Epidemiology Commons^™

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) …

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

Walden Dissertations and Doctoral Studies

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

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, …

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 …

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.

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 …

The Relationship Between Chlamydia, Gonorrhea, Syphilis And Race, Gender, And Age, Johnny James Mcgrew

Walden Dissertations and Doctoral Studies

The purpose of this quantitative correlational design using secondary data from Colorado Department of Public Health and Environment was to examine the relationship between different types of sexually transmitted infections (STIs), specifically, chlamydia, gonorrhea, and syphilis, and race, gender, and age in the United States. This study is significant because it could assist medical personnel to focus on more personally-based STI treatments. This study could also lead to a call for more research regarding sexual health programs across the nation, individuals’ willingness to share personal information regarding STIs, and how sexual health programs could increase testing for STIs. The study …

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.

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

Walden Dissertations and Doctoral Studies

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

Nutrient Pollution And Chlorophyll-A As A Precursor To Harmful Algal Blooms And Cyanotoxins In Rehabilitated Machado Lake, California, Michael E. Shiang

Walden Dissertations and Doctoral Studies

Algal blooms result in the formation of cyanotoxic conditions in a freshwater lake causing severe detrimental impacts to community and public health. Nitrogen, phosphorous, and ammonia stimulate the growth of phytoplankton biomass and algae, as measured by chlorophyll. This retrospective quantitative research study, grounded in the socioecological model, examined the relationship between nutrient pollutants and chlorophyll-a (Chl-a) that forecast harmful algal blooms, a precursor to cyanotoxins. A former impaired lake, Machado Lake in California, provided an ideal setting to assess relationships among nutrient indicators and Chl-a post-lake rehabilitation. Correlation and multiple regression analyses were performed to determine if a relationship …

Association Between Antidepressant Adherence And Major Depressive Disorder Complications, Philip Lisinge

Walden Dissertations and Doctoral Studies

Despite evidence that antidepressants are more effective at treating major depressive disorder (MDD) symptoms, there is growing evidence that MDD management is still hampered by nonadherence to antidepressant treatment regimens. Researchers have suggested that MDD, if untreated, might lead to MDD-related complications, but other researchers have argued that adherence to antidepressants can lead to these same MDD-related complications. This quantitative cross-sectional study used primary data collected from 298 volunteers to examine the association between MDD-related complications and antidepressant adherence to clarify these diverging opinions. The study’s objective was to provide evidence to accept or reject the premise that antidepressant adherence …

An Association Of The Transgenerational Implications Of Redlining And Obesity On Pediatric Type Ii Diabetes, Carlin Dexter Nelson

Walden Dissertations and Doctoral Studies

s the prevalence and incidence of childhood obesity has increased, so has the number of cases of pediatric Type 2 diabetes mellitus (T2DM). Although made unconstitutional in 1968, the transgenerational implications of redlining can be observed in disinvestments resulting in neighborhood detraction. Utilizing the 2019–2020 National Children’s Health Survey, the purpose of the study was to evaluate the relationship between obesity, T2DM, and neighborhood detraction elements as well as assessed indicators of T2DM in non-institutionalized children 6 through17 years of age (N = 34,725). The social determinants of health perspective served as the conceptual framework for the study. Results indicated …

Evaluation Of Recovery Level And Surgical Site Infection For Hip Replacement Surgeries, Misha Foster

Walden Dissertations and Doctoral Studies

Surgical site infection (SSI) is one of the most common healthcare associated infections and is a major cause of morbidity and mortality. Existing studies have focused primarily on perioperative intervention strategies to reduce infection risks following total joint replacement (TJA) procedures. However, postoperative (post-op) SSI risk factors may account for a significant percentage of hospital readmissions due to infections at the surgical site. Therefore, the purpose of this study was to examine the association between post-op recovery level and SSI among patients who underwent primary hip arthroplasty procedures. Using the social ecological model, which conceptualizes health broadly and focuses on …

A National Assessment Of Household, Community, And Environmental Situations On Breastfeeding Decisions, Marnita Siglar Thomas

Walden Dissertations and Doctoral Studies

Exclusively breastfeeding has been proven to be an effective preventive measure for childhood obesity; however, breastfeeding practices decline after 6 months. Secondary data from the 2018-2019 combined National Survey of Children's Health were used for this study to determine the household, community, and physical environment relationship between individuals' decisions to breastfeed and sustainment in the United States (N=16,750). Grounded by the theoretical framework of the socio-ecological model, the results suggested that household, community, and physical environments predict individuals' decisions to initiate breastfeeding and sustainment nationally (p < 0.001). Binary logistic regression, controlling for maternal age, indicated a statistical significance between breastfeeding initiation and income (p = 0.043, p = 0.041), family structure (p = 0.003, p < 0.001), education (p < 0.001, p < 0.001, p < 0.001), neighborhood support (p < 0.001), and neighborhood amenities (p = 0.039, p <0.001, p < 0.001). A statistical significance between breastfeeding duration and family structure (p = 0.061), education (p < 0.001, p < 0.001), maternal overall health (p <0.001), neighborhood support (p = 0.008), neighborhood safety (p = 0.006), and neighborhood amenities (p = 0.019) was found when controlling for maternal age. Implications for positive social change include providing health professionals with knowledge on breastfeeding decision making to encourage new recommendations and implement new practices and policies to promote breastfeeding and ultimately reduce the incidence of overweight and obesity in children nationwide.

Comparative Effectiveness Study Of Acute Ischemic Stroke Care Between Stroke Belt And Non-Stroke Belt Hospitals Using The Get With The Guidelines-Stroke Program, Michael Earl Brown Jr

Walden Dissertations and Doctoral Studies

Stroke is a leading cause of mortality in the United States, particularly in a cluster of states termed the stroke belt. This study examined the efficacy of the Get With The Guidelines (GWTG)-Stroke program in stroke belt hospitals (SBHs) compared to non-stroke belt hospitals (NSBHs) regarding disparities related to mortality and acute ischemic stroke (AIS) treatment (i.e., recombinant tissue-type plasminogen activator [r-tPA] rates, Door-to-Needle [DTN], Door-to-Imaging [DTI]). Use of the GWTG-Stroke program was assessed to determine if SBHs and NSBHs were quantitatively equivalent in terms of specific core stroke measures. This quantitative employed an equivalence study design with over 2.9 …

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 …

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 …

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, …

Depression, Drug Use, And Hsv-2 Among Women Who Have Sex With Women, Viani Picchetti

Walden Dissertations and Doctoral Studies

Herpes simplex virus type 2 (HSV-2), the main cause of genital herpes, is an incurable sexually transmitted infection responsible in 2018 for 18.6 million infections in the United States. HSV-2 is twice as frequent in women than in men. Women who have sex with women (WSW) have a higher prevalence of depression and drug use than women who have sex exclusively with men (WSM), which are each related to HSV-2 as they increase the likelihood of engaging in risky sexual behaviors. The purpose of this study was to assess the predictive relationship between depression status, nonprescription drug use status, and …

Evaluating The 2012 Vaccination Reporting Mandate: Applications To Adventist Health Network, May Abdalla

Walden Dissertations and Doctoral Studies

Influenza is a public health concern that claims up to 56,000 lives annually in the United States, though it is a vaccine-preventable disease. Influenza vaccination among health care personnel (HCP) is highly encouraged to prevent influenza transmission in health care settings. The objective of this study was to examine the relationship between mandatory reporting of HCP influenza vaccination rates (implemented in 2012) and HCP influenza vaccination intake in a health care network with 20 hospitals. The protection and motivation theory was used as the theoretical framework. Data collected from surveys of hospital administrators and archives of the Center for Medicare …

Treatment Outcomes And Associated Factors In Tb/Hiv-Coinfected Patients In Namibia, Esland Shilongo

Walden Dissertations and Doctoral Studies

AbstractHIV and TB have merged into a deadly co-epidemic in Namibia. Currently, though, TB and HIV data at the national, regional, and district level might be underreported and insufficient to understand the full burden and outcome rates of TB and HIV. Targeting the TB outcomes rate among TB/HIV-coinfected individuals is an effective strategy for decreasing future TB burden and furthering the gains in the control of both diseases. The objective of this study was: to assess the outcomes of patients registered for anti-TB treatment in //Karas Region which has the largests burden of TB in Namibia. A 5-year retrospective cohort …

The Association Of Suicidality With Video Gaming And Physical Inactivity Among U.S. Adolescents, Mary Colleen Cyrus

Walden Dissertations and Doctoral Studies

Suicide represents a leading cause of death in U.S. young people, and the rate is increasing. Although young people are spending more time each day playing video or computer games, there is limited research on the association, if any, between playing video games and suicidality. The purpose of this study was to identify whether there is a statistically significant association between video gaming, physical inactivity, and suicidality (suicidal ideation, planning, and attempts). Age, race, gender, and being bullied electronically and in school were assessed as potential confounding variables. The interpersonal theory of suicidal behavior and the social-ecological theory served as …

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 …

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 …

Role Of Hypertension In Low-Birth-Weight Racial Disparities Among Virginian Women, Ashli Owen

Walden Dissertations and Doctoral Studies

Low birth weight (LBW) is a leading cause of infant mortality globally, but it disproportionately burdens the Black community in the United States, with a rate twice that of White women. Further, hypertensive disorders of pregnancy (HDsP) increase LBW incidence. The purpose of the study was to assess the association between HDsP and LBW, maternal race and LBW, and the moderation effect of HDsP on race and LBW on Black and White women in Virginia. The theoretical framework for this study was based on the lifecourse health development model, which states that health should be viewed as an outcome of …

Predictors Of Glycemic Control Among Type 2 Diabetes Mellitus Patients In Owerri, Nigeria, Jideuma Ikenna Egwim

Walden Dissertations and Doctoral Studies

Diabetes mellitus (DM) is a significant public health concern globally and in Owerri, Nigeria. The deleterious effects of diabetes have been linked to poor glycemic control. According to the International Diabetes Federation, poor glycemic control is reflected in glycosylated hemoglobin (HbA1c) levels greater than 7.0%, which are associated with substantial morbidity and mortality. Studies have shown a dramatic rise in diabetic complications in Nigeria, particularly in Owerri. However, evidence is lacking on specific risk factors associated with poor glycemic control among DM patients in Owerri. With health insurance assuming a significant position in healthcare service delivery in Nigeria, addressing this …