Public Health Commons^™

Associations Between Substance Use And Obesity Among Native American Adolescents, Joseph Jude Janosky

Walden Dissertations and Doctoral Studies

Obesity and substance use are two significant public health issues among Native American adolescents. Despite much evidence linking obesity and substance use during adolescence to several long-term health conditions and increased morbidity and mortality, evidence describing the relationship between current substance use and obesity among Native American adolescents is lacking. The purpose of this quantitative study was to investigate associations between current substance use – specifically alcohol, marijuana, and tobacco products – and obesity among Native American high school students, when adjusted for sex, soda consumption, and physical activity. Rosenstock’s health belief model served as the theoretical foundation for this …

Relationship Between Screentime And Depressive Symptoms And Associated Mediators For African American Adolescents In The United States, Brittney Jones

Walden Dissertations and Doctoral Studies

The prevalence of adolescent depression in the United States is increasing as adolescents’ use of electronic screen devices increases. Some studies have found associations between screentime and adolescent depression, and other researchers have posited that screentime is not intrinsically harmful. High screentime in African American adolescents may place them at risk for worse depressive symptom outcomes, but the relationship between screentime and depressive symptoms for this population is unknown. The three research questions of this study addressed whether there is a relationship between screentime and depressive symptoms in African American adolescents, and whether sleep duration and the frequency of physical …

Association Of Socioeconomic Status And Marital Status With Genuine Halitosis Among Dental Patients In Sudan, Eiman Abd Almonim Khidir

Walden Dissertations and Doctoral Studies

AbstractThe prevalence of halitosis has been rising in recent years and has become a social and public health problem worldwide. People’s concerns about halitosis can influence their psychological, social, and professional lives and lead to social isolation and anxiety. The purpose of this quantitative cross-sectional study was to examine the association of socioeconomic status and marital status with genuine halitosis after adjusting for age, gender, and smoking among patients attending dental clinics in Khartoum, Sudan. The social-ecological model grounded the study. Secondary data from dental clinics in Khartoum, Sudan, were used with a sample size of 340. Data analysis included …

Examination Of Exposure Types Association With Stigma And Impacts On Sharps Injury Reporting In Ambulatory Surgical Centers, Timothy William Lynch

Walden Dissertations and Doctoral Studies

Public health depends on the efficiency of work delivery among healthcare workers (HCWs) and their positive goal orientation in healthcare. Effective minimizing of needlestick and sharp injuries (NSSIs) and timely reporting are fundamental to meeting public health goals. The specific research problem addressed through this study is whether the independent variable of exposure type (needle stick injury, splash exposure injury, other sharp injuries) has an association with stigma associated with sharps injury reporting (dependent variable) among HCWs in ambulatory surgical centers. A quantitative, cross-sectional design involving secondary data analysis was used. Regression was used to analyze pre- and post-workshop survey …

Comparative Study Of Risky Sexual Behaviors In African American Adolescents Who Use Drugs And Alcohol, Angela Matthew

Walden Dissertations and Doctoral Studies

Sexually transmitted infections (STIs) are a major public health problem in the United States. Adolescents are a high majority of these cases, with African American adolescents being affected disproportionally. Previous research has shown that risky sexual behaviors, such as non-condom use, multiple sexual partners, early initiation of sexual intercourse, and alcohol or marijuana use before sexual intercourse put adolescents at a higher risk of contracting an STI when they are sexually active. These behaviors can be observed through the theoretical framework of the problem behavior theory that describes the constructs of why individuals engage certain behaviors. How alcohol and drug …

Health Education Needs For Mortality Surveillance In Machakos County, Kenya, James S. Mwanza

Walden Dissertations and Doctoral Studies

Reporting mortality information is the primary data source from which evidence can be drawn to monitor disease trends and inform public health policy to improve population health. Still, only two-thirds of expected annual deaths are reported globally. Health education and promotion play a significant role in empowering communities to uptake public health services such as mortality surveillance. This qualitative descriptive study aimed to understand health workers’ (HWs’) perspectives regarding the need for health education to support mortality surveillance in Machakos County, Kenya. The capabilities, opportunities, and motivation for the behavior change model guided the study. Semi-structured interviews were used to …

Age, Race/Hispanic Origin, And Covid-19 Mortality Among Sickle Cell Disease Patients In The United States, Joe Lamont Ndula

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic remains a global health challenge, with 6.7 million deaths worldwide as of January 2023. It has illuminated the health iniquities in underserved communities and populations like those with sickle cell disease (SCD). Researchers have associated the COVID-19 outcome among SCD patients in other regions of the globe. The purpose of this retrospective cross-sectional observational study was to investigate the relationship between age, race/Hispanic origin, and COVID-19 mortality among persons with SCD in the United States from January 2020 to March 2021. The Krieger ecosocial theory of disease distribution framed the study. Data were drawn from an existing …

Factors Associated With Intent To Quit Smoking Among U.S. Adult Smokers, Patrese Ann Nesbitt

Walden Dissertations and Doctoral Studies

Smoking and tobacco use continue to be a public health issue for over 40 million Americans, which explains the appropriateness and abundance of smoking cessation programs throughout the United States. The purpose of this quantitative correlational study was to examine the associations between independent variables of marital status, advice from a medical clinician, and use of community smoking cessation resources and the dependent variable of intent to quit smoking, controlling for race, ethnicity, gender, and age. The theory of reasoned action was used to guide the study. Data from the National Adult Tobacco Survey (N = 12,357) were analyzed using …

Association Between Psychosocial, Obstetric, And Lifestyle Factors And Antenatal Depression, Tomnema Xiong

Walden Dissertations and Doctoral Studies

Antenatal depression, or depression during pregnancy, is a mental health concern in the United States that impacts mothers and their infants. This study examined the associations between psychosocial, obstetric, lifestyle factors, and antenatal depression. This study was guided by social cognitive theory, specifically the reciprocal determinism construct. Secondary data from the 2007–2018 National Health and Nutritional Examination Survey (NHANES) were used in this quantitative cross-sectional study. Every participant of the NHANES completed the Patient Health Questionnaire-9 depression screening form. The study sample consisted of 274 women who were pregnant at the time of participating in the NHANES, approximately 28.8% of …

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 …

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 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 …

Relationship Between Food Insecurity, Depression, And Race/Ethnicity Among U.S. Adults Aged 60–69 Years, Patrick E. Crandon

Walden Dissertations and Doctoral Studies

Abstract Food insecurity (FI) and depression among older populations in the United States are public health concerns. Although FI has declined in the United States, it is a psychosocial stressor prevalent among the growing population of adults over 60. It is unknown to what extent FI contributes to depression among racial/ethnic minorities in this population. The purpose of this quantitative cross-sectional study was to examine the relationships between FI and race and depression among U.S. adults aged 60–69 years when adjusting for other variables. The social-ecological model was used to understand the interplay between individual and environmental factors that may …

Influences On Influenza Vaccine Uptake Among Older Lebanese Adults, Doha D'Agostini

Walden Dissertations and Doctoral Studies

Influenza is a viral infection that is globally transmitted and that increases the risk for infectious diseases, hospitalization, and morbidity and mortality, especially among the older adult population. Although influenza vaccines are recommended in several countries, influenza vaccine hesitancy remains a challenge. In Lebanon, there is minimal research related to older adults’ attitudes and perceptions associated with influenza vaccination. To explore older Lebanese adults’ vaccination experiences and perceptions of the factors that affect their influenza vaccine uptake, a qualitative investigation was conducted. The theory of planned behaviors served as the theoretical framework for the study. A thematic analysis was conducted …

Tuberculosis-Associated Knowledge, Stigma, And Health Seeking Behavior Among Traders In Onitsha Main Market, Anambra State, Nigeria, Benedeth N. Ezeosim

Walden Dissertations and Doctoral Studies

The utilization of tuberculosis (TB) health care services in a Nigerian state has not been optimal. Many residents do not utilize available health care resources when they experience symptoms of TB. Although much is known about the determinants of health seeking behavior (HSB), there is a gap on how TB knowledge and TB related stigma among traders in one main market contribute to HSB. This study examined the effect of TB knowledge and TB related stigma on HSB among traders. The health stigma and discrimination and health belif models served as the theoretical foundation. A quantitative cross-sectional analytical survey design …

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 …

The Experiences Of Women In The Healthcare Profession With Alcohol Use During The Covid-19 Pandemic, Amber Olsen

Walden Dissertations and Doctoral Studies

Women have severe health risks associated with drinking alcohol long-term and excessively. The purpose of this qualitative study was to explore the lived experience of women in healthcare positions regarding alcohol use during the COVID-19 pandemic. The study was informed by the theory of planned behavior. Semistructured interviews were used to gather information from participants based on their firsthand experiences with alcohol usage. Understanding women’s attitudes toward alcohol use during the COVID-19 pandemic can improve intervention. Data were analyzed using an inductive, thematic procedure. Participants associated their own use of alcohol with socialization, and all participants reported that they regarded …

Factors Impacting College Students’ Receipt Of Human Papillomavirus Vaccination, Joy Yvette Payne

Walden Dissertations and Doctoral Studies

Less than half of U. S. students entering college have had a human papillomavirus (HPV) vaccination, placing them at risk for HPV-related cancers. This study’s purpose was to identify predictors of HPV vaccination initiation in college students. Andersen’s behavioral model of health services use was used to examine the differences in predisposing, enabling, and need factors in U.S. college students ages 18–26 years who received an initial HPV vaccination in college compared to those who never received an HPV vaccination. The study was a quantitative, cross-sectional survey design using multivariable logistic regression for data analyses. Data were collected through an …

Education To Increase Nurse Knowledge And Compliance With Social Determinants Of Health Screening, Bonnie Rieger

Walden Dissertations and Doctoral Studies

To provide holistic care and ensure positive patient health outcomes, the social determinants of health (SDOH) must be addressed. Research demonstrates that while medical care is a contributor to wellness, the SDOH serve an influential role in patient health outcomes. There is limited literature describing how to best educate practicing nurses about SDOH concepts. The purpose of this DNP project was to provide an educational intervention to increase inpatient staff nursing knowledge of the SDOH. Sources of evidence used to create the education module included scholarly literature describing the SDOH concepts and their application to patient, community, and population health. …

Clinical Research Principal Investigators’ Perspectives Of Improving The Diversity Of Clinical Research Participants, Nadine Hyacinth Spring

Walden Dissertations and Doctoral Studies

Clinical trials are needed to make new medications, devices, and diagnostic tools available. Participants in these clinical trials have historically come from a homogeneous group, and there is a recognized need for increased diversity and representation in these clinical research studies. The absence of diversity in clinical trials makes it difficult for clinicians and researchers to know which medications and devices are safe and effective for specific populations. This basic qualitative phenomenological study was conducted to explore the experiences of clinical research principal investigators regarding diversity in clinical research studies and how to improve it. The theoretical framework for this …

Role Of Racially Concordant Patient-Physician Relationships In Health Outcomes Among African American Women, Joy Thomas

Walden Dissertations and Doctoral Studies

Abstract There are gaps in the literature regarding how patient-physician racially concordant relationships affect African American women’s health. This quantitative study evaluated the effects of non-minority physician influence on the perceptions of medical mistrust, racial discrimination, and healthcare-specific racial discrimination on African American women. The behavioral model for vulnerable populations guided the study. Two research questions involved understanding the relationship between trust in the physician scale and medical mistrust and the association between racial discrimination and perceived healthcare-specific racial discrimination among African American women living in a Southern U.S. state. A stratified random sampling strategy was used to obtain a …

The Role Of Family Support In The Relationship Between Childhood Obesity And The Number Of Days Bullied In Trinidad, Sharon Antoine-Mills

Walden Dissertations and Doctoral Studies

There is limited data on childhood obesity and the number of days bullied in Trinidad and Tobago. This study examined the association between childhood obesity and the number of days an obese child has been bullied in Trinidad in the past 30 days, with family support as a moderator. The theoretical framework for this study was Bronfenbrenner’s social-ecological model, which posits that a child’s microsystems are instrumental in influencing their behaviors. A self-administered low-cost 2017 Global School-based Student Health Survey (GSHS) was used for this cross-sectional study. The sample comprised 2,229 school adolescents 13 to 17 years of age. Childhood …

Disparate Access To Medical Coverage Associated With Type 2 Diabetes Care In Low-Income And Rural Communities In Georgia, Crystal Alexis Symone Edwards

Walden Dissertations and Doctoral Studies

Disparate access to diabetes care in rural and low-income communities among older adults has been an ongoing issue among Americans. Type 2 diabetes in low-income and rural communities has continuously burdened many residents due to age, costs of care, income, geographic location, and education levels. Researchers have demonstrated that providing resources and tools to rural and low-income communities would assist in decreasing type 2 diabetes and increase education and awareness. The purpose of this quantitative cross-sectional study using secondary data was to examine the relationship between health insurance status and lack of access to health care resources and delay of …

Factors Associated With Patient Portal Utilization, Preventive Services Utilization, And Health Promoting Behaviors Among Adults In The United States, Elizabeth Ayangunna

College of Graduate Studies: Theses & Dissertations

Background: Nearly 60% of adults in the United States are estimated to have one or more chronic conditions, necessitating strategies to improve the health status of persons with chronic disease. Given that health information technology (HIT) is considered highly valuable for superior disease management, it is imperative to examine how HIT use can improve health behaviors, which can in turn improve health status. This study aimed to examine if there was an association between patient portal utilization and the use of preventive services & health-promoting behaviors. Also, this study examined the influence of self-efficacy on preventive health behaviors among adults …

Evaluation Of The Loving Support Peer Counseling Program On Breastfeeding Duration Rates Among African American Women Enrolled In The Program (2017-2018), Nancy S. Jeffery

College of Graduate Studies: Theses & Dissertations

Mothers and babies form an inseparable biological and social unit; the health and nutrition of one group cannot be divorced from the health and nutrition of the other.”-World Health Organization. The aim of this study was to evaluate the effectiveness of the Loving Support Peer Counseling (LSPC) program, under the WIC program in the state of Georgia, on breastfeeding duration rates among African American postpartum primiparas women. This observational study analyzed state-level data from January 2017 through December 2018. A cross-sectional design was used to evaluate the effectiveness of the Loving Support Peer Counseling Program (LSPC) in six of the …

Knowledge Of Pregnancy And Postpartum Complications Up To One Year Postpartum Compared By Rurality, Evelyn Frances Fagan, Alisha Riggins, Ariel A. Alston, Mario Keko, Ana M. Palacios, Helen Bland, Joanne Chopak-Foss

Georgia Public Health Association Annual Meeting & Conference

Introduction: Georgia has one of the highest maternal mortality rate in the U.S. at 46.2 maternal deaths per 100,000 live births, disproportionately affecting Black and rural populations. This study sought to 1) assess knowledge of Georgian adults about complications and urgent warning signs both during pregnancy and up to 1-year postpartum, and 2) characterize knowledge within rural and urban population.

Methods: As part of a larger study, an online survey with previously validated questions was distributed to Georgia residents through social media and email. Data was grouped into 2 different categories: 1) pregnancy warning signs and 2) post-partum warning signs. …

Navigating Missed Visits In Hiv Primary Care: Exploring Risk Factors Associated With Missed Visits, Jiaying Hao

All ETDs from UAB

The HIV care continuum is a public health model that outlines the steps or stages people with HIV go through from diagnosis to achieving and maintaining viral suppression. Retention in care, a key component of the HIV care continuum, is critical in achieving good health outcomes for people with HIV (PWH) and preventing HIV transmission. Consistent HIV care is essential for the health of PWH as a part of retention in care. De-spite no standard measure for retention in care to PWH, the missed (no-show) vis-its/appointments is one of the most commonly used methods for evaluating retention in HIV care. …

The Genetic Epidemiology Of Complex Lung Diseases, Ava Claire Wilson

All ETDs from UAB

This research utilizes precision medicine techniques to advance our understanding of Chronic Obstructive Pulmonary Disease (COPD) and Idiopathic Pulmonary Fibrosis (IPF) with the overall goal of improving the etiology of and identifying molecular targets and pathways in COPD and IPF to help improve patient outcomes. We aimed to 1) identify novel drug targets and uncover potential mechanisms by which pirfenidone and nintedanib attenuate fibrosis by performing an integrative ‘omics analysis of transcriptomics and proteomic responses to TGFb1-stimulated lung fibroblasts; 2) define a skeletal muscle fiber shift phenotype in both males and females with COPD and begin to disentangle underlying mechanisms …

Perceptionf Of Multipurpose Prevention Technologies Aimed At Hiv/Sti/Unintended Pregnancy Among African American Women In The Deep South, Kristina Wilbekin Walker

All ETDs from UAB

Sexual and reproductive health (SRH) needs for women are not being met globally. In addition to efforts towards providing widespread access to currently available contraceptives and sexually transmitted infection (STI) treatment or prevention products, another focus is the development of multipurpose prevention technologies (MPTs). These MPTs are combination methods that prevent pregnancy, and protect against HIV and/or additional STIs. The objective of this dissertation research was to assess factors related to sexual and reproductive decision-making that may influence interest in MPTs and inform MPT implementation strategies for African and African American (AA) women. The first aim of this research, I …