Public Health Commons^™

The Lived Experiences Of Black Women With Hysterectomy For Benign Fibroids, Clarise M. Jackson-Hall

Walden Dissertations and Doctoral Studies

Black women are more likely than women of any other race in the United States to undergo an abdominal hysterectomy instead of a less invasive and less damaging laparoscopic or robotic procedure for benign fibroids. Although Black women are the population most disparately affected by benign fibroids, as evidenced by higher morbidity and mortality rates due to complications, they are often excluded in clinical research. The purpose of this qualitative phenomenological study was to explore the lived experiences of Black women who decided to undergo an invasive abdominal hysterectomy for benign fibroids. Semistructured interviews were conducted with 14 Black women, …

The Disaster Health System: Built For Collaboration And Coordination In A Complex Environment, Leslie E. Taylor

Walden Dissertations and Doctoral Studies

This qualitative case study examined patient distribution and coordination during complex, rapidly changing, uncertain emergencies or disasters. The study explored how Washington State’s Northwest Healthcare Response Network (NHRN) uses the state’s patient tracking system, WaTrac, as a collaboration tool for Emergency Support Function 8 (ESF 8) and public health emergency operations. This study used complexity theory to address a gap in the literature, acknowledging the importance of relationships among members of the NHRN and how the patient tracking system could enhance positive patient outcomes. This study included nine healthcare response participants; all were members of the NHRN healthcare coalition serving …

Improving Student Nurse Clinical Reasoning, Critical Thinking, And Clinical Judgment Through Simulation Debriefing, Deborah Brester

Walden Dissertations and Doctoral Studies

Simulation is an educational strategy in nursing education that incorporates structured activities that depict real-life situations to develop and enhance the knowledge, skills, and attitudes of nursing students by allowing them to analyze and initiate interventions for realistic situations in a simulated environment. Debriefing is a reflective process and is a key component in the simulation education process, but there is a lack of evidence on debriefing methods that enhance learning outcomes in nursing education. This study, which was guided by the National League for Nursing Jeffries simulation theory, was to determine the effect simulation debriefing, as assessed using the …

Self-Efficacy Facilitated Sleep, Physical Activity, Towards Regulating Bmi Of Permanent 12-Hour Shift Registered Nurses, Veronica Brock

Walden Dissertations and Doctoral Studies

Shift workers with obesity-related comorbidities have reduced health and lifespan. Registered nurses (RNs) are ranked fifth among the most obese professionals in the United States, according to recent studies. Researchers have not examined the relationship between self-efficacy, physical activity, sleep, and 12-hour night shift RNs despite demonstrating that self-efficacy inspires confident health habits in the general population. For this quantitative study, the social cognitive theory was applied to study the interrelationships among the independent variables, sleep self-efficacy, self-efficacy for physical activity, and body mass index (BMI), with multiple dependent demographic variables, quality and quantity of sleep, and the level and …

The Hospital Consumer Assessment Of Healthcare Providers And Systems And Central-Line-Associated Bloodstream Infections, Mary Kerich

Walden Dissertations and Doctoral Studies

Central-line-associated bloodstream infections (CLABSIs) are common healthcare-associated infections (HAIs) contributing to extended hospital stays, morbidity, mortality, and healthcare costs. In 2011, the Centers for Medicare and Medicaid Services implemented the Hospital Value-Based Purchasing initiative, which links acute care hospitals' payments to quality performance. A gap in the literature existed regarding the relationship between hospital characteristics, patient experience, and CLABSI rates. This quantitative study aimed to explore the relationship between patient experience scores reported by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and CLABSI standardized infection ratio (SIR) in nonprofit acute care hospitals in the United States. Three …

Using Multi-Theory Model (Mtm) To Predict Intention To Promote Physical Activity By Primary Care Providers, Shirley Mcclendon

Walden Dissertations and Doctoral Studies

Physical inactivity persists as a public health concern worldwide and results in more than a million deaths per year. This modifiable behavior can result in improved health when primary care providers (PCPs) communicate recommendations to patients and behavior change is supported. In this study, a quantitative cross-sectional design was used to investigate the intentions of PCPs in providing physical activity counseling, using the constructs of the multi-theory model (MTM) of health behavior change as the theoretical framework. An anonymous 37-item electronic survey was administered to participants practicing primary care and family medicine from rural areas in the Southeastern region of …

Association Between Covid-19 Health Knowledge, Self-Efficacy And Preventive Behaviors Among Nursing Students, Josephine Miane Britanico

Walden Dissertations and Doctoral Studies

Abstract Nursing students possess valuable public health knowledge to prevent the spread of COVID-19 infection. They can provide health education to the public with reliable information and adequate resources. To better understand the role nursing students can take in prevention efforts, the purpose of this quantitative correlational study was to examine the association between COVID-19 health knowledge, self-efficacy, and preventive behavior among undergraduate nursing students. The health belief model was the theoretical framework that guided this study. The primary research questions assessed (a) if there was a statistically significant association between COVID-19 health knowledge and preventive behavior among nursing students, …

Occupational Risk Perceptions Among Foreign-Born Construction Workers In Central Florida, Matthew Edison Law

Walden Dissertations and Doctoral Studies

Hispanic and Latino foreign-born construction workers in the United States experience higher rates of serious injuries and fatalities in the workplace than their native-born peers. Previous research has pointed to specific vulnerabilities among this population, including birthplace, age of the worker, language barriers, and education level, but little to no research has examined addressable risk factors, such as occupational risk perceptions, among this population. The purpose of this quantitative study was to determine the relationship between birthplace, number of years working in the United States, and occupational risk perceptions while controlling for age of the worker, language barriers, and education …

Relationship Between Homelessness, Substance Use, Employment, Living On A Reservation And Tuberculosis Among Northern Plains Native Americans, Darla Mccloskey

Walden Dissertations and Doctoral Studies

Native Americans in the Northern Plains have a long history of tuberculosis (TB) infections. There is limited research on the causes of latent TB infections (LTBI) and TB in this population. The purpose of this quantitative study was to assess the relationship between latent TB and factors of homelessness, substance use, employment, living on a reservation, and active or latent TB among this population using the eco-social theory as the theoretical framework. Data from 146 TB cases of Native Americans living in the Northern Plains and diagnosed with TB from 1999 to 2019 were analyzed using chi-square tests that showed …

Risk Factors Influencing Poliomyelitis Seroprevalence In Polio High Risk Areas Of Afghanistan, Wasan Abdulaziz Al-Tamimi

Walden Dissertations and Doctoral Studies

Afghanistan is one of the remaining polio endemic countries in the world. Nearly one million children under 5 years of age have missed polio vaccination in Afghanistan from May 2018 until January 2021. This quantitative study used the socioecological model as the theoretical framework and secondary data analysis of the 2020 polio serosurvey (N = 1384) to investigate various risk factors such as gender, parental education, family origin (language/location), wealth, distance to nearest health facility, and number of polio vaccine doses on the level of antibodies (i.e., seroprevalence) against all three types of polioviruses in children of two age groups, …

Risk Factors Influencing Poliomyelitis Seroprevalence In Polio High Risk Areas Of Afghanistan, Wasan Abdulaziz Al-Tamimi

Walden Dissertations and Doctoral Studies

Afghanistan is one of the remaining polio endemic countries in the world. Nearly one million children under 5 years of age have missed polio vaccination in Afghanistan from May 2018 until January 2021. This quantitative study used the socioecological model as the theoretical framework and secondary data analysis of the 2020 polio serosurvey (N = 1384) to investigate various risk factors such as gender, parental education, family origin (language/location), wealth, distance to nearest health facility, and number of polio vaccine doses on the level of antibodies (i.e., seroprevalence) against all three types of polioviruses in children of two age groups, …

The Effects Of Vesico-Vaginal Fistula In The Lives Of Women In Southeastern Nigeria, Chioma Esther Amutaigwe

Walden Dissertations and Doctoral Studies

Vesico-vaginal fistula (VVF) is a maternal health problem faced by women in developing countries. VVF is one of the most devastating consequences of prolonged obstructed labor and is still prevalent in resource-poor countries like Nigeria where fertility is high, the status of women is low, and obstetric services are often inadequate. The objective of this study was to enrich our understanding of the effects of VVF as it relates to women’s experiences in southeastern Nigeria. I adopted the Transactional Model of Stress and Coping in this study; this theory posits that people, when contending with any kind of stressors, are …

Sexual Violence And University Campus Response To Sexual Violence, Jennifer Bivins

Walden Dissertations and Doctoral Studies

While anyone can be a victim of sexual violence, college-aged females between the ages of 18 and 21 are more likely to be victimized than any other group. Sexual violence continues to be a barrier to education, and colleges/universities make it challenging for students to report on campus. The purpose of this study is to explore the factors, intervention/prevention strategies, and policies/procedures used to address sexual violence on a university campus. The framework used was the ecological model, which focuses on factors and influences within the environment that affected individual behavior. The research questions focused on participants describing their experiences …

Mental Health Treatment And The Criminal Justice System, Susana Lehan-Trasente

Walden Dissertations and Doctoral Studies

The criminal justice system has established interventions for those who have mental illness and have been charged with criminal complaints. In New York State, the Mental Health Court has been established to address these issues and is to be used by all counties. However, the treatment and probation interventions vary from county to county. Saratoga County uses a Single Point of Access (SPOA) which receives referrals from the general court and probation officers. SPOA refers clients to a variety of treatment interventions available in the county. In Monroe County, the Mental Health Court refers the criminally involved/mentally ill individual to …

Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae

Walden Dissertations and Doctoral Studies

Abstract Managing HIV requires lifelong therapy. Retaining clients on lifelong therapeutic antiretroviral therapy (ART) ensures the suppression of viral replication and better health outcomes. The time of the start of ART management is also a factor in determining better health outcomes for persons living with HIV. This study examined the association between initiation criteria (treat all, Option B+, and CDC T-cell count < 500) and retention on ART at 12 months for 17,974 randomly selected clients in the Ghana Health Service's HIV patient electronic database. Analyses controlled for age, gender, educational status, alcohol use, treatment/adherence monitoring, and tuberculosis disease treatment. Bronfenbrenner's ecological systems theory guided the interpretation of the findings. Results shows that retention was positively associated with all treatment initiation criteria. Clients initiated with CD4 count ≤ 500 criteria seemed to be retained at 12 months on ART at a higher rate than initiation criteria based on Option B+ and treat all. The study results may contribute to positive social change by supporting CD4 testing for clients before initiation of ART to improve retention and ensure the availability and use of adherence counseling, no tuberculosis disease and its prevention, and low use of alcohol among people living with HIV. The results of this study may also provide opportunities for public health policy intervention efforts requiring a personalized, group-based approach to service delivery at the intrapersonal level, interconnected with interpersonal, meso, and meta factors at the community level.

The Relationship Between Preterm Birth Rates, Sociodemographic Factors, And Prenatal Care, Natasha Grant

Walden Dissertations and Doctoral Studies

Reducing preterm births is a local, national, and global public health priority. Preterm birth rates continue to rise with evident racial and ethnic differences. The purpose of the quantitative study was to analyze the Mississippi Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 8 data to investigate the association between preterm births, timing of prenatal care, insurance types, and marital status among 5,666 women who gave birth in Mississippi between 2016 - 2020 using logistic regression. The social-ecological model was used to explain the impact of preterm births at the individual, interpersonal, and policy levels. Marital status was shown to be …

Associations Of Stress, Health Behaviors, And Obesity Among African American Immigrants, Wole David Akinsola

Walden Dissertations and Doctoral Studies

AbstractObesity has been identified as a predisposing factor that poses a serious threat for the development of chronic diseases and contributes to health disparities affecting both minority and vulnerable populations. Though previous studies reported the association of stress with health status and behavior, there is little or no research on the heterogeneity of obesity predictors in specific minority populations in the United States. The purpose of this study was to examine the predictors of obesity among adult African American immigrant populations in the United States. Studying obesity in this population may help policymakers tailor interventions that could reduce obesity prevalence. …

A Comparison By Ethnicity Of Usage Of Medication, Intubation Use, And Mortality Rates Of Covid-19 Patients In An Urban Hospital, Howard Rubin Baruch

Walden Dissertations and Doctoral Studies

Evidence from an urban hospital initially revealed that ethnicity had no bearing on treatment modalities or mortality among patients admitted and diagnosed with COVID-19 symptoms from January 1, 2020 to January 1, 2021. The purpose of this study was focused on answering three principal research questions concerning evidence at one hospital of differences in medication used, whether intubation was used, and mortality by ethnicity for those treated for COVID-19 while controlling for age, gender, and co-morbidities. The health belief model served as the theoretical framework. Data was collected from 1188 patient charts, and binary logistic regression was used to test …

Disparities In Mental Health Technology Among African Americans: Breaking Cultural Inclusion Barriers, Nyoki Cosey-Brown

DSW Capstone Projects

Mental health technology is a healthcare delivery model of the future. The engagement in virtual healthcare was intensified when traditional healthcare methods were inaccessible during the federal restrictions implemented due to the COVID-19 pandemic. Utilizing digital apparatuses for healthcare improved the convenience, efficiency, and accessibility of various mental health services that were inoperable in past healthcare models. However, the historical constructs of stigma, discrimination, inequity, exclusion, and structural racism in mental healthcare were prevalent problems that remained present in virtual mental health platforms concerning the experiences of African-American patients and professionals who utilized the spaces.

This research explored mental health …

A Constructivist Grounded Theory Analysis Of Seven Medical Provider Perspectives On Major Barriers To Prescribing Buprenorphine To Youth With Opiold Use Disorder In Outpatient Medical Settings: "We Should Be Providing Them With What We Know To Be The Gold Standard Of Care"., Maeve O'Leary Sloan

Antioch University Dissertations & Theses

This study utilized Primary Care Provider (PCP) perspectives to unveil major barriers to prescribing buprenorphine to youth (ages 16-25) with opioid use disorder (OUD). Semi-structured interviews were conducted with seven PCPs recruited through convenience and snowball sampling. Interviews were conducted and recorded via Zoom video conferencing. Transcripts were generated and analyzed for themes using a Constructivist Grounded Theory (CGT) approach. The CGT of the present study describes four major barriers that limit PCP prescription of buprenorphine to youth: 1) PCPs Feel Overwhelmed, 2) PCPs Feel Ill Equipped to Treat Youth Patients with OUD, 3) PCPs Hold and Observe Stigma toward …

Biocybersecurity And Deterrence: Hypothetical Rwandan Considerations, Issah Samori, Gbadebo Odularu, Lucas Potter, Xavier-Lewis Palmer

Community & Environmental Health Faculty Publications

Digitalization and sustainability are popular words within modern disciplines as practitioners each look toward the future of their respective fields. Specifically for the African continent, which is making great strides in developmental targets, those two terms are central to core aspects of policy initiatives that may foster cooperation across its varied lands and nations. One of the underlying challenges that confront Africa is a lack of strong regional integration across socioeconomic and political programs; there is value in African regions having more regional connectedness. We assess the rate of regional integration and development in Africa and discuss how to alleviate …

Assessment Of Spatio-Temporal Variations In Pm2.5 And Associated Long-Range Air Mass Transport And Mortality In South Asia, Md Sariful Islam, Shimul Roy, Tanmoy Roy Tusher, Mizanur Rahman, Ryley C. Harris

Political Science & Geography Faculty Publications

Fine particulate matter (PM_2.5) is associated with adverse impacts on ambient air quality and human mortality; the situation is especially dire in developing countries experiencing rapid industrialization and urban development. This study assessed the spatio-temporal variations of PM_2.5 and its health impacts in the South Asian region. Both satellite and station-based data were used to monitor the variations in PM_2.5 over time. Additionally, mortality data associated with ambient particulate matter were used to depict the overall impacts of air pollution in this region. We applied the Mann–Kendall and Sen’s slope trend analysis tool to investigate the …

Modeling Spatial Access To Healthcare, Yaxiong Shao

Graduate Research Theses & Dissertations

Health disparity has been a persistent concern in the United States, and the COVID-19 pandemic has brought more attention to this ongoing challenge. Improving access to healthcare is a crucial step toward achieving health equity and starts with accurately measuring and portraying the existing landscape of access to healthcare. Even though numerous spatial accessibility models have been proposed to measure the spatial accessibility to healthcare, many gaps still exist. The main purpose of this dissertation is to develop novel models and leverage recently available datasets for a more accurate portrayal of true spatial accessibility. Three models were developed to address …

Passive Earplug Including Helmholtz Resonators Arranged In Series To Achieve Broadband Near Zero Occlusion Effect At Low Frequencies, Kevin Carillo, Franck Sgard, Olivier Dazel, Olivier Doutres

Études primaires

The use of passive earplugs is often associated with the occlusion effect: a phenomenon described as the increased auditory perception of one's own physiological noise at low frequencies. As a notable acoustic discomfort, the occlusion effect penalizes the use and the efficiency of earplugs. This phenomenon is objectively characterized by the increase in sound pressure level in the occluded ear canal compared to the open ear canal. Taking inspiration from acoustic metamaterials, a new design of a three-dimensional printed “meta-earplug,” made of four Helmholtz resonators arranged in series, is proposed for achieving near zero objective occlusion effect measured on artificial …

Ultrahigh-Performance Liquid Chromatography–Tandem Mass Spectrometry Quantitation Of O-Cresol In Hydrolyzed Human Urine To Assess Toluene Exposure, Eric Langlois, Sébastien Gagné

Études primaires

Rationale

Toluene is a volatile organic compound used in domestic and industrial applications. The main routes of workplace exposure to toluene are inhalation and dermal contact. As toluene exposure can cause severe nervous system damage, its quantification is crucial to prevent occupational illness. Toluene is metabolized mainly as hippuric acid, S-benzylmercapturic acid and epoxides. These are rapidly converted to o-/p-cresol, which is then excreted in the urine as conjugated glucuronides and sulfates. o-Cresol and its conjugates can be chemically hydrolyzed to form free o-cresol, which can then serve as a urinary biomarker of toluene exposure. Current …

Does The Degree Matter? Understanding Employer Hiring Perspectives On Community College Health Information Technology Program Graduates, Tricia L. Broughton

Graduate Research Theses & Dissertations

Health Information Technology (HIT) is an in-demand occupation across Illinois and as such community colleges offer related preparation programs in the form of one-two semester Career and Technical Education (CTE) Certificates and Associate of Applied Science (A.A.S.) degrees. Community college applied programs aim to meet the needs of local employers and the interest of students to obtain employment within their communities. Research suggests that employability as perceived by employers goes beyond the technical skill requirements of the job. This dissertation project aimed to better understand employer’s hiring perspectives on community college health information technology (HIT) program graduates and ultimately whether …

Clinical And Economic Burden Of Inflammatory Chronic Conditions Among Adults In The United States: Evidence From Three Nationally Representative Surveys, Mohammad Ikram

Graduate Theses, Dissertations, and Problem Reports (ETD)

A significant proportion of adults in the United States (US) suffer from various inflammatory chronic conditions (ICCs). They include a wide range of diseases such as diabetes, rheumatoid arthritis, asthma, and chronic obstructive pulmonary diseases. ICCs are not curable, and their management typically involves medications such as NSAIDs and corticosteroids. Recently, a whole health approach that places patients’ well-being at the center is increasingly being used for better management of ICCs. The whole health approach uses an integrated approach that includes multimodal management with complementary and alternative medicines (CAM) and prescription drugs. However, the use of CAM and prescription drugs …

Optimizing Sample Collection And Data Interpretation For Effective Wastewater-Based Epidemiology In Combined Sewer Systems, Christopher Allen Anderson

Graduate Theses, Dissertations, and Problem Reports (ETD)

COVID-19 has spurred growth in the science surrounding wastewater-based epidemiology (WBE) pertaining to the detection of severe acute respiratory virus 2 (SARS-CoV-2) in waste streams as an early warning signal for public health. However, the highly variable wastewater environment has made it difficult to standardize an approach for sampling and analysis, especially in locations using combined sewer infrastructure. This study addresses knowledge gaps of WBE via three specific aims: (1) to compare diurnal fluctuations of SARS-CoV-2 and the human fecal indicator, pepper mild mottle virus (PMMoV) in wastewater treatment plant (WWTP) influent samples collected during dry versus wet weather conditions; …

Nature Based Interventions For Human Health And Wellbeing, Samantha I. Moyers

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background. Nature exposure is beneficial to human health and wellbeing, but the evidence base for nature-based interventions (NBI) is still developing. Heterogeneous naming conventions, study designs, and intervention contexts create difficulty in accessing and assessing the evidence for such programming. While NBI have been utilized in a wide array of human populations, no interventions have been reported among clinical health professions students. Aims. The objectives of this dissertation project were to review the existing body of NBI literature exploring health and wellbeing outcomes, and to conduct a feasibility trial of forest bathing, a type of NBI, among clinical students. Specifically, …

Study Of Barrier Face Coverings And Respirator Exhalation Filtration Efficiency And Exhaled Air Velocity During Wear, Weihua Yang

Graduate Theses, Dissertations, and Problem Reports (ETD)

This study aimed to assess the effectiveness of different types of respiratory protection, including National Institute for Occupational Safety and Health (NIOSH) Approved respirators and surgical masks in healthcare settings, as well as barrier face coverings (BFCs) used by the public as source control. The assessment was based on three components: total outward leakage (TOL), particle size distribution, and exhalation airflow velocity. To achieve this, the study utilized headform testing systems to measure TOL and airflow velocity. Specifically, a hard surface headform was used for NIOSH Approved respirators and surgical masks, while two soft surface headforms of different sizes were …