Public Health Commons^™

Readiness Of Adolescent And Young Sickle Cell Patients To Transition From Pediatric To Adult Care, Tanisha D. Belton

Walden Dissertations and Doctoral Studies

Patients with sickle cell disease (SCD) face many challenges as they enter adulthood; therefore, preparing for the transition to adult care is crucial. Assessing the knowledge and skills adolescents and young adults (AYAs) possess before transitioning to adult care can aid in the success of their transition. However, a gap exists regarding factors attributed to guiding patients’ sense of readiness. The purpose of this quantitative study, driven by the theory of self-care management of SCD, was to examine the self-perceived readiness of SCD patients as they prepare to transition to adult care. Cross-sectional survey data were collected from 68 sickle …

The Impact Of Electronic Cigarettes Use On Traditional Cigarette Uses Among U.S. Adolescents, Ismail Mensah Dwumfour-Poku

Walden Dissertations and Doctoral Studies

The increased usage of e-cigarettes among adolescents in the United States (U.S.) is a major public health concern. According to the Centers for Disease Control and Prevention (CDC), nicotine, an active ingredient in e-cigarettes, is the most addictive drug in use today. The purpose of the current study was to explore the relationship between smoking of e- cigarettes and the risk of smoking traditional cigarettes among middle and high school students in Grades 6 through 12 in the U.S., and to determine if demographic factors contribute to this predisposition. This, quantitative cross-sectional study used the social ecological model as the …

Relationship Between Early Years’ Activities Of Daily Living And Alzheimer’S Disease Onset, Linyi Fan

Walden Dissertations and Doctoral Studies

A few promising studies have indicated that activities of daily life (ADL) may be a useful way of predicting Alzheimer’s Disease (AD). However, the existing cross-sectional studies fail to show how ADLs in early years predict AD, and how social factors influence health either in addition to or in interaction with individual risk factors. Using a social epidemiology framework, this study examined the relationship between early years’ ADL and the development of AD in later years. This quantitative study included 4,526 participants derived from the Health and Retirement Study (HRS) dataset. The dependent variable was whether the participant has been …

Fielding Vaccines-Challenges And Opportunities In Outbreaks, Complex Emergencies, And Mass Gatherings, Laura J. Fischer, Robert C. Rains, Sherry M. Brett-Major, Mikiko Senga, Debra Holden, David Brett-Major

Journal Articles: Epidemiology

With the recent COVID-19 pandemic, the importance of vaccine development, distribution, and uptake has come to the forefront of the public eye. Effectively fielding vaccines during an emergency-whether that emergency is a result of an infectious disease or not-requires an understanding of usual vaccine-related processes; the impact of outbreak, complex emergencies, mass gatherings, and other events on patients, communities, and health systems; and ways in which diverse resources can be applied to successfully achieve needed vaccine uptake. In this review, both the emergency setting and briefly vaccine product design are discussed in these contexts in order to provide a concise …

Differential Methylation Patterns In Lean And Obese Non-Alcoholic Steatohepatitis-Associated Hepatocellular Carcinoma, Emma Hymel, Kurt W. Fisher, Evi A. Farazi

Journal Articles: Epidemiology

BACKGROUND: Nonalcoholic fatty liver disease affects about 24% of the world's population and may progress to nonalcoholic steatohepatitis (NASH), cirrhosis, and hepatocellular carcinoma (HCC). While more common in those that are obese, NASH-HCC can develop in lean individuals. The mechanisms by which HCC develops and the role of epigenetic changes in the context of obesity and normal weight are not well understood.

METHODS: In this study, we used previously generated mouse models of lean and obese HCC using a choline deficient/high trans-fat/fructose/cholesterol diet and a choline supplemented/high trans-fat/fructose/cholesterol diet, respectively, to evaluate methylation differences in HCC progression in lean versus …

Bilateral Retractile Testis: A Possible Risk Factor For Male Infertility, Syed Intesar Burni, Shazia R. Khan, Fareena Khalil Ahmed, Sameera Ali Rizvi, Tazeen Saeed Ali

School of Nursing & Midwifery

Healthy youth is an asset and strength for economic and social growth of any society. Developmental changes during puberty of youngsters need proper guidance to avoid future physical, physiological and psychological ailments. Bilateral Retractile Testis (BRT) is a health problem if remains unnoticed till adolescence can lead to tribulations. BRT may affect testicular parenchyma and spermatogenesis. Cremasteric muscles (muscles attached with testes) pull the testes up into groin so it randomly moves up and down and do not reside in its natural pouch always. It has been a controversial issue in male infertility as retraction may affect infertility.
Objective: To …

Black Vs. White: What Is Bipolar Disorder?, Delmy Mendoza, Kendall Childs, Maedot Aklilu, Tynise Phillips

DC Health and Academic Prep Program (DC HAPP)

This intervention will show that underdiagnosing and misdiagnosing mental health disorders can be prevented by creating more high school medical pipeline programs and encouraging POC students interested in healthcare to participate in diversifying the healthcare system. Pipeline programs have shown to be beneficial in increasing the numbers and quality of underrepresented ethnic minority applicants from disadvantaged backgrounds, and achievement motivation. For example, the pipeline program The Teen Medical Academy created in 2008 combated unrepresentative health disparity in adolescents by successfully improving interest in medical and allied health careers, confidence in their ability to accomplish a health profession, learning surgical and …

Sequencing Sars-Cov-2 Genomes From Saliva, Tara Alpert, Chantal B. F. Vogels, Mallery I. Breban, Mary E. Petrone, Anne L. Wyllie, Nathan D. Grubaugh, Joseph R. Fauver

Journal Articles: Epidemiology

Genomic sequencing is crucial to understanding the epidemiology and evolution of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Often, genomic studies rely on remnant diagnostic material, typically nasopharyngeal (NP) swabs, as input into whole-genome SARS-CoV-2 next-generation sequencing pipelines. Saliva has proven to be a safe and stable specimen for the detection of SARS-CoV-2 RNA via traditional diagnostic assays; however, saliva is not commonly used for SARS-CoV-2 sequencing. Using the ARTIC Network amplicon-generation approach with sequencing on the Oxford Nanopore MinION, we demonstrate that sequencing SARS-CoV-2 from saliva produces genomes comparable to those from NP swabs, and that RNA extraction is …

Increasing Hpv Vaccination In Elliott And Lawrence Counties, Keeghan Francis

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Appalachian counties within Kentucky have higher rates of HPV-related cancers, including cervical cancer. HPV vaccines are effective at reducing the risk of cervical cancer, but vaccination coverage in Appalachia remains low. The proposed program relies on recommended strategies to improve vaccine uptake by increasing access and demand for HPV vaccines. This will be done through school vaccine clinics and parent education on HPV, cervical cancer, and HPV vaccines.

Key Factors Associated With Late-Stage Diagnosis Of Endometrial Cancer In Kentucky, Lexee Long

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objectives: Cancer of the endometrium is the most common female reproductive cancer in the United States, but is understudied in relation to stage at diagnosis, which is a potential predictor of survival. The primary objective of this study is to analyze potential associations of independent variables such as age at diagnosis, race, marital status, smoking status, Appalachian status, and insurance type with late-stage diagnosis of endometrial cancer.

Methods: This population-based study used Kentucky Cancer Registry data to study endometrial cancer cases diagnosed between January 1^st,2015 and December 31^st, 2019. Chi-square statistics were used to examine bivariate …

Patterns Of Continuous Glucose Monitoring Utilization Among Adults With Type 1 Diabetes, 2016-2018, Katherine Elizabeth Lee

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

BACKGROUND: Continuous glucose monitoring (CGM) improves diabetes control by reducing HbA1c and decreasing rates of hypoglycemia. Despite clinical benefits and clear guidelines from the American Diabetes Association, <20% of patients with type 1 diabetes mellitus (T1DM) use CGM. Studies report disparities in CGM among youth with T1DM by race/ethnicity, socioeconomic status, and region, but, insight into patterns of CGM utilization in adults with T1D is limited. METHODS: This project retrospectively analyzed CGM utilization among individuals with T1DM age 18-64 using the Truven MarketScan® Commercial Claims and Encounters (CCAE) database from 1/1/2016-12/31/2018. CGM utilization was determined using National Drug Code (NDC), Current Procedural Terminology (CPT), or Healthcare Common Procedure Coding system II (HCPCS II) claim identifiers. Individuals with >365 days of continuous medical and pharmacy insurance eligibility were followed from their first Type 1 diabetes-related diagnosis code until the end of the study period or >120 day gap in coverage. Using descriptive statistical analysis, CGM utilization was examined in the overall population and was stratified by patient demographics (age, sex, region), and clinical characteristics (insulin pump, diabetes complications). As a secondary analysis, CGM utilization was further stratified by both calendar year …

The Risk Factors For Hiv In African American Transgender Women In Connecticut, Oliver Kunda

Walden Dissertations and Doctoral Studies

AbstractThe human immunodeficiency virus (HIV) incidence rate is 70 times higher for African American transgender women than in the general population. Despite decades of outreach and intervention effort to reduce HIV incidence in the transgender community by the lesbian, gay, bi-sexual, transexual, queer, plus (LGBTQ+) community and public health organizations, the HIV prevalence rate for transgender women remains high at 38%. The purpose of this qualitative exploratory case study was to gain insights into how attitude, subjective social norms, and perceived behavioral control influence HIV risk behaviors of African American transgender women in Connecticut. Ajzen’s theory of planned behavior provided …

An Evidenced-Based Nursing Education Discharge Plan For Prescription Opioids, Josephine J. Messelmani

Walden Dissertations and Doctoral Studies

The reported number of prescription opioid overdoses justifies the need for providing patients with opioid discharge information and follow-up care as recommended. To prevent any misuse of prescription opioid drugs, it was critical for patients to receive a thorough review of their medications prior to being discharged. The purpose of the project was designed to educate nurses on the importance of delivering essential information to patients prescribed opioids. Implementation of an opioid discharge plan integrated with the teach back method increased patients’ understanding of how to properly take prescription opioids compared to the patients who did not receive opioid education …

Use Of The Hester Davis Falls Risk Assessment Scale In Medical-Surgical Patients, Gideon M. Nyakundi

Walden Dissertations and Doctoral Studies

AbstractIdentifying and containing patient falls before they happen, reporting fall occurrence, and analyzing fall causes could increase patient safety to achieve the triple aim of improved quality, reduced cost, and accessibility in healthcare. Patient falls within the medical-surgical population continue to present challenges to patients, families, hospitals, and society, despite the use of fall-related predictive analysis tools. The purpose of this quantitative study was to determine the extent to which the overall score on the Hester Davis Falls Risk Assessment Scale (HDS), comprised of patient-related factors such as medications, volume/electrolyte status, age, last known fall date, mobility, toileting needs, communication/sensory …

Knowledge And Experiences Of African American Women With Polycystic Ovary Syndrome, Kristy L. Vance

Walden Dissertations and Doctoral Studies

While polycystic ovary syndrome (PCOS) is a nationwide phenomenon, African American or Black women often have little to no information on the education and support available to manage the condition. PCOS is one of the most poorly understood disorders among patients which has led to limited resources and management. The lack of education could contribute to increased risks to many health issues for African American women with PCOS. The purpose of this basic qualitative study was to explore and examine the level of health knowledge related to PCOS among African American women living in or around the Northern Region of …

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

Walden Dissertations and Doctoral Studies

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

Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli

Walden Dissertations and Doctoral Studies

AbstractNurses who work in the critical care unit are more likely to experience work-related stress, fatigue, understaffing, undesirable performance outcomes, and compromised workplace safety than general care nurses. Nurse managers in these units possess insights into nurses' stress-inducing challenges, in addition to managerial and administrative perspectives. Yet there is a lack of available knowledge about the experiences of critical care nurse managers in addressing nurses' work-related stress. The purpose of this study was to explore critical care nurse managers’ experiences of potential strategies to effectively address work-related stress among nurses. The job-demand resource model was the theoretical framework for the …

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

Walden Dissertations and Doctoral Studies

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

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

Walden Dissertations and Doctoral Studies

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

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

Walden Dissertations and Doctoral Studies

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

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

Walden Dissertations and Doctoral Studies

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

Opioid Types And Adolescent Prescription Opioid Misuse, Orchid George

Walden Dissertations and Doctoral Studies

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

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

Walden Dissertations and Doctoral Studies

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

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

Walden Dissertations and Doctoral Studies

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

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

Walden Dissertations and Doctoral Studies

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

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

Walden Dissertations and Doctoral Studies

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

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

Walden Dissertations and Doctoral Studies

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

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

Walden Dissertations and Doctoral Studies

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

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

Walden Dissertations and Doctoral Studies

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

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

Walden Dissertations and Doctoral Studies

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