Epidemiology Commons^™

Predictors Of Homelessness Among Female Veterans And Civilians, Victoria Caridad Justiniano Quinones

Walden Dissertations and Doctoral Studies

Homelessness among female veterans is a problem that is likely to increase as growing numbers of women in the U.S. military reestablish themselves into their communities as veterans. There has been increasing concern about the greater risk for homelessness found among female veterans when compared to their nonveteran counterparts, so further investigation of homeless incidence by gender is also warranted. This quantitative, exploratory study was grounded in the social ecological theory, the Balshem and colleagues conceptual model of risk factors for veteran homelessness, and the Susser, Moore, and Link conceptual model which investigated causal pathways that are possible risk factors …

Risk Factors Of Infant Mortality Among Sub-Saharan Immigrants In The United States, Roland Lankah

Walden Dissertations and Doctoral Studies

While prepregnancy body mass index (BMI), gestational weight gain (GWG), and birthplace have been suggested to play a key role in predicting infant mortality outcomes, they have not been thoroughly investigated across all races/ethnicities. The purpose of this study was to examine the associations between prepregnancy BMI, GWG, birthplace as independent variables, and infant mortality as the outcome variable within the United States Sub-Saharan African Immigrants (SSAI). A quantitative cross-sectional study design grounded in the biopsychosocial model was used. Data were extracted from the 2017-2018 natality-linked birth/infant death file from the Centers for Disease Control and Prevention Wonder Database. It …

Perceptions Of Hiv Testing Among African-Born Immigrants In Washington State, Phoebe Kirigo Mugo

Walden Dissertations and Doctoral Studies

African born immigrants (ABIs) face challenges associated with HIV testing. As a result, many ABIs are not tested for HIV, and this population is among some of the most diagnosed at late stages of HIV/AIDS. The purpose of this qualitative phenomenological study was to explore and seek to understand the lived experiences of ABI adults ages 25 to 49 living in Washington State. I gathered data to gain their perceptions of HIV testing through in-depth interviews. The study was informed by the health belief model, which helped to understand the complex nature of healthcare-seeking behaviors among this population and how …

Risk Factors Associated With Type 2 Diabetes Among Adults In Alabama, Peter Okeke

Walden Dissertations and Doctoral Studies

In the 21stcentury Diabetes mellitus is recognized as one of the most important public

health challenges that carry a substantial individual and community burden.

It is necessary to do a detailed search regarding DM2 from adolescence till adulthood is in

Alabama which should aim to provide recent information. T2D is influenced by a many

factors including demographics including age, sex, income level, educational, BMI,

physical activities, etc. Identification of the associated risk factors is very important to

inform decision making by concerned bodies and T2D management. The study aimed to

examine the risk factors associated with T2D in adults aged …

Non-Disclosure Of Child Sexual Abuse: The Lived Experience Of Victims In South Africa, Chima Obiora Ozor

Walden Dissertations and Doctoral Studies

Child sexual assault (CSA) has been reported all over the world. Studies indicated that South Africa has one of the highest incidences with far reaching social, physical and emotional consequences. However, non-disclosure is common, which increases the risk of revictimization. Understanding the complexities surrounding the low reporting and non-disclosure will provide guidance for better intervention of CSA in South Africa. This study explored the past experiences of adults who were sexually abused as minors, and how their experiences and outcomes may have been influenced by factors at the micro, meso, macro, and chrono-system levels of Bronfenbrenner’s social ecological model. The …

Impact Of Poverty On Antibiotic Prescribing Rates In The United States Through Mediation Effects Of Underlying Health Conditions, Nato Tarkhashvili

Walden Dissertations and Doctoral Studies

Resistance to antibiotics among bacteria develops largely due to frequent use of antibiotics in human and animal medicine. Little is known about how patients’ socioeconomic factors, in conjunction with chronic health conditions, impact antibiotic prescribing rates in the United States. The research questions aimed to explore the relationship between poverty and antibiotic prescribing rates while also adjusting for confounders such as population aged ≥ 65, physician density, prevalence of obesity, diabetes, and chronic obstructive pulmonary disease (COPD). The relationships were evaluated using a quantitative, ecological study design using the ecosocial theory and mediation analysis of 2020 survey results provided by …

Vitamin K Deficiency And Ischemic Stroke In Atrial Fibrillation Patients On Warfarin, Kimberly Therese Thompson

Walden Dissertations and Doctoral Studies

Individuals with poor nutritional vitamin K status can suffer from atrial fibrillation (AF) due to misinterpretation of warfarin instructions by healthcare providers. The purpose of this quantitative study was to determine if there was an association between inadequate dietary vitamin K intake in AF patients and stroke outcomes to address the lack of research surrounding stroke outcomes in patients with true vitamin K deficiency. Grounded in the health belief model, this study assessed if individual beliefs from health education influenced the nutritional quality of their diet and health outcomes. The study is a secondary data analysis of the Framingham Heart …

Assessment Of Multidrug Resistance Among Tuberculosis Patients In Lesotho, Jerry Yakubu Yahaya

Walden Dissertations and Doctoral Studies

The emergence of multidrug-resistant tuberculosis (MDR-TB) jeopardizes the tremendous efforts in the fight against tuberculosis in Lesotho. To understand the occurrence of MDR-TB, it is important to identify the associated risk factors and how to address them. There is a literature gap on the sociodemographic risk factors associated with MDR-TB in Lesotho. This study assessed whether there is any significant association between age, employment, income, sex, education, place of residence and MDR-TB. The association between HIV and MDR-TB was also evaluated. Guided by the health belief model and social cognitive theory, a retrospective case-control study design and a proportionate stratified …

Gestational Weight Gain, Level Of Education, And Infant Mortality Among African American Women, George Lee Amanambu

Walden Dissertations and Doctoral Studies

Abstract

African American (AA) women in Mississippi have a higher burden of infant mortality, especially those with low income and educational levels, as compared to other regions of the country. However, it is unknown if abnormal gestation weight gain (GWG) is contributing to this increased burden. This quantitative cross-sectional study examined the association between GWG (25-35lbs), level of education, income, and infant mortality among AA women with normal prepregnancy body weight who were between 30 to 47 years old in the state of Mississippi from 2016 to 2018. Biopsychosocial and ecosocial models were used as the theoretical foundation to design …

The Influence Of Race And Ethnicity On The Prevalence Of Social Stigma For People With Type 1 Diabetes Mellitus, Donielle Hyde

Walden Dissertations and Doctoral Studies

Various studies attempting to evaluate the prevalence of health-related social stigma in people with type 1 diabetes mellitus (T1DM) identified themes that coincide with increased prevalence including anxiety, low self-esteem, depression, fear of judgement, anger, and feeling ashamed. This phenomenon is believed to be due to the lack of knowledge and understanding about the differences between the diagnosis, treatment, and prevention strategies for T1DM and type 2 diabetes mellitus (T2DM). The Resilient, Empowered, Active Living intervention dataset (n=115) was utilized to further examine this phenomenon by determining whether race and ethnicity influence the prevalence of the following health-related social stigma …

Diabetes, Obesity, Geographic Location Of The Patient And Clostridium Difficile Infection In The United States, Mary (Maribeth) Greenway

Walden Dissertations and Doctoral Studies

AbstractClostridium difficile infection (CDI) is a major nosocomial threat to be reckoned with in the current health care setting in the United States. Advancing age, underlying chronic disease associated with inflammation (including Diabetes Mellitus Type I ([DMI]), Diabetes Type II ([DMII]), and obesity), trauma, immunodeficiency and other factors that diminish the overall health of an individual, and increase an individual’s susceptibility to CDI. The ecological framework was used to determine the relationship between geographic, chronic diseases and the occurrence of infectious diseases. To continue enhancing knowledge related to CDI susceptibility this quantitative study used the 2010 National Hospital Discharge Survey …

Bullying, Participation In Violence, Suicidal Ideation, And Behavior Among African American Youth, Kierystan Lorquoyea Johnson

Walden Dissertations and Doctoral Studies

Suicide is the second leading cause of death among adolescent, teens, and young adults. Suicidal ideation is a predictor of suicide attempts. Guided by the integrated motivational-volitional model and social cognitive theory, Youth Risk Behavior Surveillance Survey data were used to investigate whether traditional bullying, cyberbullying, and participation in physically violent behavior (independent variables) were associated with suicidal ideation and behavior (dependent variables) among African American high school aged youth controlling for age, gender, physical, and sexual abuse. It was found that experiencing traditional bullying increased suicidal ideation significantly, as there is an 82% increase in likelihood. There was also …

Microaggression Experiences Among African American Women And Their Effects On Health In Academia, Anta'sha Moni Jones

Walden Dissertations and Doctoral Studies

Racial microaggressions are brief daily negative verbal behaviors and environmental slights directed as intentional or unintentional towards minorities. These negative interactions lead minorities to feel powerless and oppressed in their environments. These adverse experiences result from stressors in their environment that negatively affect the human body by causing acute and chronic stress. This qualitative study aimed to investigate the relationship between personal, racial microaggression experiences, and their impact on health through a phenomenological approach. The critical race theory provided a framework to explore and understand how systematic discrimination experiences impacted the 17 African American faculty member participants’ health. A phenomenological …

External Validation And Modification Of A 30-Day Readmission Risk Prediction Model For Heart Failure Patients, Debra Kelly

Walden Dissertations and Doctoral Studies

The development and validation of 30-day readmission risk prediction models, such as the LACE index, have been of interest to researchers and healthcare organizations, especially since the Centers for Medicare and Medicaid Services began to impose monetary penalties on hospitals with higher than expected 30-day readmission rates. However, there is a lack of consensus concerning the efficacy of the LACE index in the heart failure population. The purpose of the study was to examine the discriminative accuracy of the LACE index to predict all-cause 30-day readmission for heart failure patients and to build a modified 30-day readmission risk prediction model …

Stigma And Discrimination’S Effect On Hiv Testing Of Pregnant Women In Nigeria, Charles Echezona Nzelu

Walden Dissertations and Doctoral Studies

The utilization of HIV testing services among pregnant women in Nigeria has not been optimal. Although much is known about the determinants of HIV testing among pregnant women, there is a gap in knowledge on determinants for pregnant women infected with the virus, specifically whether stigma and discrimination are barriers. The purpose of this study was to examine the effect of stigmatizing attitudes and personal knowledge of discriminatory practices towards persons living with HIV/AIDS on the decision by pregnant Nigerian women aged 15-49 years to test for HIV during antenatal visits or childbirth. The health belief model served as the …

Health Department Prevention/Education Plans And Perceived Risks Of Zika Infection, Lacey Jacques

Walden Dissertations and Doctoral Studies

AbstractZika virus is an infectious disease caused by the bite of an infected mosquito that has been linked to increased rates of microcephaly and other devastating birth defects. The existing body of knowledge has focused on the individual-level factors that influence a person’s decisions about prevention activities and risk perceptions related to Zika virus. The purpose of this study was to determine the relationship between state-level plans for prevention and education and individual-level risk perceptions. Rosenstock’s health belief model lays a foundation for why individuals make the health decisions they do and helps explain how these can be influenced for …

Health Department Prevention/Education Plans And Perceived Risks Of Zika Infection, Lacey Jacques

Walden Dissertations and Doctoral Studies

AbstractZika virus is an infectious disease caused by the bite of an infected mosquito that has been linked to increased rates of microcephaly and other devastating birth defects. The existing body of knowledge has focused on the individual-level factors that influence a person’s decisions about prevention activities and risk perceptions related to Zika virus. The purpose of this study was to determine the relationship between state-level plans for prevention and education and individual-level risk perceptions. Rosenstock’s health belief model lays a foundation for why individuals make the health decisions they do and helps explain how these can be influenced for …

Looking Upstream For Factors Influencing Mental Illness In A Low-Resource Setting, Adewole Adebola Adefalu

Walden Dissertations and Doctoral Studies

An investigation into the upstream determinants of mental disorders could provide insight into pathways by which these risk factors could relate to different groups of mental illness. The study was a quantitative inquiry using constructs within the Rothman’s sufficient and component cause framework to examine the pathways existing between upstream risk factors for schizophrenic and mood disorders. The study population was drawn from a convenience sample of clients accessing services at the psychiatry departments of a secondary mental health institution in North-Central Nigeria. The mean age of the participants in this study was 35.5years. The majority were males (53.4%), single …

Risk Factors Associated With Access To Intermittent Preventive Treatment For Malaria Among Pregnant Women In Uganda, Mayanja Simon Peter

Walden Dissertations and Doctoral Studies

Intermittent preventive treatment of malaria in pregnancy (IPTp) is an intervention consisting of the full course of therapeutic antimalarial medicine administered to pregnant women during routine antenatal visits regardless of whether the woman is infected with malaria. The use of intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) has been reportedly low in most of the malaria endemic areas, including Uganda. The coverage of IPTp in Uganda has been estimated to be as low as 17%. An in-depth secondary data analysis using the 2016 Uganda Department of Health Services survey was conducted to understand the causal relationships between …

Factors Associated With Accidental Drug Exposure In U.S. Adults Over 65 Years Of Age, Edwin Raj

Walden Dissertations and Doctoral Studies

Medication errors are a major public health issue and a leading cause of fatalities in the United States and globally. Older adults who rely on medications to address age-related health issues are at higher risk of medication errors. Accidental exposure to drugs is a major type of medication error that impacts older people more than other age groups. The purpose of this quantitative correlational study was to examine the association between patient gender, age group, and reporter type and accidental exposure to drugs in older people. The ecological model was used to guide the study. Logistic regression analysis was used …

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 …

Prophylactic Antimalarial Intermittent Preventive Therapy In Pregnancy And Birth Weight In Togo, Epiphane Awokou

Walden Dissertations and Doctoral Studies

In Togo, prophylactic antimalarial intermittent preventive therapy in pregnancy (IPTp) is provided to disrupt suboptimal pathways leading to the issue of low birth weight. However, there is a lack of nationally representative data on the determinants of this adverse birth outcome. The purpose of this quantitative cross-sectional study was to determine pregnancy-related determinants of low birth weight through a nationally representative dataset. Bronfenbrenner’s ecological systems model guided this study to explore potential associations between the covariates IPTp, utilization of long-lasting insecticidal bed nets, age of pregnant women, socioeconomic status of pregnant women, and gravidity type of pregnant women and the …

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 …

Variables On The Proportion Of Children With Sickle Cell Hemoglobin, Oyekola Oluyimika Oloyede

Walden Dissertations and Doctoral Studies

AbstractThe case fatality rate among children living with sickle cell disease was approximately 50% to 90% in Sub-Saharan Africa. Though researchers have contributed social determinants of health more broadly, they have not provided adequate screening information on children living with sickle cell disease aged 6 months to 59 months. The purpose of this cross-sectional study was to examine the association between sickle cell disease status, infection prevention, pain and anemia management, demography, socioeconomic status, and healthcare use. This study included approximately 11,536 genotype results of children under 5-years-old in Nigeria. Bronfenbrenner’s systems theory and Krieger’s ecological theory formed the theoretical …

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 …

Primary Care Physicians’ Knowledge, Attitudes, And Practices Regarding Lyme Disease In High- Versus Low-Incidence Lyme Disease Midwestern States, Alexander Karnga

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this quantitative cross-sectional study, guided by the barriers to physician behavior change (BPBC) framework, was to address the gaps in the Lyme disease empirical literature by examining whether there were significant differences in Lyme disease knowledge, attitude, and practices between primary care physicians in Wisconsin, a high-incidence Midwestern Lyme disease state, and Michigan, a low-incidence Lyme disease Midwestern state. The study was conducted with 65 physicians (53.8% male and 46.2% female). The study hypotheses were tested by conducting a one-way multivariate analysis of covariance (MANCOVA), controlling for physicians’ years of practice (the number of patients seen per …

Gestational Weight Gain, Level Of Education, And Infant Mortality Among African American Women, George Lee Amanambu

Walden Dissertations and Doctoral Studies

Abstract

African American (AA) women in Mississippi have a higher burden of infant mortality, especially those with low income and educational levels, as compared to other regions of the country. However, it is unknown if abnormal gestation weight gain (GWG) is contributing to this increased burden. This quantitative cross-sectional study examined the association between GWG (25-35lbs), level of education, income, and infant mortality among AA women with normal prepregnancy body weight who were between 30 to 47 years old in the state of Mississippi from 2016 to 2018. Biopsychosocial and ecosocial models were used as the theoretical foundation to design …

Alternative Diet Practices As Predictors For Vaccine Confidence, Nancy Dolin

Walden Dissertations and Doctoral Studies

Perceived risks and side effects have left some with a lack of confidence in the safety and efficacy of vaccines. This may lead to not adhering to the recommended vaccination schedule and result in outbreaks that have the potential to harm those who are unable to get vaccinated due to age or infirmity. It is vital to seek and address the characteristics that may predict one’s confidence in vaccines. The aim of this study was to identify whether an individual’s alternative diet behavior may be able to predict their confidence in the measles, mumps, and rubella (MMR) vaccine. The theoretical …

Health-Related Quality Of Life For Veterans Transitioned Into Civilian Life, Vicki Ann Guerra

Walden Dissertations and Doctoral Studies

Texas veterans transitioning to civilian life have experienced health issues after discharge. There are processes to follow before seeking treatment or diagnosis for any health issue prior to military discharge. Given the gaps in the literature on veteran health, quality of life and transition to civilian life, scholars lack understanding of the transitional events that take place. Veteran health issues are impacted by medical appointment wait-times, day to day life events, and this can lead to decreased quality of life. The purpose of this mixed-methods study (N=36) was to evaluate veterans’ health related quality of life who had transitioned from …

Weight Change And Hyponatremia As Predictors Of Polydipsia Among Persons With Schizophrenia, Kingsley Okechukwu Nwachukwu

Walden Dissertations and Doctoral Studies

AbstractPolydipsia is found in 20% of inpatients with chronic severe mental disorders. Of this, 80% are diagnosed with chronic schizophrenia, hence polydipsia is strongly associated with chronic schizophrenia. Despite the prevalence and serious health complications of coexisting polydipsia in this population, its current method of detection is flawed. The purpose of this quantitative study was to accurately identify comorbid polydipsia in schizophrenia using periodic weight change and hyponatremia. The Wilson’s complexity theory and primary data were used to attempt to explain the relationship between weight change and hyponatremia and polydipsia, in a cross-sectional study design. The dependent variable was polydipsia, …