Public Health Commons^™

Relationship Between Patients Of Low Socioeconomic Status With Multiple Sclerosis And Health Care Providers, Jennifer N. Rhoads

Walden Dissertations and Doctoral Studies

Many health care initiatives seek to improve patient–provider experiences and relationships to support patient satisfaction rates and health outcomes. However, a small amount of published research has examined the perceptions of low socioeconomic status (SES) patients diagnosed with multiple sclerosis (MS) regarding their relationship with their health care provider and how these perceptions affect patient outcomes. Prioritizing communication and approachability between the health care provider and a patient can be instrumental in creating and fostering an authentic relationship. The research question for this study was designed to understand the relationship between participants of low SES who had been diagnosed with …

Suicidal Ideation Among American Indian And Alaska Natives In The United States, Lacie Lashawn Tillman

Walden Dissertations and Doctoral Studies

Suicidal ideation is a silent public health issue across the United States. Evidence suggests that suicidal ideation is a predictor of suicide attempt and completion. Suicide is a leading cause of death among American Indians and Alaska Natives (AIs/ANs) in the United States, especially among younger people. Alcohol and illicit drug use, coupled with poor social conditions, can lead to suicidal ideations—and sometimes suicide completion. Using social cognitive theory, this quantitative cross-sectional study compared variables within the 2017, 2018, and 2019 National Survey on Drug Use and Health to determine the effect that alcohol and/or illicit drug use has on …

Legislative Efforts And Community Change To Combat Female Genital Mutilation In Egypt, Maryam Berkshire

Walden Dissertations and Doctoral Studies

Female genital mutilation is recognized as a violation of human rights as it violates the bodily rights of young girls by cutting part of their bodies without their consent and leaves long term psychological, physical and sexual harm to women who were exposed to the practice. The World Health Organization estimates that 130 million girls and women are subjected to Female Genital Mutilation/Cutting (FGM/C) in African and Middle Eastern Countries. According to a UNICEF 2020 report, Egypt will not meet the SDG goal of eradicating FGM as the decrease in the practice is too slow despite the policy and community …

Spirituality, Hiv And Black/African American Women, Shawanna D. Brun

Walden Dissertations and Doctoral Studies

Despite the surmounting prevalence of human immunodeficiency virus (HIV) among Black women, few studies have been conducted to examine culturally appropriate prevention methods to reduce the occurrence of the disease. The purpose of this cross-sectional study was to explore how religion/spirituality affects the attitudes, beliefs, and self-perceptions of HIV/AIDS among 151 Black/African women, ages 25-44, in Florida, and to investigate the impact of HIV-related stigma on the attitudes, beliefs, and self-perceptions of HIV/AIDS within this population. Social cognitive theory was the framework of the study. Multiple linear regression and hierarchical regression were used to analyze the survey data. Results revealed …

Beliefs About Food Education And Healthy Food Consumption In Food Insecure Areas, Eboni Drummond

Walden Dissertations and Doctoral Studies

Many food desert residents suffer from food insecurity as a result of residing in communities where access to affordable, healthy foods is limited. This limited access can make it difficult for these residents to consume healthy foods, such as fruits and vegetables, on a consistent basis. To increase access to healthy foods, interventions such as the building of supermarkets, the introduction of mobile farmers markets or mobile produce markets, and the conversion of local corner stores into healthy corner stores are often introduced to food desert communities. However, these intervention efforts fail to focus on non-physical factors, such as the …

Opioid Types And Adolescent Prescription Opioid Misuse, Orchid George

Walden Dissertations and Doctoral Studies

AbstractAdolescent prescription opioid misuse (POM) in the United States is a significant public health issue, and there is a lack of studies investigating the association between opioid types and adolescent POM. The purpose of this quantitative cross-sectional study was to explore possible associations between a set of independent variables: opioid types, gender, religiosity, and education, and the outcome variable, POM among adolescents ages 12 to 17 in the United States. The socio-ecological model was the theoretical framework that guided the study. A sample size of 13,722 from the 2017 Substance Abuse & Mental Health Data Archive was analyzed using descriptive …

Effects Of Socioeconomic Status, Demographic Characteristics, And Education On Sarcopenic Obesity, Moruf Oladele Olaleye

Walden Dissertations and Doctoral Studies

The general problem is that although the body of research about obesity is robust, there is a lack of research addressing the problem of sarcopenic obesity. Specifically, there is a lack of research examining the statistical significance of the relationship between the independent variables of socioeconomic status, demographic characteristics, and education and the dependent variable of sarcopenic obesity. This research may advance practice and policy by lending support for developing interventions to address factors that have a statistically significant relationship with sarcopenic obesity. The purpose of this quantitative causal-comparative study was to identify independent variables among socioeconomic, demographic, and education …

Barriers To Blood Availability Within The New Orleans Area, Tishawn Michelle Francis

Walden Dissertations and Doctoral Studies

An adequate and reliable supply of blood and blood components is becoming an increasing public health concern. Over the past decade, researchers have indicated a continued decline in the collection of blood products. An insufficient blood supply may present a risk to both patients and reserves for emergencies and disasters. The purpose of this quantitative, cross-sectional study was to determine whether gender, age group, ethnicity, year, serological tests, and discard factors were associated with the availability of the donated blood supply throughout the New Orleans region. The donated blood supply chain model guided this study. Secondary data were retrieved from …

The Role Of Health And Diet In The Development Of Metabolic Syndrome Stratified By Race, Sex, And Age, Michael D. Harada

Walden Dissertations and Doctoral Studies

Obesity is now recognized as a disease in need of treatment by the medical profession and is associated with other chronic diseases including hypertension, hyperglycemia, hypertriglyceridemia, insulin-resistance, and reduced levels of high density lipoproteins. Metabolic syndrome (MetS) occurs when a combination of at least three of these chronic conditions are comorbid with each other. The purpose of this quantitative cross-sectional study was to find significant health and nutritional predictors of MetS status across race, sex, and age. The evolutionary mismatch hypothesis and health belief model provided the framework for this study. Data were collected from 2,303 participants from the 2015-2016 …

Lead Toxicity, Attention–Deficit Hyperactivity Disorder, And Gun Violence Among Young African American Men, Gwendolyn Hooker-Mcintosh

Walden Dissertations and Doctoral Studies

Violence among adolescents and young adults is a major public health concern in the United States, but it disproportionally affects African Americans. This racial disparity is especially concerning in New Orleans, Louisiana, where fatal and nonfatal shootings have been consistent since 2010 for young African American men. Also, Louisiana ranks third in the nation in prevalence of attention–deficit hyperactivity disorder (ADHD) among children. African Americans in New Orleans have lived in areas known to have greater concentrations of lead in the soil, and African American children and their parents have a lower level of awareness of lead toxicity. The purpose …

Exploring African American Single Mothers’ Experiences With Child Welfare System, Paul J. Melbourne

Walden Dissertations and Doctoral Studies

African Americans are overrepresented in the child welfare system in New York City (NYC). They face racial and ethnic bias, complex procedures, and policies that govern child welfare. The main research question for this study explored the experiences of African American single mothers with the child welfare system. This qualitative study was guided by policy feedback theory; data were gathered from 10 African American single mothers who have had experiences with child welfare investigation within the past 10 years. Participants were interviewed using semistructured questions designed to capture their experiences with the child welfare system. The data were coded for …

Cognition, Neurocognitive Disorder, Psychotropic Group Of Medication, And Fall Among Canadians Aged 65+ Years, Victoria Elaki Momoh

Walden Dissertations and Doctoral Studies

Despite the high incidence of fall among the elderly in residential care, this problem has been minimally explored and reported. This study examined the association between (cognitive performance, dementia, four groups of psychotropic medication-hypnotics, antidepressants, antianxiety medication, and antipsychotics) and fall among Canadian elderly in residential care. A multi–variate logistic regression was used for the analysis. The Social Cognitive Theory was used to interpret the findings of an analysis on 180,231 Canadian residents from 2018–2019. Cognitive performance at intact level (OR=1.114, p<0.001), cognitive performance at moderate level (OR=1.192, p<0.001), dementia diagnosis (OR=1.075, p<0.001), antipsychotics (OR=2.571, p<0.001), antidepressants (OR =1.486, p<0.001) and antianxiety prescription (OR=3.284, p<0.001) increased the odds ratio of fall. However, cognitive performance at severe level (OR=0.898, p<0.001), no dementia diagnosis (OR=0.001, p<0.001) and hypnotics prescription (OR=0.389, p<0.001) decreased the odds ratio of fall. Findings indicate that cognitive performance at the intact and moderate levels, antianxiety, antipsychotic and antidepressant medications and dementia were strong predictors of fall among the elderly in residential care in Canada. A limitation of the study was that the dataset used captured data from 7 out of 13 Canadian provinces and territories therefore, limiting external validity. The potential positive social change impact of this study is that it would guide caregivers, enhance fall prevention practices and decrease fall occurrence in this population.

Competency-Based E-Learning Module For Nurses In A Multi-Service-Line Surgical Unit, Exequiel P. Naculangan

Walden Dissertations and Doctoral Studies

Negative patient outcomes have been attributed to surgery-related complications. A gap was identified in an acute care unit in southern Texas because postoperative surgical complications were above acceptable rates. The purpose of this Doctor of Nursing Practice project was to educate staff nurses on the provision of evidence-based postsurgical care. This doctoral project was conducted to determine whether completion of a learning module would increase nurses’ level of knowledge in acute postoperative care. The project was grounded on Knowles’s adult learning theory and the Dreyfus model of skill acquisition. Learning material using competency-based education was developed using the analyze, design, …

Role Of Hypertension In Low-Birth-Weight Racial Disparities Among Virginian Women, Ashli Owen

Walden Dissertations and Doctoral Studies

Low birth weight (LBW) is a leading cause of infant mortality globally, but it disproportionately burdens the Black community in the United States, with a rate twice that of White women. Further, hypertensive disorders of pregnancy (HDsP) increase LBW incidence. The purpose of the study was to assess the association between HDsP and LBW, maternal race and LBW, and the moderation effect of HDsP on race and LBW on Black and White women in Virginia. The theoretical framework for this study was based on the lifecourse health development model, which states that health should be viewed as an outcome of …

Associations Of Fast-Food Zoning Policy And Cardiovascular Disease In African American Communities, Starrlett Pena-Johnson

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) remains a major public health concern, causing one in every four deaths in the United States. Despite availability of effective disease management, African Americans bear the burden of incidence and mortality as CVD prevails as the primary cause of disparities in life expectancy, stroke, and heart failure. This cross-sectional study investigated fast-food restaurant (FFR) availability and socioeconomic status (SES; income, occupation, and education) to predict CVD risk scores in African Americans residing in Jackson, Mississippi. The social construction of target populations theory was used to inform this study. Using hierarchical multiple linear regression, a secondary data analysis …

Association Of The Use Of Combination Therapy Self-Management Of Prediabetes And Type-2 Diabetes Mellitus In Adults, Celestina Reed

Walden Dissertations and Doctoral Studies

Diabetes is a long-lasting chronic health condition that encompasses three types: Type 1, Type 2, and gestational diabetes. The disease affects how the body breaks down food into energy. It is an insulin-deficient disease and causes heart disease, vision loss, and kidney disease. Investigators of the Centers for Disease Control and Prevention and the American Diabetes Association evaluated patient treatment preferences to determine the upsurge in patient health-related quality of life (HRQOL) and optimum health. The literature revealed that patients' preferences consisted of therapies and achievable goal setting using the health belief model (HBM) framework. This quantitative research aimed to …

Health Educator Experience: Recommendations For Physical Activity For Mental Health In Women, Patricia Schneider

Walden Dissertations and Doctoral Studies

Mental health issues, specifically anxiety and depression, continue to be a public health crisis in the United States. Despite the established therapies of pharmacology and cognitive behavioral therapy, not all patients seek or find relief using these methods. Therefore, other treatment strategies need to be studied. The purpose of this basic qualitative study was to understand the experiences of health educators who use physical activity as a strategy for anxiety and depression management among middle-aged women as well as their own attitudes, norms, and perceived behavioral controls. The theory of planned behavior (TPB) was leveraged as the theoretical foundation for …

Services For Homeless Veterans: A Study Of Access To Benefits, Sheryl Maddox Williams

Walden Dissertations and Doctoral Studies

AbstractHomelessness among veterans in the United States is a multifaceted social and health concern that has continued to increase despite immense efforts to minimize and eliminate this issue. Numerous organizations have dedicated resources; however, many veterans do not use benefits and resources that are available to them, and homelessness remains a health and social concern. The purpose of this study was to explore and describe how individual and interpersonal barriers, community factors, organizational structure, and existing policies for assistance are perceived by support staff that work with veterans with mental disorders who are homeless or at risk of becoming homeless. …

Gestational Weight Gain, Level Of Education, And Infant Mortality Among African American Women, George Lee Amanambu

Walden Dissertations and Doctoral Studies

Abstract

African American (AA) women in Mississippi have a higher burden of infant mortality, especially those with low income and educational levels, as compared to other regions of the country. However, it is unknown if abnormal gestation weight gain (GWG) is contributing to this increased burden. This quantitative cross-sectional study examined the association between GWG (25-35lbs), level of education, income, and infant mortality among AA women with normal prepregnancy body weight who were between 30 to 47 years old in the state of Mississippi from 2016 to 2018. Biopsychosocial and ecosocial models were used as the theoretical foundation to design …

Factors That Determine Utilization Of The Canadian School-Based Human Papilloma Virus Vaccine Programs, Diane Gloria Brown

Walden Dissertations and Doctoral Studies

Human Papilloma Virus (HPV) is the most common sexually transmitted infection in the world and is the known causative agent of many HPV-associated cancers in both males and females. HPV vaccination rates in Canada are significantly lower than other developed countries and this finding is poorly understood as Canadian adolescents have access to free-of-charge HPV vaccines through school-based vaccination programs. This quantitative descriptive study used an online survey to collect data from 992 eligible respondents. This study identified predisposing, enabling, and need factors characterized by the Andersen behavioral model of health services use which facilitate or impede the use of …

Secondary Data Analysis Of The Association Of Screen Time With Selected Health Behaviors, Kellany Cadogan Noland

Walden Dissertations and Doctoral Studies

The noticeable disparity in youth access of preventive healthcare and youth’s tendency towards excessive screen time have been linked to poor health outcomes. This issue prompted the current study, which had three core purposes: to identify associations between screen time and selected health behaviors, to identify target sociocultural and personal determinants of youth health, and to provide evidence to prompt innovation in promoting youth health via screen-based strategies. The social cognitive theory provided a context for triadic reciprocity between youth personal factors, environmental factors, and behaviors. A quantitative secondary analysis was completed using SPSS-27 to identify whether there was an …

Nurses' Experiences Caring For Patients With Opioid Use Disorder, Pamella Maureen Campbell

Walden Dissertations and Doctoral Studies

Over the past 2 decades, opioid use in the United States has taken thousands of lives, reached the level of epidemic in 2017, and has been an area of study among scholars. The problem is health care professionals, including nurses, lack training on how to care for people with opioid use disorder (OUD). Nurses are at the frontline of patient care and understanding the nurses’ experiences in the care of patients with OUD may help to improve the patients’ quality of care. The purpose of this qualitative descriptive study was to develop an understanding of the experiences of nurses with …

Fortitude, Spiritual Fortitude, And The Cancer Care Continuum In African American Breast Cancer Survivors, Karen Y. Boone

Walden Dissertations and Doctoral Studies

African American breast cancer survivors (AABCS) struggle with physical, emotional, psychological, spiritual, and financial challenges. Navigating these challenges can require the use of inner resources such as fortitude and spiritual fortitude. Using Folkman and Lazarus’ transactional model of stress and coping as the theoretical framework, the purpose of this study was to examine fortitude and spiritual fortitude as coping responses by African American women living with breast cancer and whether fortitude and spiritual fortitude were associated with phases of the cancer care continuum. A quantitative nonexperimental cross-sectional design was used for primary data collection that involved using Pretorius’ Fortitude Questionnaire …

The Impact Of Electronic Health Records Meaningful Use On Patient Safety And Satisfaction, Paulette Brown

Walden Dissertations and Doctoral Studies

AbstractThe widespread adoption of electronic health records (EHRs) is encouraged because of their potential to improve the quality of care provided. It was unknown to what extent the meaningful use of EHRs would impact patient safety and satisfaction in general and specialty hospitals. The researcher’s purpose for this quantitative correlational research was to examine the impact of meaningful EHR use of EHRs on patient safety and satisfaction outcomes in general and specialty hospitals in Philadelphia (PA). The constructs of the institutional theory guided the study. The hypotheses that guided the study included (a) Meaningful EHR use positively influences patient satisfaction …

Working Mothers’ Lived Experiences Of Maintaining An Exercise Practice During A Pandemic, Sabrina Marie Cali

Walden Dissertations and Doctoral Studies

Working mothers have been associated with low levels of exercise during the COVID-19 pandemic. This population faces many challenges and obstacles to exercise as they manage a household and work; this lack of exercise could leave their health at risk. Researchers have not yet considered working mothers’ lived experiences with exercise during a pandemic. Existing research on working mothers indicates there are barriers to exercise for this population, but more information on what allows these mothers to sustain exercise is needed. This qualitative narrative study was conducted to explore the lived experiences of working mothers who maintained an exercise practice …

Obesity's Impact Among Asian Americans In Southern California, Alyssa Mae Sunga Carlos

Walden Dissertations and Doctoral Studies

Obesity continues to be an important public health issue in the United States, especially among minority populations. However, one minority group experiences the lowest obesity rate: Asian Americans. As a result, there is not much research available involving the impact of obesity and weight gain among this population. The purpose of this basic qualitative exploratory study was to improve the understanding of obesity’s impact on the Asian American population, specifically in Southern California, whose goals were to lose weight and become more informed about obesity’s impact on health. The study consisted of three main research questions. Twenty-five participants were interviewed …

Nutrition And Physical Exercise Prevention Strategies To Reduce Obesity During The Covid-19 Pandemic, Carmesha Vajill Carter

Walden Dissertations and Doctoral Studies

Obesity has reached an epidemic level of 75 million obese adults and 15 million obese children in the United States. The research problem addressed in this study is the lack of information on how obese people manage their weight-loss strategies to prevent or reduce obesity during shut-in place restrictions for the COVID-19 Pandemic. This study included the Prochaska and DiClemente Trans-Theoretical Model of Behavioral Change and the Stage of Change Theory. The phenomenon approach using phenomenology described participants' lived experiences of being obese. The researcher completed data collection and evaluation among sixteen participants using email questionnaires to analyze participant's responses …

Pharmacists’ Responses To Medication Management Following Disasters, Rellamichelle W. Tyree

Walden Dissertations and Doctoral Studies

Disasters, both natural and human made, can cause emerging health threats in the United States and the Caribbean. The disasters that pharmacists experienced and reported for this study included hurricanes, snowstorms, ice storms, flooding, and a pandemic. The purpose of this research was to investigate the challenges and outcomes associated with pharmacists’ medication management practices during and following disasters. This generic qualitative study focused on pharmacists’ experiences and their responses to disaster planning and medication management activities. The ecological model of disaster management was the conceptual framework used to investigate the pharmacists and their responses and actions used to address …

Parents' And Caregivers' Attitudes About Child Passenger Safety, Latoya Wider

Walden Dissertations and Doctoral Studies

Motor vehicle crashes are a leading cause of childhood injury and death in the United States. Many car seats are installed incorrectly, and many children under the age of 6 are seriously injured or killed in a motor vehicle crash. The purpose of this study was to examine the relationship between age of child, age of parent/caregiver, attitudes, and behaviors of child passenger safety among parents and caregivers in South Carolina. The influence of age and attitude on consistent car seat use was also examined. The study was based on the theory of planned behavior. A survey design featuring questions …

Early-Life Farm Exposures And Eczema Among Adults In The Agricultural Lung Health Study, Annah B. Wyss, Thanh T. Hoang, Hilde K. Vindenes, Julie D. White, Sinjini Sikdar, Marie Richards, Laura E. Beane-Freeman, Christine G. Parks, Mikyeong Lee, David M. Umbach, Stephanie J. London

Mathematics & Statistics Faculty Publications

Background

Several studies conducted in Europe have suggested a protective association between early-life farming exposure and childhood eczema or atopic dermatitis; however, few studies have examined associations in adults.

Objectives

We investigated associations between early-life exposures and eczema among 3217 adult farmers and farm spouses (mean age, 62.8 years) in a case–control study nested within an US agricultural cohort.

Methods

We used sampling-weighted logistic regression to estimate odds ratios and 95% confidence intervals for associations between early-life exposures and self-reported doctor-diagnosed eczema (273 cases) and polytomous logistic regression to estimate odds ratios (95% confidence intervals) for a 4-level outcome combining …