Public Health Commons^™

Why Some Cancer Patients Chose Fasting Instead Of, Or With, Conventional Treatments, Richard Alvin Sacks

Walden Dissertations and Doctoral Studies

Abstract Conventional cancer treatment consists of some combination of three therapies: chemotherapy, surgery and radiation. The purpose of this study was to understand why some individuals diagnosed with cancer elected to follow an alternative course of treatment, consisting of fasting on juices or water only rather than, or in addition to, conventional cancer treatment. The theory chosen to guide this study was the Markula Center for Applied Ethics framework for ethical decision making. Research questions were designed to understand the decision-making process of study participants in choosing fasting on juice or water only, rather than, or in addition to, the …

Sociodemographic And Behavioral Predictors Of Obesity Among Female Asian Indian Immigrants In The United States, Afiya Saleem

Walden Dissertations and Doctoral Studies

Individuals from low-income countries such as those in the Asian region migrate to high-income countries and adopt obesogenic behaviors like sedentary lifestyles and high fat and sugar intake. This results in increased susceptibility to obesity, diabetes mellitus, cardiovascular disease, and stroke. Previous research has demonstrated that migrants from South Asian countries are at an increased risk of developing obesity, type 2 diabetes, and hypertension; however, little is known about the factors that contribute to this phenomenon. This was a quantitative, cross-sectional study guided by the social-ecological model. This study used secondary data from the National Health Interview survey to investigate …

Relationship Between Student-Centered, Active Learning Strategies And Student Success In An Undergraduate Nursing Course, Camden Seal

Walden Dissertations and Doctoral Studies

In 2010, the Institute of Medicine issued a report calling for the transformation of undergraduate nursing education to prepare new graduates for the complexities of practice. To improve preparation for practice, faculty responded by incorporating student-centered, active learning strategies (SCALS); however, the effectiveness of SCALS has not been examined. The purposes of this descriptive correlational study, guided by Brunner’s constructivist theory, were to determine the relationship between (a) a nurse educator’s use of SCALS and the percent of students that successfully completed the course, (b) an educator’s self-perception of their learner-centeredness and the use of SCALS, and (c) an educator’s …

Public Safety Personnel And The Use Of Peer-To-Peer Mental And Emotional Support Through Social Media, Tiffany R. Shinton-Truitt

Walden Dissertations and Doctoral Studies

The emotional and mental health of public safety personnel has been a topic that is continuing to receive attention. Being exposed to multiple traumatic events takes a mental and emotional toll on those who place their lives in harm’s way to help others. The study was based on social cognitive theory which focused on self-efficacy through social influences and environment. The purpose of this study was to understand the experience of public safety personnel’s training regarding their perceptions to mitigate emotional stress; the experience of public safety personnel with seeking mental health services; experience of public safety personnel with the …

Beyond The Basics: Educating Nurses At The Bedside About Evidence-Based Practice, Katherine D. Simpson

Walden Dissertations and Doctoral Studies

The nursing profession is a large and dynamic part of the healthcare industry with the greatest percentage of nurses practicing at the bedside. An increase in nursing professionalism with evidence-based practice has emerged over the past several decades. However, evidence continues to support a lack of knowledge among registered nurses in implementing evidence-based patient care at the bedside and the need for education related to evidence-based practice. The analysis, design, development, implementation, and evaluation model of instructional design framed this Doctor of Nursing Practice project. The purpose of the project was to fill the practice gap through the planning, implementation, …

Impact Evaluation Of The Brfss In New York On Obesity Prevention For Weight Loss Among Women, Nikisha Skeete

Walden Dissertations and Doctoral Studies

Abstract Obesity has increased among the adult population, specifically women, in the United States within the past few decades. While the increase in obesity has been linked to a lack of physical activity and poor dietary intake, obesity lacks contextual analysis within adult women as a group. The purpose of this quantitative study was to examine the impact of the Behavioral Risk Factor Surveillance System (BRFSS) on obesity prevention for weight loss in women. Health behavior change theory, the transtheoretical theory model, and the health behavior model guided this study. The research questions were designed to examine whether modifiable lifestyle …

Impact Of Poverty On Antibiotic Prescribing Rates In The United States Through Mediation Effects Of Underlying Health Conditions, Nato Tarkhashvili

Walden Dissertations and Doctoral Studies

Resistance to antibiotics among bacteria develops largely due to frequent use of antibiotics in human and animal medicine. Little is known about how patients’ socioeconomic factors, in conjunction with chronic health conditions, impact antibiotic prescribing rates in the United States. The research questions aimed to explore the relationship between poverty and antibiotic prescribing rates while also adjusting for confounders such as population aged ≥ 65, physician density, prevalence of obesity, diabetes, and chronic obstructive pulmonary disease (COPD). The relationships were evaluated using a quantitative, ecological study design using the ecosocial theory and mediation analysis of 2020 survey results provided by …

Military Health Services Impact On Patient Understanding Of The Zika Virus Within A Military Community, Gabrielle Tellis

Walden Dissertations and Doctoral Studies

AbstractThe Zika virus does not have a known treatment, despite ongoing efforts since 2016 to develop a vaccine. The Zika virus has been labeled by World Health Organization and the Department of Defense as a threat to the readiness, resiliency, and preparedness of military service members and dependents that currently travel or serve in areas where high concentrations of the virus are present. As such, it is important to understand how the military community understanding of the Zika virus is impacted by military health services and education. A phenomenological qualitative approach was utilized to conduct this study. Twenty active-duty military …

Vitamin K Deficiency And Ischemic Stroke In Atrial Fibrillation Patients On Warfarin, Kimberly Therese Thompson

Walden Dissertations and Doctoral Studies

Individuals with poor nutritional vitamin K status can suffer from atrial fibrillation (AF) due to misinterpretation of warfarin instructions by healthcare providers. The purpose of this quantitative study was to determine if there was an association between inadequate dietary vitamin K intake in AF patients and stroke outcomes to address the lack of research surrounding stroke outcomes in patients with true vitamin K deficiency. Grounded in the health belief model, this study assessed if individual beliefs from health education influenced the nutritional quality of their diet and health outcomes. The study is a secondary data analysis of the Framingham Heart …

The Association Between Self-Efficacy, Patient Health Education, And Self-Management In Patients With Rheumatoid Arthritis, Julie Vultaggio

Walden Dissertations and Doctoral Studies

Although previous researchers have studied education for patients with chronic conditions, they have not adequately considered the relationship between self-efficacy (SE), patient health education, and perception of self-management (SM) in patients with rheumatoid arthritis (RA). Educating a patient can empower them to better SM. The purpose this study was to examine these associations in this patient population. This quantitative research study featured a descriptive, nonexperimental cross-sectional survey design using nonprobability convenience sampling. The theoretical framework was the social cognitive theory. The independent variables were SE and patient health education. SM was the dependent variable. Patients with RA from a rheumatology …

Factors Influencing Human Papillomavirus Vaccination Among Hispanic Youth In Bexar County, Texas, Timothy Edward Wallum

Walden Dissertations and Doctoral Studies

A high number of Hispanic youth in Bexar County, Texas, face morbidity and mortality related to human papillomavirus (HPV) infection due to inadequate vaccination coverage youth. A better understanding of the factors that influence vaccination might help public health authorities to increase coverage. The aim of this quantitative, cross-sectional study, which was based on the socioecological model and involved analysis of weighted survey data from the 2016 to 2018 National Immunization Survey-Teen, was to better understand the multilevel factors influencing HPV vaccine use among Hispanic youth. The weighted sample was representative of the study population in terms of survey characteristics …

Staff Education To Improve Workplace Wellness Program Resource Use, Joann Coley Ward

Walden Dissertations and Doctoral Studies

Workplace wellness programs, as a determinant of health, have the potential to improve the health of people, but are often underutilized due to a lack of knowledge of the programs. This project was conducted to examine whether a panel of experts would validate a staff education module designed to improve knowledge deficits amongst Army civilian employees and their supervisors about the Army’s civilian fitness program (CFP). The purpose of this project was to create a staff education module with a pretest and a posttest that could be validated by a panel of experts. The education module addressed the public health …

Weight Management Clinical Practice Guidelines For The Obese, Pre-Diabetic, And Diabetic Population, Dawn Williams

Walden Dissertations and Doctoral Studies

AbstractDiabetes is among chronic or lifestyle-related illnesses posing health care challenges at epidemic proportions, pressuring health care systems infrastructure for positive outcome-driven practices and sustainable costs, as continued research suggests that obese people are up to 80 times more likely to develop type 2 diabetes. In June 2021, a weight-loss and wellness center serving this high-risk population established recommended guidelines for Hemoglobin A1C (HbA1C) screening and education. During the initial 3 months of implementation, data findings captured 37% in a total of 220 with elevated HbA1C levels. The gap in practice is that the Wellness Center did not have a …

Perceived Diabetes Susceptibility Among African American Female College Students, Khaliah India Wilson

Walden Dissertations and Doctoral Studies

Type 2 diabetes is a leading cause of death among African American women ages 20-44 years, and African American female college students are at high risk. Research shows that college students tend to underestimate their susceptibility to Type 2 diabetes, despite their existing risk factors. There is a gap in knowledge concerning African American female college students and their perception of diabetes susceptibility, despite their increased risk. The purpose of this quantitative nonexperimental, correlational study was to identify the factors associated with perceived personal susceptibility to Type 2 diabetes and Type 2 diabetes-related health behavior among African American female college …

Subnational Data To Inform Measles Vaccination Campaigns In Children Under 5 Years In Tanzania, Tracie Jean Wright

Walden Dissertations and Doctoral Studies

Measles is one of the most contagious diseases ever known, infecting as high as 90% of susceptible persons encountering the virus, and globally is one of the main causes of disability and death among children. Measles remains an avoidable disease that can be prevented by receiving a measles containing vaccine using supplemental immunization activities (SIA) implementation strategies. Because national-level measles data may not reflect geographic differences, program capacity, or localized outbreaks, SIAs prompted by and geared toward the subnational level may have a greater impact than a nationwide SIA. The purpose of this retrospective cross-sectional study was to examine the …

Treatment-Seeking Behaviors And Malaria Prevalence Among Under-5 Children In Niger, Aissa Yaye Habi

Walden Dissertations and Doctoral Studies

Malaria is a deadly vector-borne disease that mainly affects children in Africa, especially in Niger. Although public health efforts in malaria prevention have been successful in many parts of the world, malaria remains a significant public burden in sub-Saharan Africa, especially among children. Despite the numerous studies conducted on individual factors influencing the prevalence of malaria in sub-Saharan Africa and Niger, there is little knowledge about the collective influence of treatment-seeking behaviors and malaria prevalence among under-5 children in Niger. This study was a quantitative study with a cross-sectional design guided by the social-ecological model (SEM) that used secondary data …

Relationships Between Stress Self-Management, Social Support, And Health In Hispanic Informal Caregiver Burnout Prevention, Nicole Alexandra Mas Román

Walden Dissertations and Doctoral Studies

Burnout syndrome is a psychological disorder characterized by physical, emotional, and mental distress and exhaustion resulting in feelings of depression, anxiety, irritability, and negative attitudes. If left unattended, burnout syndrome can lead to new or worsening health outcomes. The purpose of this nonexperimental quantitative study was to examine the relationship between stress self-management, perceived social support, health status, and burden among Puerto Rican informal caregivers. The theoretical foundations for this research were the informal caregiving integrative model and the individual and family self-management theory. Survey data were collected from 415 participants. Multiple regression analyses were performed to determine the relationship …

Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo

Walden Dissertations and Doctoral Studies

Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …

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 …

Exposure To Malaria Awareness Messages And Preventive Health Behaviors Among Informal Workers In Ghana, Nora Larkai

Walden Dissertations and Doctoral Studies

Malaria is a global health issue that is most prevalent in Sub-Saharan countries such as Ghana. In the past, various studies have examined the use of malaria messages and malaria prevalence; however, very few Ghanaian studies focus explicitly on using various types of malaria-related messaging modalities and the impact of these messaging systems on lessening malaria contraction among the informal sectors. The aim of this study was to analyze the relationship between exposure to malaria awareness messages, place of residence, and preventive health behaviors controlling for sex, occupation group, marital status, and educational level among Ghanaian informal workers. This study …

Hand Hygiene Education For Nursing Homes, David La Rosa-Presume

Walden Dissertations and Doctoral Studies

In the health care sector, hand hygiene has been identified as one of the most appropriate approaches to preventing health-associated infections or nosocomial infections. A nursing home in the western United States had repeated survey findings showed that their hand hygiene compliance rates did not meet the expectations of the Long-Term Care Institute. This project was aimed to develop and implement an education program to improve hand hygiene compliance in a nursing home setting. The project practice question asked whether an education program would increase staff’s knowledge of hand hygiene methods within a skilled nursing facility. The Joint Commission’s Targeted …

Weight Change And Hyponatremia As Predictors Of Polydipsia Among Persons With Schizophrenia, Kingsley Okechukwu Nwachukwu

Walden Dissertations and Doctoral Studies

AbstractPolydipsia is found in 20% of inpatients with chronic severe mental disorders. Of this, 80% are diagnosed with chronic schizophrenia, hence polydipsia is strongly associated with chronic schizophrenia. Despite the prevalence and serious health complications of coexisting polydipsia in this population, its current method of detection is flawed. The purpose of this quantitative study was to accurately identify comorbid polydipsia in schizophrenia using periodic weight change and hyponatremia. The Wilson’s complexity theory and primary data were used to attempt to explain the relationship between weight change and hyponatremia and polydipsia, in a cross-sectional study design. The dependent variable was polydipsia, …

Risk Factors Associated With Access To Intermittent Preventive Treatment For Malaria Among Pregnant Women In Uganda, Mayanja Simon Peter

Walden Dissertations and Doctoral Studies

Intermittent preventive treatment of malaria in pregnancy (IPTp) is an intervention consisting of the full course of therapeutic antimalarial medicine administered to pregnant women during routine antenatal visits regardless of whether the woman is infected with malaria. The use of intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) has been reportedly low in most of the malaria endemic areas, including Uganda. The coverage of IPTp in Uganda has been estimated to be as low as 17%. An in-depth secondary data analysis using the 2016 Uganda Department of Health Services survey was conducted to understand the causal relationships between …

Depression, Drug Use, And Hsv-2 Among Women Who Have Sex With Women, Viani Picchetti

Walden Dissertations and Doctoral Studies

Herpes simplex virus type 2 (HSV-2), the main cause of genital herpes, is an incurable sexually transmitted infection responsible in 2018 for 18.6 million infections in the United States. HSV-2 is twice as frequent in women than in men. Women who have sex with women (WSW) have a higher prevalence of depression and drug use than women who have sex exclusively with men (WSM), which are each related to HSV-2 as they increase the likelihood of engaging in risky sexual behaviors. The purpose of this study was to assess the predictive relationship between depression status, nonprescription drug use status, and …

Gaps In Immunization Prevention In The State Of Ohio, Audrey Shaw

Walden Dissertations and Doctoral Studies

In the United States, the total cost for vaccine preventable diseases was $8.95 billion in 2015. The unvaccinated accounted for 80% of the total costs. This quantitative study was conducted to investigate the success and/or gaps in the implementation of the measles, mumps, and rubella (MMR) vaccine through the Vaccine for Children (VFC) Program by the Ohio Department of Health. General systems theory was chosen as a theoretical framework due to the complicated nature of the healthcare system. Healthcare is a complex system composed of multidisciplinary units that have their own structure and purpose that interact to accomplish the mission …

Factors That Influence Seeking Prostate Cancer Preventive Care In African Immigrants, Millicent N. Seilenga

Walden Dissertations and Doctoral Studies

AbstractProstate cancer is a major public health problem, being the second leading cause of cancer deaths in U.S. men, but mortality can be prevented with the use of early detection strategies. African American men are more than twice as likely to die of prostate cancer as compared to Hispanic and White men. African immigrant men as compared to African American men born in the United States have higher mortality rates of prostate cancer due to not seeking preventive care. However, little is known about the factors that prevent African immigrant men living in the United States from seeking prostate cancer …

Health Belief Effects On Preventive Health Among Hispanic Migrant And Seasonal Farmworkers, Angela M. Trawick

Walden Dissertations and Doctoral Studies

Migrant and seasonal farmworkers (MSFWs) are the unhealthiest workers in the United States and experience barriers to preventive healthcare. While faced with numerous health risks, many Hispanic MSFWs may not seek preventive health services or have access to them when they need them. The purpose of this study, guided by the rural nursing theory, was to understand the beliefs/health seeking behaviors of MSFWs and how they described usage of preventive health services. Fourteen Hispanic farmworkers volunteered to do telephone or in person interviews. The codes and categories were reviewed to identify patterns and make connections between the data using Saldana’s …

Factors Associated With The Uptake Of Hiv Testing Among African American Male College Students, Brittney Sade Washington-Ball,Drph

Walden Dissertations and Doctoral Studies

HIV testing rates are much lower among African American male college students than male college students of other racial groups. Routine HIV testing on college campuses can decrease HIV rates among African Americans and increase students' awareness of their HIV status. This study was an investigation of factors associated with HIV testing among a sample of 140 African American male college students. The health belief model guided the research study and served as the theoretical framework to examine the influence of factors such as the location of testing, STD status, number of sexual partners, insurance coverage, health information, and alcohol …

Adverse Childhood Experiences And Hiv Risk Behaviors Among Transgender Populations, Linda Baggio

Walden Dissertations and Doctoral Studies

Adverse childhood experiences (ACEs) have a negative impact on health and have created a social challenge in managing HIV risk behavior in the transgender population. The aim of this study was to determine the association between ACEs and HIV risk behavior among the transgender population and identify the association between ACE score (1, 2, 3, 4, or more) and HIV risk behavior among the transgender population. This involved a quantitative methodology using a Behavioral Risk Factor Surveillance System (BRFSS) questionnaire to obtain data from 323 transgender participants. Multivariable regression analyses were conducted to determine the association between ACEs and HIV …

Perceived Barriers To Health Care Access And Delivery Among Arkansas Medicaid Beneficiaries, Kimbra D. Butler

Walden Dissertations and Doctoral Studies

Arkansas has historically been one of the lowest ranking states in the United States in education, economy, opportunity, crime and corrections, and health care. Though more than 3 million Arkansans live in the state, nearly 1 million receive Medicaid-funded health insurance. This phenomenological study employed a constructivist paradigm and focused on the perceptions of underserved Arkansans regarding their health and their access to health care; additionally, within this study, the Health Belief Model shifted the study’s focus to individuals’ perspectives, perceptions, experiences, and opinions through interview responses. The research was intended to identify factors that may relate to the higher …