Public Health Commons^™

Effects Of Trained Providers And Naloxone Distribution On Prescription Opioid Use Disorder, Samuel Sarpong

Walden Dissertations and Doctoral Studies

AbstractOpioid abuse and overdose are associated with substantial morbidity and mortality rates, as well as social and economic costs. The purpose of this study was to evaluate the independent and interactive effects of state-sponsored prescription drug monitoring program (PDMP) trained healthcare providers and community-based naloxone distribution program related factors in the states of Florida and Georgia for the prevention and reduction of prescription opioid use disorder, overdose, and deaths. The research theory adopted was the socio-ecological model with an emphasis on risk factors such as age. The study used secondary data from 2014 to 2018 from the Florida and Georgia …

Social Determinants Of Health And Type 2 Diabetes Among Enrollees Of California Children’S Services Program In Fresno County, California, Daniela Marie Aghadjanian

Walden Dissertations and Doctoral Studies

Despite extensive study in adults, Type 2 diabetes (T2D) has been the subject of little research concerning young adults or children. Doctors believed T2D to develop only in a person’s later years until health care providers found younger individuals developing this disease. The purpose of this cross-sectional quantitative analysis was to determine correlations between T2D and social determinants of health in Fresno County, California, based on children and adolescents. The 2017-19 data came from the Fresno County Department of Public Health. The theoretical foundation for the study was the socio-ecological framework focusing on individuals’ traits having a bidirectional impact on …

Understanding How Religious Practices Influence Self-Care In Black Churchgoers Diagnosed With Hypertension, Taquina C. Davis

Walden Dissertations and Doctoral Studies

Religion plays an essential role in managing health; however, there is limited research on religious practices among Black churchgoers diagnosed with hypertension. This research aims to understand how religious practices influence self-care in Black churchgoers diagnosed with hypertension. The sample consisted of 21 Black men and women, ages 29 to 70 years, with a clinical diagnosis of hypertension. Participants were recruited from two local, predominately Black churches in South Carolina and administered semistructured interviews to participants. A grounded theory design was used, and the data analysis consisted of constant comparison. Two core concepts were identified. One core concept identified was …

Developing A Clinical Practice Guideline For Colorectal Cancer Screening In Primary Care, Michelle Janise Berkley-Brown

Walden Dissertations and Doctoral Studies

Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States for both men and women combined. CRC screening is an effective way to reduce mortality and morbidity related to the disease. Practitioners within primary care practices can play an essential role in encouraging people to be screened. Yet, CRC screening rates remain low in primary care practices. Evidence-based strategies are available to help practitioners improve CRC screening activities and improve screening rates. The lack of a clinical practice guideline (CPG) with strategies to help improve CRC screening interventions was identified as a practice gap for …

The Power Of Exogenous Variables In Predicting West Nile Virus In South Carolina, Christopher Lee Glaze

Walden Dissertations and Doctoral Studies

Despite the availability of medical data, environmental surveillance tools, and heightened public awareness, West Nile Virus (WNv) remains a global health hazard. Reliable methods for predicting WNv outbreaks remain elusive, and environmental health managers must take preventive actions without the benefit of simple predictive tools. The purpose of this ex post facto research was to examine the accuracy and timeliness of exogenous data in predicting outbreaks of WNv in South Carolina. Decision theory, the CYNEFIN construct, and systems theory provided the theoretical framework for this study, allowing the researcher to broaden traditional decision theory concepts with powerful system-level precepts. Using …

Patient Perceptions Of Access To Chronic Pain Medications, Lauren Amy Durham

Walden Dissertations and Doctoral Studies

AbstractThe 2014 Drug Enforcement Administration’s reclassification of hydrocodone combination products caused significant unintentional consequences to patients with chronic pain. Although a few researchers have looked at the problems that resulted immediately following the reclassification, none have as yet repeated their studies, creating a knowledge gap. Additionally, previous researchers have shown that most of the current opioid restricting policies in place today were not created using a strong evidence-based or ethically inclusive approach. The purpose of this study was to assess whether common factors identified as issues impacting care for these patients immediately following the reclassification continue to affect care standards. …

Change Fatigue, Job Satisfaction, And Organizational Commitment Among Nurses, Melissa Kapping

Walden Dissertations and Doctoral Studies

The healthcare environment is complex and ever-changing, which has a direct impact on the nurse. The effects of the constant change to the nurse may result in the development of change fatigue, which causes the loss of trust in the organization, a feeling of resentment, and a sense of apprehension while depleting the individual’s reserves. The purpose of this correlational study guided by Lazarus and Folkman’s stress and coping theory was to determine if there is a relationship between (a) job satisfaction and change fatigue and (b) organizational commitment and change fatigue in nurses who work in an outpatient clinical …

Perceived Health And Preventative Care In The Transgender Population, Gregory Page Carpenter

Walden Dissertations and Doctoral Studies

Historically, the transgender community has been treated and studied myopically, using the lens of psychological illness. As treatment and research efforts have expanded in the past decade, the transgender population is becoming better understood. The purpose of the study was to examine the relationship between perceived health and preventative care in the transgender community. The health belief model was the theoretical framework for this cross-sectional study, which included data from the 2014–2018 Behavioral Risk Factor Surveillance System Survey. Chi-square tests and binomial logistic regressions were performed to investigate associations between perceived health and preventative care in the transgender community. The …

Hospital Emergency Room Visits For Heavy Menstrual Bleeding, Henry John Mead

Walden Dissertations and Doctoral Studies

Heavy menstrual bleeding (HMB) is a well-recognized health issue among women of reproductive age. The characteristics and demographics of women in the community with HMB who present at the emergency department (ED) are not well described. This research aimed to describe the cohort of women who seek treatment at the ED. The Healthcare Cost and Utilization Project 2016 National Emergency Department Sample was examined. The theory of reasoned action predicts that women who present at the ED are exhibiting health seeking behavior. From 32 million records, the inception cohort identified N = 111,555 cases. Using national estimation weights, this translates …

Chronic Obstructive Pulmonary Disease Readmissions And Mortality In Veterans Administration Hospitals, Carolyne S. Davis

Walden Dissertations and Doctoral Studies

AbstractRates for chronic obstructive pulmonary disease (COPD) have continued to increase, resulting in readmission tracking by the Centers for Medicare and Medicaid for community hospitals and Veterans Health Administration (VHA) hospitals. By using the Andersen healthcare utilization model as the theoretical framework, the purpose of this quantitative correlational research was to examine differences in 4,879 COPD readmission and mortality rates in VHA hospitals for the four Veteran Administration (VA) regional districts—Northeast, Southeast, Continental, and Pacific—as well as and between rural and urban VA hospitals. Secondary data was acquired from an open website through the Centers for Medicare & Medicaid Services. …

The Determinants Of Endometrial Cancer Survival Disparities In The United States, Evelyn Anegbe

Walden Dissertations and Doctoral Studies

Endometrial cancer is the most common gynecologic cancer in the United States with recent trends showing a continued increase in incidence and mortality. Prognosis is influenced by cancer stage at diagnosis and differs by race/ethnicity. Researchers have documented poorer survival among Blacks than Whites diagnosed with endometrial cancer. The 5-year survival rates for women with endometrial cancer is 81%; while survival for White and Black women are 84% and 62%, respectively. There is a gap in literature examining the widening disparity in incidence and survival of women diagnosed with advanced stage disease among population subgroups across the United States. The …

Sociodemographic And Psychosocial Factors And Wellbeing Among Adults 65 And Older In England, Dainelle Clark

Walden Dissertations and Doctoral Studies

The increased number of older adults living longer parallels with the growth of public health concerns regarding the impact of sociodemographic and psychosocial factors (e.g., loneliness and social isolation) on older adults' wellbeing. The purpose of this quantitative study was to examine the association between loneliness, social isolation, the combined model of loneliness, and social isolation on wellbeing among older adults when accounting for age, gender, ethnicity, and social support. The socioecological model (SEM) was used to evaluate the multiple levels of environmental determinants for loneliness, social isolation, and wellbeing. The target population included older adults 65 years and older …

Perceptions Of Caregivers Of Parkinson's Patients Regarding Using Advance Directives, Meghan Morgan

Walden Dissertations and Doctoral Studies

The increasing focus on end-of-life (EOL) care is influencing the role of advance directive (AD) documents. Difficult conversations among family caregivers and their loved ones are becoming more and more critical. Considering the value of communicating EOL wishes, family caregivers’ perceptions about ADs for their loved ones with Parkinson’s disease (PD) must be examined. Using the theory of planned behavior (TPB) as a foundation, the purpose of this generic qualitative study was to understand family caregivers of PD patients and their perceptions and experiences relating to AD documents. This study involved using purposeful sampling and semi-structured interviews with 11 family …

Relationship Between Trust, Race, And Health Care Information Sources Among African American Men, Uzochukwu Onukogu

Walden Dissertations and Doctoral Studies

AbstractAfrican American men have not been sufficiently at the center of research studies, especially when it comes to health. Most researchers have explored African Americans as a whole, and few have looked at African American men specifically, especially when it comes to their perceptions and ability to trust sources of health information. The purpose of this quantitative cross-sectional study was to examine the relationship between race and trust in health information sources, including the relationship between prostate cancer health outreach done through the internet and the acceptance of such information outreach among African American men. The theory of planned behavior …

Knowledge And Perceptions Of Antibiotic Resistance Stewardship Among Prehealth And Agriculture Students, Claudia Maria Da Silva Carvalho

Walden Dissertations and Doctoral Studies

The global threat of antibiotic resistant infection has resulted in health organizations to compile an antibiotic stewardship program, in which the education of current/future medical prescribers and farmers is central for the preservation of current and future antimicrobial treatments. The purpose of this study was to assess and compare the knowledge and perceived threat of antibiotic and antibiotic resistance, as well as the perceived benefit of antibiotic stewardship, among undergraduate students in biology and agriculture at a state university in Kansas. Framed by the health belief model, a cross-sectional study was conducted using a structured online survey of 136 undergraduate …

Exploring The Influences Of Culture On Hand-Hygiene Beliefs Of Foreign-Born Healthcare Workers, Sheila Blanche Davis

Walden Dissertations and Doctoral Studies

AbstractThe hand-hygiene practices of nonadherent health care workers (HCWs) are a major threat to patient safety and thus continue to be a concern for healthcare leaders and administrators worldwide. Healthcare-associated infections (HAIs), which are linked to HCWs' unclean hands, are prevalent throughout global healthcare settings. Global migration in the nursing profession and intercontinental travel among direct patient care providers make it challenging for healthcare leaders to sustain HCWs' adherence to hand-hygiene practices. The purpose of this grounded study was to explore the influence of the cultural beliefs about hand-hygiene practices of foreign-born HCWs. The theory of planned behavior was used …

The Impact Of Socioeconomic Status And Ethnicity On Chronic Obstructive Pulmonary Disease Patients, Donald Garret Abshier

Walden Dissertations and Doctoral Studies

Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating respiratory condition that leads to significant medial and financial burdens. For many patients with COPD, multiple socioeconomic factors contribute to health disparities, including income, education, employment status, and race/ethnicity. The purpose of this study was to examine the impact of SES and race/ethnicity on COPD patients. For this cross-sectional study, using secondary data analysis, the Social-Ecological Model (SEM), which discusses five levels of influence, was utilized. Data from over 3,222 participants aged 18 and over, living in Nevada were obtained from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) study. …

Melanoma Cancer Survivors: An Online Community Perspective And Prevention Effort, Lisa Marie Chung

Walden Dissertations and Doctoral Studies

AbstractMelanoma cancer is a major public health issue and has been associated with tanning and exposure to ultraviolet radiation. Minimal information is known about prevention efforts specific to survivors of melanoma cancer who participate in an online community. Surveys of this community differ from previous research of individuals through nononline research; the online community is more likely to be younger in age, comfortable seeking health information using Internet resources, and more advanced in technological capabilities. The main aim of this cross-sectional study was to investigate the impact of age, gender, and race on melanoma prevention efforts (health maintenance and skin …

Drug-Resistant Neisseria Gonorrhoeae; Identification Of At-Risk Groups In Florida By Regional Variation, Scott August Herber

Walden Dissertations and Doctoral Studies

Neisseria gonorrhoeae has been on the rise in the State of Florida since 2013. Florida currently follows the Centers for Disease Control and Prevention guidelines for identifying those at-risk for gonorrhea and drug resistant gonorrhea infections. These groups are narrowly defined and do not consider the different population dynamics throughout the State. This study examined the question of who is at-risk for contracting drug resistant strains of gonorrhea in the eight different regions of Florida based on the prescribed use of last-line-of-antibiotic-defense. Florida’s Surveillance Tools and Reporting System provided 12 years of secondary data from 2007 to 2018. The data …

Mental Health Literacy Among Rural And Urban Young Adults In Zambia, Etta Y. Mwambwa-Johnson

Walden Dissertations and Doctoral Studies

Misconceptions that negatively influence attitudes and beliefs about mental illness are still prevalent in Zambia. Researchers have reported that young adults are the most impacted population for mental disorders in Zambia. Researchers have also highlighted mental health literacy (MHL) as a useful strategy for influencing positive attitudes and beliefs about mental disorders. The purpose of this quantitative cross-sectional study was to investigate the relationship between levels of MHL and attitudes and beliefs about mental illness and health-seeking behaviors of Zambian young adults aged 18 to 24. The study used the health belief theoretical model. A MHL questionnaire was used to …

The Impact Of Obesity, Race, Age, Education, Income, And Healthcare Coverage On Cervical Cancer Screening Among Mississippi Women, Henrietta Tamika Ross

Walden Dissertations and Doctoral Studies

The human papilloma virus is the necessary agent in the development of cervical cancer. It is through screening exams like the Papanicolaou (Pap) test that cervical changes can be identified, and cervical cancer can be diagnosed in the early stage of cancer. The Pap test has aided in decreasing the rate of cervical cancer and the morbidity of cervical cancer. However, cervical cancer rates and mortality rates from cervical cancer are still the highest among women in Mississippi. Additionally, obesity rates among those who reside in Mississippi are the second highest in the United States. The purpose of this quantitative …

Effects Of Hepatitis On Human Immunodeficiency Virus Viral Suppression, Andrenita Checoby West

Walden Dissertations and Doctoral Studies

Coinfection with human immunodeficiency virus (HIV) and viral hepatitis leads to unfavorable health outcomes, making treatment of HIV difficult and increasing the odds of HIV transmission. The purpose of this study is to assess whether viral hepatitis (B and C) hinders HIV viral suppression and impacts the white blood cell count (CD4) when a person is concurrently infected with both viruses. The syndemics theory guided this study. Two research questions tested whether there was an association between coinfection with viral hepatitis and HIV viral load suppression. The research design was quantitative case-control with secondary data from 65,626 reports of HIV, …

Covid-10, Healthcare Interior Design + Provider Experience - How Does Your Space Work For You?, Ruth E.P. Deibler

Graduate Research Posters

The lack of research on healthcare staff experience and interior design of the spaces they work in is evident. A focus on staff perspective is needed, particularly staff who navigated the COVID-19 pandemic. This research seeks to capture those stories to develop further research in order to improve staff experience. The initial phase of this mixed-methods approach is a survey. Hypothetically, by placing providers at the center of qualitative research related to healthcare interior design, we can better understand existing healthcare spaces. Ideally, we can develop additional evidence-based, human-centered solutions to transform interior environments in healthcare.

The 20-year Women’s Health …

Modeling Longitudinal Change In Cervical Length Across Pregnancy, Hope M. Wolf, Shawn J. Latendresse, Jerome F. Strauss Iii, Timothy P. York

Graduate Research Posters

Introduction: A short cervix (cervical length < 25 mm) in the mid-trimester (18 to 24 weeks) of pregnancy is a powerful predictor of spontaneous preterm delivery (gestational age at delivery < 37 weeks). Although the biological mechanisms of cervical remodeling have been the subject of extensive investigation, very little is known about the rate of change in cervical length over the course of a pregnancy, or the extent to which rapid cervical shortening increases maternal risk for spontaneous preterm delivery.

Methods: A cohort of 5,160 unique women carrying 5,971 singleton pregnancies provided two or more measurements of cervical length during pregnancy. Cervical length was measured in millimeters using a transvaginal 12-3 MHz ultrasound endocavity probe (SuperSonic Imagine). Maternal characteristics, including relevant medical history and birth outcome data, were collected for each participant. Gestational age at delivery was measured from the first day of each woman’s last menstrual period and confirmed by ultrasound. Repeated measurements of cervical length during pregnancy were modeled as a longitudinal, multilevel growth curve in MPlus. A three-level variance structure was …

The Occupational Depression Inventory—A Solution For Estimating The Prevalence Of Job-Related Distress, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

We are concerned about researchers’ reliance on the burnout construct and the MBI-GS to estimate the prevalence of job-related distress. In this paper, we first describe some of the problems plaguing the burnout construct and its measures. Then, we present the Occupational Depression Inventory, a new instrument designed to help occupational health specialists get a clearer view of the mental health status of the workforce (Bianchi and Schonfeld, 2020).

Barriers And Facilitators To Pre-Exposure Prophylaxis Uptake Among Black Women: A Qualitative Analysis Guided By A Socioecological Model, Alexa B. D'Angelo, Leah N. Davis Ewart, Juline Koken, David Bimbi, Justin Brown, Christian Grov

Publications and Research

Background This study included Community Health Workers and their supervisors from HIV clinical care teams who participated in the Healthy Choices intervention program. Healthy Choices is a Motivational Interviewing-based intervention aimed at improving medication adherence and reducing alcohol use for adolescents and emerging adults ages 16—24 living with HIV. In this study, the intervention was “scaled up” for delivery by local HIV care providers in real-world clinic settings. Methods Providers (N = 21) completed semi-structured interviews (N = 29) about their experiences with intervention scale-up. Rigorous thematic analyses were conducted within discussions of barriers and facilitators of intervention implementation. Results …

Digging Deeper: Improving Health Communication With Patients, Jennifer Ko, Miranda Steinkopf, Abby A. Kahaleh, Sharon Connor

Pharmacy Faculty Books and Book Chapters

At the end of this activity, students will be able to:

• Identify five theories and models that can be used to facilitate the patient-provider health communication process
• Describe opportunities to optimize communication with patients in healthcare settings
• Apply health communication theories within patient care, providing specific approaches and language to utilize

Optimizing Maternal, Newborn, And Child Health Outcomes Through Use Of Multidisciplinary 'Improve' Teams In Lesotho: Costing Component, Adebiyi Adesina, Rachael Linder, Lori Bollinger

HIV and AIDS

This study builds on the USAID-funded prevention of mother-to-child transmission service delivery program (IMPROVE) already being implemented by Elizabeth Glaser Pediatric AIDS Foundation in Lesotho. Rather than designing a suite of entirely new services and delivery platforms, the intervention (conducted under Project SOAR) focused on improving existing services and strengthening the connection between facility- and community-based care. This brief describes the approach and key quantitative findings of the costing component of the IMPROVE intervention from the service provider perspective.

Effects Of Moderate Sleep Restriction During 8-Week Calorie Restriction On Lipoprotein Particles And Glucose Metabolism, Joshua R. Sparks, Ryan R. Porter, Shawn D. Youngstedt, Kimberly P. Bowyer, J. Larry Durstine, Xuewen Wang

Faculty Publications

Study Objectives

This study examined how glucose, glucose regulatory hormones, insulin sensitivity, and lipoprotein subclass particle concentrations and sizes change with sleep restriction during weight loss elicited by calorie restriction.

Methods

Overweight or obese adults were randomized into an 8-week calorie restriction intervention alone (CR, n = 12; 75% female; body mass index = 31.4 ± 2.9 kg/m2) or combined with sleep restriction (CR+SR, n = 16; 75% female; body mass index = 34.5 ± 3.1 kg/m2). Participants in both groups were given the same instructions to reduce calorie intake. Those in the CR+SR group were instructed to reduce their …

A Case Of Primary Infertility Treated With Icsi And Tesa, Saumya Raj

Digital Journal of Clinical Medicine

No abstract provided.