ ability to age successfully. The population under study consisted of 8 familial caregivers, …

Staff Instruction On Patient Health Questionnaire And Collaborative Care Model In Primary Care, Jennifer Carton

Walden Dissertations and Doctoral Studies

The DNP project examined the effectiveness of the Patient Health Questionnaire-9 (PHQ-9) and the Collaborative Care Model (CCM) as a practice protocol for patients suffering from depression in primary care to address the problem of a shortage in mental health specialists. Research reveals an increase in Americans suffering from depression. Many primary care clinics do not have a practice protocol in place to screen and manage depression. The project's purpose was to develop a lesson plan to instruct staff on the PHQ-9 and CCM to implement into their practice. The project questions were if the lesson plan developed by the …

Impact Of Demographic Characteristics And Therapy On Tuberculosis Incident Cases, Iliedor Garcon

Walden Dissertations and Doctoral Studies

For more than two decades, tuberculosis (TB) has ranked second among the top killers of infectious diseases, with an estimated 10.4 million incident cases in 2018. Demographic characteristics and drug susceptibility influence TB incidence worldwide. Using a retrospective cohort design, the purpose of this quantitative study was to investigate whether race/ethnicity, age, sex (gender), therapy completion within one year (COT), and testing for isoniazid and rifampin susceptibility (TIRS) were predictors of 672 cases of TB in New York-Newark-Jersey City from 1993 to 2017. Guided by the epidemiological triad theory, this research was conducted using a secondary TB dataset from the …

Positive Behavior Support-Based In-Home Services For Traumatic Brain Injury, Charles Jack

Walden Dissertations and Doctoral Studies

Researchers have demonstrated the effectiveness of positive behavior support (PBS) services in the in-home (IH) setting but few studies examined its use with traumatic brain injury (TBI) clients, and most of these were small sample cases. Additional research on IH PBS services for TBI clients was recommended, in particular using larger samples. The purpose of this study was to address that need by examining the effectiveness of IH PBS services in treating TBI-related challenging behaviors on a larger sample. The theoretical foundations for PBS, behaviorism, cognitive constructivism, social learning theory, and the biopsychosocial model of behavior, are described. The research …

Comparison Of Health Factors And Outcomes Between Accredited And Nonaccredited Health Departments, Deborah Koester

Walden Dissertations and Doctoral Studies

The launch of the Public Health Accreditation Board in 2012 established national public standards. This study examined possible correlations between the accreditation status of local health departments and specific indicators for health, including communicable disease, disease prevention and health promotion, and maternal child health factors, and outcomes of premature death and infant mortality. The population for the intervention group included all 212 local health departments accredited from September 2012 through December 2017. Accredited health departments were matched with nonaccredited health departments based on population, rurality, agency type, governance authority, and state public health structure. Linear regression analysis was performed on …

Factors Affecting Seatbelt Use Among The Deaf And Hard-Of-Hearing, Deidre G. Mott

Walden Dissertations and Doctoral Studies

In the United States, despite the proven significant economic, health, and social benefits of seatbelt use, millions of Americans do not use seatbelts. It is known that some factors, including obesity, reduce the rates of seatbelt use; however, a lack of research exists regarding whether individuals who are deaf or hard-of-hearing (HOH) have different rates of seatbelt use. The purpose of this study was to examine the difference in seatbelt use between deaf or HOH individuals and hearing individuals after adjusting for individual-level factors (BMI, marital status, education, and access to health care). The theoretical foundation for this study was …

Bioterrorism: Exploring Factors For Improving Nurse Preparedness, Policies, And Practices, Leone Okey Tom-James

Walden Dissertations and Doctoral Studies

Ebola virus release/attack in New Jersey could go unnoticed but have immediate and long-lasting effects on the broader population and security. The risk underscores the need to prepare and enhance the state’s efforts to deal with a release and treat the confirmed cases. This descriptive single case research explored factors for improving nurses’ preparedness, policies, and practices for a bioterrorism release/attack. The epidemiological triangle conceptual framework was used descriptively in exploring, and developing a knowledge base of Ebola virus pathogenicity, characteristics, routes of transmission, and infection. The unit of analysis was Summit Ridge Genesis Healthcare Center. The theory of robust …

Social Cognitive Theory Constructs That Predict Betel Nut Chewing Among Secondary Students, Lepani Waqatakirewa

Walden Dissertations and Doctoral Studies

After alcohol, tobacco, and caffeine, areca or betel nut is the 4th most common substance of abuse in the world, and its prevalence of use in the Solomon Islands is estimated at 68% in young people. Long-term use of betel nut can result in detrimental health outcomes such as oral cancers and metabolic syndrome. Guided by the social cognitive theory (SCT), the purpose of this quantitative cross-sectional study was to determine whether the constructs of SCT predict betel nut use in Year 12 secondary students in the Solomon Islands. Five SCT constructs of expectations (outcome expectations and outcome expectancies), self-efficacy, …

Predictors Of Intention To Use Health Literacy Strategies Among Physicians In Grenada, Arlette Wildman

Walden Dissertations and Doctoral Studies

Low health literacy is linked to poor health outcomes. Adequate health literacy depends on effective communication between patients and their healthcare providers, so it is important physicians use health literacy strategies. Grounded in the theory of planned behavior, the aim of this quantitative correlational study was to investigate the relationship between health literacy knowledge, health literacy experience, gender, the region of training, years of practice, and intentions to use health literacy strategies among physicians in Grenada. One hundred and eighteen physicians were sampled using a cross-sectional survey method. The results of the multiple linear regression analysis were significant, F(5, 112) …

Mandibular Attachment Device Effects On African American Veterans With Heart Failure, Tracey T. F. Carter

Walden Dissertations and Doctoral Studies

Heart failure is a growing epidemic that affects people nationwide and is disproportionate to African Americans. The purpose of this quantitative repeated measures study was to determine whether mandibular attachment device (MAD) therapy impacts symptoms of heart failure in African American male veterans diagnosed with obstructive sleep apnea (OSA). The oxidative stress theory was applied in this study to assess whether MAD therapy received from Veterans Affairs (VA) dental clinics impacted heart failure symptoms, after controlling for patient body mass index (BMI) levels and smoking status. Research questions examined whether MAD had a significant effect on symptoms of heart failure …

Predictors Of The Health Effects Of Marijuana Use On The Hepatic Function, Makafui Kokou Gbogbo

Walden Dissertations and Doctoral Studies

The quantity of marijuana use, the length of time it was used, and the age of initiation of the drug are at the core of the discussions about the potential health effects of marijuana use on the liver. Results of recent studies regarding how the drug affects human health have resulted in a number of conflicting conclusions. Nevertheless, based on these findings, marijuana users are being denied liver transplants. The objective of this study was to identify predictors of the health effects of marijuana on the liver and provide guidance in the care management of marijuana users. To address the …

The Relationship Between Practice Environment, Role Overload And Job Satisfaction Of Nurses In Canada, Olabisi Amao Olaniyan

Walden Dissertations and Doctoral Studies

Abstract

The shortage of nurses is a global phenomenon. The problem is particularly pronounced in rural areas and contributes to the health disparities experienced in the healthcare sector. Many factors had been shown to adversely impact the recruitment and retention of nurses, most especially in the rural areas. No study has examined how some factors such as the practice environment variation; geographical locations; and role overload impact job satisfaction of nurses. The Herzberg two-factor theory, with constructs of Motivation and Hygiene factors guided the study. In this quantitative, cross-sectional study, correlational approach was used to examine the association between the …

Association Between Childhood Secondhand Smoke Exposure And Inflammatory Bowel Disease Development, Stephanie Eve Walsh

Walden Dissertations and Doctoral Studies

Inflammatory bowel disease (IBD) is a group of diseases that affect the gastrointestinal tract. Environmental factors, such as smoking, have been shown to play a role in the development of IBD; however, minimal research regarding secondhand smoke (SHS) exposure and the development of IBD has been conducted. The purpose of this study was to examine whether there was a relationship between childhood SHS exposure and the development of IBD. Bronfenbrenner’s ecological systems theory was used in this study as a basis that the environment can aid in the development of disease. The research questions addressed the potential association between childhood …

Staff Education On Type 2 Diabetes Mellitus, Joan P. Williams

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a major health concern that affects the physical and financial facets of communities. During the past 4 years, a multidisciplinary health care clinic in a northern state reported an increase in the number of type 2 diabetes (T2D) patients. Forty-three percent (43%) of adults with T2D had an elevated glycated hemoglobin A1c of 7.5% or higher. Yet, the staff at the clinic lacked current knowledge of T2D, quality of care, and prevention strategies for patients with T2D. This resulted in increased serious health care issues, associated costs, and increased complications of the patients with T2D. The purpose …