Public Health Commons^™

A Staff Educational Model For Prevention Of Type 2 Diabetes In The Primary Care Setting, Mieshia Staples Clark

Walden Dissertations and Doctoral Studies

Type 2 diabetes is a chronic, debilitating disease affecting millions of Americans. Though preventable, it is the most common form of diabetes in the United States, costing the U.S. health care system billions of dollars annually. Lifestyle modifications taught, encouraged, and supported in established, evidence-based diabetes prevention programs (DPP) are proven to be more effective than medications alone in preventing Type 2 diabetes. While DPPs are cost-effective and can reduce or delay the incidence of Type 2 diabetes, they are greatly underutilized due to primary care providers’lack of knowledge about the benefits and availability of these programs and also due …

Improving Care Of Patients With Asthma Through Staff Education, Nicholas Moscatelli

Walden Dissertations and Doctoral Studies

Chronic asthma is a health epidemic and an increasing problem in the pediatric population. The purpose of this project was to raise nursing staff awareness of symptom recognition, treatment protocols, preventive measures, and detrimental effects of asthma for children. Adult learning theory provided the framework to support the staff education program on asthma. The project site stakeholders and the DNP student identified educational opportunities to assist staff in meeting caregiver needs, improving symptom recognition, and improving asthma outcomes. Prior to presentation of the educational program to the clinic nursing staff, it was reviewed by an expert panel including the clinic …

Public Health Leadership In The Philippines: Effective Approaches In Malaria Surveillance, Gethro Nullan

Walden Dissertations and Doctoral Studies

Leadership traits that affect and shape cost-effective practices ensure the long-term

growth and success for any organization. The purpose of this single case study was to explore leadership traits that may contribute to cost-effective approaches in a malaria surveillance program in the Philippines. The National Health Service Leadership Framework provided the conceptual framework for this study. The participants included 12 public health leaders/managers who have worked or been involved in malaria surveillance programs with budgetary oversight. Data were collected through in-depth interviews and document analysis. Values coding was used for data analysis, in which participants’ perspectives were coded using the …

Program Evaluation Of A Black Barbershop Health Outreach Campaign, Berkina Denise Porter

Walden Dissertations and Doctoral Studies

Black-owned barbershops in the Black community lack barber administered interventions to provide education and health screenings to Black men. Increasing knowledge of health assessments in a black barbershop setting increases the number of health screenings and preventative care among Black men. Grounded in general systems theory, the purpose of this qualitative summative program evaluation was to explore the extent to which a nonprofit Black barbershop health program aligns with the Health Research (HR) program objectives. The evaluation was performed for a nonprofit organization located in Maryland, 6 years after the organization implemented the HR Program Network of barbers and salon …

Predictors Of Condom Use Among High School Students In North Carolina, Danielle Cierra Robinson

Walden Dissertations and Doctoral Studies

The spread of sexually transmitted diseases is a major ongoing public health issue in North Carolina. Adolescents between the ages of 13 and 19 years have consistently contributed to this trend. Researchers have found that condom use among high school students has decreased. High school students continue to engage in sex with multiple partners, with lack of knowledge about sexually transmitted diseases, even though sex education and prevention programs have been recommended. The purpose of this quantitative study was to evaluate the predictors of condom use among adolescents. The socioecological model theoretical framework was applied to guide this research involving …

Socioeconomic And Sociocultural Factors Associated With Parenting Choice And Fertility Experience Among Lesbian And Nonlesbian Women, Annette Silvia

Walden Dissertations and Doctoral Studies

Minorities including lesbians may face disparities that contribute to minority stress, which leads to adverse health outcomes. The purpose of this social epidemiology study was to examine the association between insured status, perceived stress, and parental status among lesbians and nonlesbians. The theoretical foundation was minority stress, and the design was quantitative with a convenience sample of women aged 18 years and older. Data on demographics, perceived stress, fertility quality of life, and lesbian identity disclosure were collected via online survey. Among the 314 respondents, 102 self-selected as lesbian (49% parents), and 212 self-selected as nonlesbian (73.1% parents). More than …

Association Between Metabolic Syndrome And Second Primary Cancer Among Colorectal Cancer Patients, Olukayode Ayodeji Agbeyomi

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is the third most common diagnosed cancer in both women and men in the United States. The gradual increase of incidence of second primary cancer (SPC) among CRC individuals has been a concern in recent times. Many CRC survivals have been forced back to be hospitalized for life-threatening cancers that are nonmetastatic cancers of CRC. Literature has suggested that there may be a relationship between metabolic syndrome (MetS) and CRC cases. The importance of early surveillance, detection, and treatment of SPC in CRC patients is significant to achieve better survival rates. The aim of this retrospective quantitative …

Obesity And Overweightness Among African-American Adolescent Population And Health-Related Quality Of Life, Emmanuel Anene

Walden Dissertations and Doctoral Studies

Obesity and overweightness are a significant public health problem and a risk factor for many chronic diseases. The purpose of this study was to find the associations between gender, race, physical activity, and health-related quality of life (HRQOL) among obese and overweight African American adolescents aged 12 to 19 years. An improved understanding of the health issues could help this population live a longer quality life and prevent serious health implications in adulthood. A quantitative approach with a sample size of 331 was used. The control variables were age and household income, the dependent variable was HRQOL, and the independent …

Mothers’ And Community Stakeholders’ Perspectives About The Vitamin A Supplementation Program In Nigeria, Olufolakemi Mercy Anjorin

Walden Dissertations and Doctoral Studies

Vitamin A deficiency (VAD) affects about one third of children under the age of five in Nigeria. There is low uptake of biannual Vitamin A supplementation (VAS) used since year 2010 as the national response to addressing VAD among children 6 to 59 months. Yet, there is limited research on barriers or facilitators to uptake of VAS. The purpose of this study was to examine the perspectives of stakeholders about the VAS program in Nigeria. The theoretical underpinning was the social marketing framework. The central question related to the views of stakeholders toward the VAS program, and their perception about …

The Lived Experience Of Child Marriage And Its Health Effects Among Young Mothers In Nigeria, Anastasia Iliwo Ashi

Walden Dissertations and Doctoral Studies

Child marriage has life-threatening implications for the mental, physical, and psychological development of the girl-child. In Sub-Saharan Africa, and other resource poor settings, child brides and very young mothers undergo various negative experiences including economic hardship and health challenges such as obstetric fistulas, birth complications, and even death. The purpose of this phenomenological study was to describe the lived experiences of child marriage and its effect on maternal health among young mothers in Nigeria. The social ecological model provided the conceptual framework for this study. Ten young women ages 18-24 years who had been child brides when age 12-16 years …

Attitudes And Beliefs Related To Risk Of Sexually Transmitted Infection In Swingers Who Do Not Use Condoms, Deborah Brown

Walden Dissertations and Doctoral Studies

Sexually transmitted infection (STI) affects the public as a hidden epidemic of contagious disease with significant economic and health impacts. There are 110 million living with STI in the United States, with 20 million new infections annually. Condom use can reduce STI, but some people have sex without condoms, with risk for contracting or transmitting STI increasing when a person is in the same sexual network. Swingers are a growing sexual network and are a group at high risk of developing and spreading STI. The purpose of this generic qualitative study was to develop an understanding of the attitudes and …

Group Education Program To Increase Obesity Knowledge In Cardiac Care Nurses, Ethel Emenogu

Walden Dissertations and Doctoral Studies

Obesity increases the severity of cardiac disease, leading to increased mortality and morbidity. The need to address obesity is critical in reducing obesity-associated complications such as heart failure, strokes, heart attacks, and even death. Obesity is also a risk factor for many chronic diseases such as heart disease, cancer, diabetes, hypertension, and depression. Evidence has shown that obese individuals with cardiac disease are at increased risk of developing complications. The practice-focused question for this doctoral project asked whether a group educational program could increase obesity knowledge among cardiac care clinic nurses. The purpose of this DNP project was to provide …

Predictors Of Hiv Testing Among African American Men Who Have Sex With Men, Jeanette Marie Higgins

Walden Dissertations and Doctoral Studies

Human immunodeficiency virus (HIV) infections affect more than 1.2 million people living in the United States and disproportionately affect African Americans (AA) men who have sex with men (MSM). The numbers of those who have HIV infections are likely higher due to lack of HIV testing by all individuals living at risk for HIV in the United States. Prior research has been inconclusive in determining the exact cause of the disparity among AA MSM. Therefore, the purpose of this quantitative secondary data study was to explore barriers to HIV testing within the AA MSM population. The sample for this study …

Demographic, Environmental, And Clinical Variables Associated With Dengue In Saint Lucia, Brendan Lee

Walden Dissertations and Doctoral Studies

Dengue is the most important arboviral disease of public health concern on the world stage. In Saint Lucia, the disease has been endemic for years. Little research has been published on the specific epidemiology of dengue in Saint Lucia, and this study sought to identify the risk factors associated with the disease specific to the island. This study was underpinned by ecological theory, which is used to explain the possible relationships between risk factors and the occurrence of dengue. This three-manuscript study was used to evaluate the relationship between demographic, environmental, and clinical variables and the occurrence of dengue as …

Healthcare Providers Perception Of Their Ability To Recognize Boys As Victims Of Human Sex Trafficking In A Pediatric Emergency Room, Deborah Susan Mican

Walden Dissertations and Doctoral Studies

The purpose of this dissertation was to explore the perceived barriers to pediatric emergency room (ER) providers’ identifying boys as victims of child sex trafficking (CST), to understand how providers working in a pediatric ER compared to a general ER believe they are better able to identify boys as CST victims, and to understand how the New Jersey-mandated human trafficking training affected the confidence of the healthcare providers’ to identify boys as CST victims using a grounded theory approach. In-depth interviews were conducted using a sample of 10 healthcare providers, including physicians, nurse practitioners, and physician assistants at a suburban …

Accuracy Of Death Certificate Data In Reporting Suicide In The United States, Miland Ned Palmer

Walden Dissertations and Doctoral Studies

Suicide is one of the leading causes of death in the United States. Death certificates are currently being used by public health professionals and policy makers as a main source of public health surveillance data on suicide. The accuracy of death certificates in tracking and reporting suicides has not been well quantified or evaluated in the United States. Death certificates from other countries have been found to under-report suicide. The purpose of this study was to evaluate the accuracy of death certificates in reporting suicides in the United States. The National Violence Death Reporting System (NVDRS) collects information on all …

Socio-Economic Determinants Of Risky Sexual Behavior In Sub-Saharan Africa, Frida Tende

Walden Dissertations and Doctoral Studies

Risky sexual behavior (RSB) is a major public health concern due to health outcomes, such as HIV/AIDS, sexually transmitted infections, and unwanted pregnancies. RSB has been identified as 1 of the main components contributing to the high HIV incidence rate in sub-Saharan Africa. The purpose of the current research was to investigate RSB and its association with education and economic status among men and women in 3 sub-Saharan African countries (i.e., Rwanda, Zimbabwe, and Cameroon) while controlling for gender, age, religion, and place of residence. The social cognitive theory provided the framework for this cross-sectional study that included data from …

Access To Healthcare For American Indians Residing In The Northeast United States, Kristine D. Thomas-Jones

Walden Dissertations and Doctoral Studies

Urban American Indians/Alaskan Natives (AIs/ANs) have limited access to health care in comparison to non-Hispanic Whites (NHWs), which furthers health disparities for indigenous communities. The purpose of this quantitative, nonexperimental study, which was guided by the socioecological model, was to examine the relationship between access to health care and healthcare utilization among urban AIs/ANs and urban NHWs in the Northeast United States. The research questions addressed the difference in access to healthcare based on health insurance, difference in healthcare utilization, and whether there is an association between health care access and health care utilization for AIs in the Northeast United …

Sexual Behavior, Contraceptive Use, And Unmet Needs Among Unmarried Teenage Women In Uganda, Lawrence Were

Walden Dissertations and Doctoral Studies

At 25%, teenage pregnancy in Uganda is one of the highest in the world, and this has been mainly attributed to low contraceptive use and a high unmet need for modern contraceptives. Unmarried women aged 15 to 19 years in Uganda face unique cultural, ethical, financial, and legal barriers to the use of contraception. The purpose of this study was to investigate how sexual behavior, contraceptive use, and unmet needs among unmarried teenage women in Uganda aged 15 to 19 years are influenced by personal and environmental factors. Bandura’s social cognitive theory was used as a theoretical framework for this …

Nurse Practitioner Approach To Care For Peripheral Vascular Disease, Jessica R. Wozniak

Walden Dissertations and Doctoral Studies

The Amputation Coalition indicates that there were approximately 2 million people with limb loss in the United States primarily caused by peripheral vascular disease in 2019. Those with amputation related to vascular disease have a 5-year mortality rate. The gap in clinical practice at the facility used for this project is that there were no comprehensive program guidelines for nurse practitioners and other health care professionals working with people who are at risk for vascular intervention or limb loss. The practice-focused question was answered that an interprofessional team did develop a prototype for a comprehensive peripheral vascular program that serves …

Association Between Obesity, Socioeconomics, Mental Illness, And Education In Native American Communities, Darrell D. Wright

Walden Dissertations and Doctoral Studies

Obesity is a profound health epidemic that adversely affects the health of all ethnicities. This growing health crisis has been found to be linked to several chronic diseases such as stroke, diabetes, and several forms of cancer. As in Native American populations, increased morbidity and mortality rates associated with obesity prevalence in minority populations has been linked to variables such as income, education, mental illness, and age. The purpose of this research was to examine the association of obesity with socioeconomic status, education, mental illness, and age in Native American populations. The theoretical framework used in this study was based …

Changes In Operating Performance In Rural Hospitals From 2012 To 2019, Oluwaseyi Tami Young-Harry

Walden Dissertations and Doctoral Studies

Rural hospitals treat patients while dealing with the challenges of an inadequate workforce, limited financial resources, and an isolated geographic location, leading to difficulties in achieving financial viability. The purpose of this quantitative study was to analyze the operating performance of rural, general, medical and surgical hospitals in the United States and to determine if performance had changed from 2012 to 2019. Guided by x-efficiency theory, this study addressed whether hospital ownership explained variation in performance and if performance had changed from 2012 to 2019. A random sample of 394 rural hospitals was used, with data drawn from the American …

Impact Of Medicare Utilization On Mortality And Readmission Rates Of Heart Failure Patients 65 Years And Over, Joanna Alexander

Walden Dissertations and Doctoral Studies

Roughly 25% of individuals 65 years and over hospitalized with heart failure are readmitted within 30 days after discharge. Elderly individuals identified with heart failure possess a 5-year mortality approaching 50%. The purpose of this study was to determine if there is a relationship between Medicare-covered services for care, mortality rates, and readmission rates for beneficiaries 65 years and over with heart failure. To address this topic, the chosen approach was retrospective and quantitative. The theoretical foundation was the Chronic Care Model. The research questions sought to determine if there is a relationship between the Medicare-covered services for care and …

Recovering Illicit Substance Users' Perspective About Mandatory Drug Testing In Schools, Julie Bowser

Walden Dissertations and Doctoral Studies

The purpose of this exploratory qualitative study was to examine recovering substance

abusers' perceptions about the usefulness of mandatory drug testing in schools for adolescent substance abuse. Illegal substance abuse has reached epidemic proportions as more than half of U.S. adolescents, aged 12 to 17 years, have engaged in illicit drug use. Substance abuse information has been a part of school health education programs since the United States Drug Free Schools and Communities Act of 1986. Despite substance abuse education and school programs about the effects of drug use, many high school students abuse illicit drugs. Face-to-face interviews were conducted …

The Impact Of Dietary Intake On Mortality Risk In Colorectal Cancer Survivors, Ellen Chow

Walden Dissertations and Doctoral Studies

The colorectal cancer (CRC) survivor population is increasing in the United States. The lack of effective dietary recommendations in recurrence prevention undermines the health-related quality of life of survivors. Grounded in the socioecological model, dietary behavior is a personal-level risk factor that individuals may control. This study investigated the CRC-specific mortality risk as predicted by diet quality, dietary fiber intake, and dietary fat intake in hope of contributing to future dietary recommendations. A secondary analysis using data from 1,166 CRC survivors in the Multiethnic Cohort Study was analyzed via Cox proportional hazard regression models to estimate mortality risk. Results from …

Voluntary Male Circumcision And Risk For Human Immunodeficiency Virus In Homa Bay, Kenya, George Obhai Gabriel

Walden Dissertations and Doctoral Studies

The role played by the belief about voluntary medical male circumcision (VMMC) in predicting HIV status has not been examined. The purpose of this study was to investigate whether there were any differences between belief about VMMC, unprotected sex, age, number of sexual partners, relationship status, and HIV status among circumcised males aged between 18-49 years in Homa Bay County, Kenya. Drawing from the health belief model and case-control study design, 936 men were recruited based on their HIV status (468 HIV cases and 468 controls). A bivariate logistic regression was applied, and the results indicated that unprotected sex, age, …

Prostate Cancer Screening Intention Among African American Males Ages 40 To 65 Years, Paul L. Johnson

Walden Dissertations and Doctoral Studies

African American men are at a higher risk of developing and dying from prostate cancer (PCa) compared with any other race or ethnic group. Despite prostate cancer screening (PCS) recommendations, African American men are less likely to be screened for PCa compared with any other race or ethnic group. The purpose of this study was to identify factors that influence the intentions of African American men to obtain a PCS. A nonexperimental cross-sectional research design was used to identify factors associated with the intention to obtain PCS. The theoretical framework for the study was the social-ecological model which posits that …

Impact Of Chlorpyrifos Exposure On Colorectal Cancer In Agricultural Communities In Ohio, Vicky Knisley-Henry

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is the third leading cancer diagnosis in the United States, and second in Ohio, for both men and women. In 2019, there were an estimated 145,000 cases of new CRC diagnoses and will lead to more than 50,000 deaths. Results from a systematic review indicate that chlorpyrifos use in agriculture is linked to the incidence of breast and lung cancers and has a possible association with CRC. Grounded in the social-ecological model, this study investigated the association between exposure to chlorpyrifos and CRC rates in agricultural communities in Ohio. The quantitative cohort design method utilized secondary data …

Obesity, Snoring, Sleep Apnea, And Coronary Heart Disease, Maryam Khalilah Muhammad

Walden Dissertations and Doctoral Studies

Coronary heart disease (CHD) is a significant public health issue that affects communities across all socioeconomic and demographic groups. Risk factors for CHD include sleep apnea and snoring. Obesity with short sleep duration also places individuals at higher risk for CHD. Although limited research has been conducted on CHD and its relationship to obesity, sleep apnea, and snoring as individual risk factors for CHD, a gap exists as these factors had not been studied as paired in this study. The purpose of this quantitative, cross sectional study was to determine if a significant relationship existed between obesity, snoring, sleep apnea, …

Factors Associated With Hepatitis B Vaccination Among Asian Adults (≥ 18 Years) In The United States., Naana Abena Ohemeng-Tinyase

Walden Dissertations and Doctoral Studies

In the United States, hepatitis B disproportionately affects Asian and Pacific Islanders (AAPIs). Hepatitis B related liver cancer is the leading cause of cancer deaths among Asian Americans. Despite the proven significant economic, health, and social effect of hepatitis B virus, immunization rates remain low. The purpose of this study is to examine the association between sociodemographic factors (age, marital status, gender, work experiences), health status factors (chronic disease, nonchronic disease), health behavior factors (smoking, alcohol intake, tobacco use, physical activity), and hepatitis B vaccination among Asian adults (≥ 18 years) in the United States. The main theory that frames …