Public Health Commons^™

Exploring Relationship Among Programmatic Expertise, Work Engagement, And Turnover Intentions Across Different Generation Cohorts In State And Local Governmental Public Health Agencies, Stephanie L. Irvin

College of Graduate Studies: Theses & Dissertations

This study examined the relationship among public health programmatic competencies, work engagement, and turnover intentions among state and local public health workers. It also explored the moderating role of generational cohorts in these relationships. It employed a quantitative secondary data analysis using the 2021 PHWINS survey, a collaboration between the de Beaumont Foundation and The Association of State and Territorial Health Officials. The study's principal findings shed light on critical relationships within the public health workforce: Firstly, an increase in programmatic expertise among public health professionals is linked to increased work engagement, particularly notable within the Millennial cohort. Secondly, a …

Deep Community Partnerships: The Future Of Community-Based Senior Care In A Value-Driven Era, Diana Wilcox

DSW Capstone Projects

This capstone reviews three scholarly products that examine how chronically ill older adults interact with healthcare systems and senior service delivery systems in the United States. The systematic literature review examines how community-based senior programs that are funded by the Older Americans Act (OAA) positively impact health outcomes and promote health and wellness among the older adult population. The conceptual paper examines how Accountable Care Organizations (ACOs), Managed Care Organizations (MCOs), Area Agencies on Aging (AAA) interact with the patient and with one another using the lens of Systems Theory. The practice application paper examines best practices regarding care coordination …

Development And Validation Of A Questionnaire To Assess Awareness And Knowledge Of Nonalcoholic Fatty Liver Disease, A Liver Cancer Etiological Factor, Among Chinese Young Adults, Yi Du, Fedja A. Rochling, Dejun Su, Kendra Ratnapradipa, Jianghu James Dong, Evi A. Farazi

Journal Articles: Epidemiology

PURPOSE: Despite the increasing prevalence of nonalcoholic fatty liver disease (NAFLD), a liver cancer etiological factor, among Chinese young adults (CYA), there is a lack of valid, reliable, ready-to-use survey instruments for assessing awareness and knowledge of NAFLD in this population. The aims of this study were to develop, validate, and assess the reliability of a web-based, self-administered questionnaire evaluating awareness and knowledge of NAFLD among CYA.

METHODS: Based on review of relevant literature, a draft questionnaire was initially developed. Face and content validity of the questionnaire was evaluated by an expert panel of seven gastroenterologists. The construct validity was …

Help-Seeking Behavior Of African American And Non-African American Victims Of Elderly Abuse, Tesfaye Yigletu Wosene

Walden Dissertations and Doctoral Studies

Elderly abuse is a pervasive public health problem in the United States. Most abuse and neglect go unreported due to barriers including fear for safety, concerns about the consequences, culture, lack of knowledge about elder abuse, shame, and self-blame. However, there is limited research on how race and ethnicity impact help-seeking behaviors of the elderly. This cross-sectional quantitative study examined the difference in reporting and help-seeking behavior between African American and non-African American victims of elderly abuse. Applying the behavioral model of health services use, this study involved a secondary data analysis using the Nation Elderly Mistreatment Study Wave II …

Adverse Childhood/Adolescent Experiences And Risk Of Recruitment Into Sex Trafficking, Shwana Coleman

Walden Dissertations and Doctoral Studies

Human trafficking victims are negatively impacted by the process of coercion, kidnapping, and forced sexual interactions. Previous research studies showed that sex trafficking impacts victims’ mental health. The purpose of this quantitative study was to investigate whether adverse childhood/adolescent experiences (i.e., substance abuse, psychological abuse, and physical abuse) influence recruitment to sex trafficking in the United States and whether age acts as a moderator. The health belief model provided the theoretical framework for the study that includes data from 2010–2015 collected by the Polaris Project, a global sex trafficking database. Convenience sampling was done to delineate the study variables and …

Examining The Relationship Between Patient Care Quality, Patient Care Safety, And Socioeconomic Status In Chicago's Acute Care Hospitals, Theresa Ann Doby

Walden Dissertations and Doctoral Studies

AbstractEnsuring high quality and safe patient care are among the main goals of all acute care hospitals. This study found that quality of patient care is not consistent across all patient populations, which draws attention to the issue of disparity in access to safe and quality health care. The purpose research questions of this quantitative study examined if patient care quality and safety are related to hospitals’ socioeconomic status (SES) among Chicago’s acute care hospitals. Secondary data were derived from a sample of 20 acute care hospitals (i.e., 10 acute care hospitals of high SES and 10 of low SES) …

Relationship Between Maternal Language And Use Of Electronic Cigarettes In Pregnancy, Tara Halpern

Walden Dissertations and Doctoral Studies

Tobacco use has been a long-standing known modifiable risk factor to maternal health. Although there have been many efforts to encourage smoking cessation, use of electronic cigarettes in pregnancy has been increasing over the years. Understanding potential factors that may play a role in the increased use of electronic cigarettes is important to improve maternal and fetal health outcomes. The social ecological model provides the theoretical framework for this study. The purpose of this study is to determine whether a woman’s primary language and pregnancy health care factors (i.e., access to health care 12 months prior to pregnancy, access to …

Gender Disparities: 5 Year Survival Rates Of Elderly Colorectal Cancer Patients With Depression, Riya Joshi

Walden Dissertations and Doctoral Studies

AbstractColorectal cancer (CRC) is a life-threatening health condition known to greatly affect the elderly than younger populations. CRC, if comorbid with mental condition such as depression, can seriously affect patients’ quality of life with a direct influence on the survival rate. There is a connection between depression and worsened cancer progression and survival rate of CRC, little is known on gender differences in survival rates on elderly CRC patients with pre-existing depression (PD). A socioeconomic model study was used to evaluate gender, initial diagnostic stage, and marital status (MS) at diagnosis as major independent variables and 5-years survival rate (5-YS) …

Association Of Income, Education, Employment And Covid-19 Mortality In Brazil, Marcelina Machado

Walden Dissertations and Doctoral Studies

The increased mortality rates from COVID-19 in Brazil have adversely affectedvulnerable populations and placed a severe burden on its public health system as compared to other nations. Focusing on socioeconomic status as a risk factor in this retrospective cohort study, I investigated the association between Brazilian COVID-19 mortality rate, income, school enrollment rate, and employment rate after controlling for the demographics and immunization rate. This is an important issue as an increase in incidence and mortality rates affects how governmental and public health leaders can effectively control and prevent disease spread. Using the fundamental causes of disease theory as the …

Hiv Testing And Counseling Uptake Predictors Among University Students In Southwest Cameroon., Lilian Belole Motia Pencille

Walden Dissertations and Doctoral Studies

AbstractDespite public health efforts to increase human immuno-deficiency virus testing and counseling (HTC) uptake, screening among college students remains low and understudied. The purpose of this cross-sectional correlational quantitative study was to explore the relationship between the constructs of the health belief model (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy) and HTC uptake while controlling for age, sex settlement type, relationship status, area of residence, religious affiliation, and level of education. Four hundred and eighty-seven (N = 487) university students in Southwest Cameroon were recruited using a convenience sampling method. Data were collected using …

Health Literacy, Race, And Understanding Health Information Among Women, Adrienne Clark

Walden Dissertations and Doctoral Studies

Health literacy is a topic often referred to by public health professionals to help improve the health of a population. This study used a quantitative approach to understanding health information among women of different races, income levels, household sizes, and education levels within a specific age range. This study used the socio-ecological model for its framework. The overall goal of this study was to improve health disparities and improve health communication one population at a time. Women tend to be the pillar of communities. Having a better understanding of how women understand health information could improve public health outreach. The …

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 …