Epidemiology Commons^™

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 …

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 …

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 …

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, …

Isocitrate Dehydrogenase-1 Mutation As A Prognostic Factor In Recurrent Glioblastoma, Haroon R. Hashmi

Walden Dissertations and Doctoral Studies

Glioblastoma (GBM) is an aggressive form of brain cancer that has a high recurrence rate and very poor prognosis. The prognostic value of various molecular markers (e.g., IDH 1 mutation, MGMT promoter methylation, etc.) and clinical factors (e.g., age, KPS, surgery and chemotherapy) has been studied in GBM after initial diagnosis but not as extensively in the recurrent GBM. Utilizing a retrospective cohort design, based on quantitative data collected through medical chart reviews, and the conceptual framework of outcomes research in oncology, this study evaluated the prognostic value of IDH-1 mutation in recurrent GBM in the context of key predictor …

Diabetes Management And Self-Perception Of Health Among Adults In The United States, Moses Ajoku

Walden Dissertations and Doctoral Studies

The burden and complications of diabetes have been a public health concern and societal challenge for decades, and the rate of prevalence is projected to increase in the future. The study aims to examine the association between blood glucose monitoring, glycated hemoglobin test, and self-perceived health status among diabetic adults in the United States. Guided by the chronic care model, the study used data from the 2019 Behavioral Risk Factor Surveillance System to investigate diabetes management practices among diabetic adults in the United States. Quantitative and cross-sectional methods were used to assess the associations between diabetes management practices and self-perceived …

Association Between Food Insecurity And Influenza Outcome In The United States., Sabrina Fiona Pink

Walden Dissertations and Doctoral Studies

AbstractThe influenza virus is one of the most commonly occurring respiratory viral infections in the world. The outer capsule of the virus contains 18H proteins and 11N proteins, which allows the virus to reform in over 100 different strands and outperform the vaccine. Despite efforts to improve access to care and reduce vaccine inequities; the Center for Disease Control and Prevention estimates 9-45 million documented influenza-related illnesses, 140,000 to 810,000 hospitalization, and 64,000 deaths yearly. The purpose of this study is to investigate whether food insecurity, access to care and other social determinants of health such as age, race, and …

Risk Factors For Foodborne Illness Outbreaks In Retail Food Establishments, Brendalee Viveiros

Walden Dissertations and Doctoral Studies

Despite policies and interventions over the last two decades, foodborne illness remains a significant public health concern. According to the CDC’s Foodborne Disease Outbreak Surveillance System, 60% of reported foodborne illness outbreaks involved food that was prepared at a restaurant. Reducing foodborne illness outbreaks that occur at restaurants would have a significant impact on the overall number of foodborne illnesses that occur each year. The purpose of this study was to quantitatively analyze the differences in risk factors in food establishments that have had a foodborne illness outbreak compared to food establishments that have not. This study used Reckwitz’s theory …

Predictors Of Cancer Information Seeking Among Adults With A Family History Of Cancer, Oluwakemi Akindeju Fawole

Walden Dissertations and Doctoral Studies

Cancer is a significant cause of illness and mortality in the United States. A family history of cancer is a valuable factor for assessing disease risk and increasing cancer information-seeking behaviors for prevention. Guided by the health belief model, this quantitative study addressed the predictors of cancer information seeking behavior among adults with a family history of cancer. In this study, data from 8,473 participants in the 2017–2019 Health Information Trends Analysis Survey were analyzed using multivariate logistic regression. This analysis addressed whether there was a statistically significant difference in sociodemographic factors, measures of health status, and health care engagement …

How Cyber Activity Influences Depression And Anxiety In Teenagers, Mary Fridah Gatwiri Muiruri

Walden Dissertations and Doctoral Studies

Both depression and anxiety have been a focus of scholars since their rates have recently skyrocketed from 5.4 % in 2003 to 20 % currently among teenagers in the United States. Although numerous studies have assessed the association between playing video games and depression, few studies have examined how cyberbullying and screen time contribute to depressive symptoms in teenagers. The purpose of this study was to analyze cyberbullying and screen time on depression in teens. . The exploration of associations between the dependent variable, depression, and the independent variables, screen time, video gaming, and cyberbullying, were guided by Bandura’s social …

Relating Overweight/Obesity And Psychosocial Outcomes Among Racial/Ethnic And Sexual Minority Adolescents, Cadene T. Douglas

Walden Dissertations and Doctoral Studies

Adolescents being overweight/obese is a public health crisis that threatens the health and welfare of adolescents going into adulthood and places a significant strain on society. It has been described as one of the most severe public health challenges of the 21st century by the World Health Organization. The pervasiveness of obesity in adolescents rose by 47.1% over the last three decades, and it disproportionally affects racial/ethnic minority lesbian, gay, and bisexual (LGB) persons. Guided by distal and proximal health behaviors, the minority stress model, and intersectionality, the purpose of this study was to examine whether being overweight or obese …

The Combined Impact Of Race And Education On Obesity Among U.S. Adults By Fidelis Okoye, Fidelis Chidi Okoye

Walden Dissertations and Doctoral Studies

Walden University

College of Health Professions

This is to certify that the doctoral dissertation by

Fidelis Okoye

has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made.

Review Committee Dr. Vasileios Margaritis, Committee Chairperson, Public Health Faculty Dr. Srikanta Banerjee, Committee Member, Public Health Faculty Dr. James Rohrer, University Reviewer, Public Health Faculty

Chief Academic Officer and ProvostSue Subocz, Ph.D.

Walden University2021

AbstractThe Combined Impact of Race and Education on Obesity Among U.S. Adults by Fidelis Okoye

MA, Walden University, 2009BS, Marygrove College, 2001

Dissertation …

Impact Of Case Management On Childhood Lead Exposure In Marion County, Indiana, Maliki Yacouba

Walden Dissertations and Doctoral Studies

The Centers for Disease Control and Prevention recently declared that no amount of childhood blood lead level (BLL) is safe. The purpose of this quantitative study with a retrospective cohort design was to evaluate the effectiveness of case management intervention on children diagnosed with elevated BLL (EBLL; ≥ 5 μg/dL) in Marion, County, Indiana. The health belief model was used as the theoretical foundation for the study. A data set of 160 lead exposure case management records was analyzed to find whether: (a) BLL at post-case-management time significantly differ from BLL at baseline (b) BLL at post-case-management time is affected …

Relationship Between Cultural And Religious Practices And Ebola Virus In Freetown, Sierra Leone, Richmond Samuel Kpange

Walden Dissertations and Doctoral Studies

The 2014 Ebola virus epidemic in the West Coast of Africa was a historically unprecedented epidemic with a sustained spread in multiple West African nations, including Sierra Leone. The World Health Organization (WHO) classified Sierra Leone as a high Ebola-affected country as it reported the highest number of deaths (14,124) during the last Ebola outbreak compared to other Ebola-affected countries. Public health experts have given little attention to the impact of sociocultural factors on infectious diseases, especially Ebola. The purpose of this study was to ascertain whether there is a relationship between the spread of EVD and a patient’s gender, …

Medication Beliefs And Behaviors Of Hypertensive Caribbean Immigrants Living In New York City, Nadia Williams

Walden Dissertations and Doctoral Studies

Hypertension remains a worldwide health phenomenon with serious health consequences including heart attack, stroke, aneurysm, and heart failure. Beliefs about medicines have been shown to influence hypertension outcomes. Medication adherence has emerged as a vital component of hypertension control and management. However, there has been limited research which addresses beliefs about medicines and medication adherence in Blacks of Caribbean origin. The purpose of this quantitative cross-sectional study was to identify the beliefs about medications held among hypertensive Caribbean immigrants living in New York City using the Beliefs about Medicines Questionnaire to identify what factors/barriers were related to these specific medication …

Living In An Oil-Polluted Region In Nigeria As A Risk Factor In Colorectal Cancer Development, Steve Nwachi Onya

Walden Dissertations and Doctoral Studies

Due to differences in exposure to various risk factors, colorectal cancer (CRC) rates differ in regions of Nigeria. Although the people living in the Southsouth, an oil-producing region, are concerned that they are most affected, there is insufficient research to address these concerns. The purpose of this quantitative ecological study was to investigate whether living in the oil-polluted region in Nigeria is associated with an excess CRC incidence rate. The potential spatial autocorrelation of CRC incidence among the contiguous regions was also examined. The study was grounded in the ecosocial theoretical framework. Data were extracted from the Nigeria National System …

Exploring The Relationship Between Antenatal Care And Postnatal Care To Newborn Outcomes In Borno State, Northeastern Nigeria, Adebe Gabriel

Walden Dissertations and Doctoral Studies

Newborn outcomes (morbidity or mortality) have been on the increase in Borno State. This study explores the relationship between antenatal care (ANC) and postnatal care (PNC) and newborn outcomes among women in Mafa local government area, Borno State. Also examined were the relationships between transportation and newborn outcomes, women’s knowledge of illness during pregnancy and ANC attendance, availability of staff/health workers, availability of supplies/equipment relations with ANC and PNC attendance. The three delays model was used as theoretical framework. The research will be useful for government and program-implementing partners to guide quality reproductive maternal newborn child adolescent health and nutrition …

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 …

Interrelationships Of Sociodemographic And Biological Factors In Breast Cancer Mortality Disparity Affecting Young Black Women, Richard Mutyabule

Walden Dissertations and Doctoral Studies

Despite improved overall survival among breast cancer patients, race and biological subtype-specific disparities persist. Subsequently, this retrospective longitudinal study, guided by ecosocial theory, examined associations between biological subtypes of breast cancer and patient-level sociodemographic factors on survival outcomes in women 25 to 44 years of age. Using Surveillance, Epidemiology, and End Results (SEER) database, 34,007 breast cancer cases between 2013 and 2018 were extracted. Kaplan Meier method and Cox proportional hazards model were used to examine time to event and the adjusted mortality risk by race and breast cancer subtype. There was a statistically significant difference in survival among young …

Predictors Of Hiv Testing Amongst Women Of Childbearing Age In Nigeria, Hassana Bashir Yakasai

Walden Dissertations and Doctoral Studies

HIV infection is still a public health issue in Nigeria. One of the sustainable development goal targets is to eliminate new HIV infections by the year 2030. Women of childbearing age are a vital group to focus on in eliminating new infections because HIV infection can be transmitted from women to their partners and their children. Nigeria accounts for about one-third of the cases of mother-to-child infections in the world. The purpose of this three manuscript dissertation was to investigate socioecological factors, demographic factors and knowledge of mother-to-child transmission of HIV infection (MTCT) as they relate to HIV testing in …

Demographic And Socioeconomic Determinants Of Lassa Fever In Edo State, Nigeria, Faith Ogagaroghene Ireye

Walden Dissertations and Doctoral Studies

Lassa fever is a viral hemorrhagic fever caused by the Lassa virus and associated with significant morbidity and mortality. Yearly outbreaks of the disease occur in Edo State, Nigeria. The purpose of this study was to examine the demographic and socioeconomic factors that can influence transmission of the disease. The Commission on Social Determinants of Health conceptual framework was used in this research study. This framework describes the relationship between structural and intermediary factors and how they determine health outcomes. To answer the research question of how demographic and socioeconomic factors influence Lassa fever transmission in Edo State, a cross-sectional …

Association Between Modifiable Risk Factors And Stroke Among Hispanics, Shanice Williams

Walden Dissertations and Doctoral Studies

Stroke is a significant public health issue that impacts the health of Hispanic adults. Understanding the multiple risk factors of stroke is an essential strategy to control the disease among this population. The purpose of this study was to examine the association between modifiable risk factors and stroke among Hispanics. The public health prevention framework guided this study. The research questions were designed to determine whether an association exists between modifiable risk factors for stroke among Hispanics. A quantitative, cross-sectional research design was used to conduct secondary analysis of the pooled 2017–2019 Behavioral Risk Factor Surveillance System annual surveys. The …

Factors That Determine The Place Of Childbirth In Lagos State, Nigeria, Ohiemi Emmanuel Adegbe

Walden Dissertations and Doctoral Studies

AbstractNigeria is among the 10 countries in the world with the worst maternal mortality. Though most of these deaths can be prevented using antenatal care (ANC) and having institutional deliveries, in Nigeria, ANC attendance and institutional delivery are suboptimal. Research is lacking on the reasons for the disparity between the use of antenatal services compared to deliveries at health centers. The aim of this study was to determine the associations between sociodemographic, obstetric, and health service factors and the place of delivery used by pregnant women in predominantly urban, cosmopolitan Lagos, Nigeria. Because both service delivery and demand factor categories …

Analysis Of Malaria-Induced Anemia And Gender Differences Among Children In Nigeria, Temitope Bamgbose

Walden Dissertations and Doctoral Studies

Malaria is one of the leading causes of death among children under 5 years old in sub-Saharan Africa (SSA). Also, public health efforts on malaria prevention have been successful in many regions but remains an issue in SSA. Malaria-induced anemia (MA) is associated with health complications among children. The impact of several sociodemographic factors (age, gender, residential type, and parent’s educational level) and malaria preventive/intervention measures such as mosquito net use and malaria medication use among children under 5 years old in Nigeria were assessed to inform malaria best practices and strategies, prioritize resource allocation, and support existing literature on …

Social Determinants Of Maternal And Neonatal Birth Outcomes Among Syrian Refugees In Lebanon, Mona Charbel Kiwan

Walden Dissertations and Doctoral Studies

Neonatal and maternal health indicators have been impacted due to Syrian refugees’ displacement in Lebanon and an increase in child marriage rates from 13% in pre-conflict Syria to 41%. Using the causal continuum framework, the retrospective cross-sectional study’s purpose was to examine whether there is a statistically significant association between adverse maternal and birth health outcomes among Syrian refugees in Lebanon and social determinants of health. The sample size drawn from UNHCR database included 48,083 maternal and 4,288 neonatal refugees admitted to the secondary health care in 2018. Pearson chi-square and binomial logistic regression results showed that employed, newcomers mothers …

Impact Of The Internet On Young Adult’S Perceptions Of Childhood Vaccinations, Hollie Leigh Xu

Walden Dissertations and Doctoral Studies

The internet and social media have transformed the way people receive information and connect, but the impact on society is still unknown. The purpose of this study was to examine the impact of indirect exposure to vaccine messages via the internet on young adults’ perceptions of childhood vaccinations. The health belief model and the social marketing theory were used as the theoretical framework. Research questions explored the relationship between exposure to anti and pro-vaccination messages and perceptions of participants as well as the relationship between perceptions of vaccination and intent to vaccinate. A quantitative correlational study design was used, with …

Marital Status And Human Immunodeficiency Virus Mortality In A Southern County, Javis Nkwanwoh

Walden Dissertations and Doctoral Studies

Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) remains a substantial cause of mortality, particularly among U.S. segments of the population. Marriage is protective of HIV/AIDS mortality due to monogamy; however, the increased risk of HIV/AIDS mortality among other marital subgroups is understudied. The purpose of this study was to examine the association between marital status and HIV/AIDS mortality among a cohort of HIV infected individuals in a southern county. Mills' behavior theory guided this research as it posits that all behaviors are acquired through conditioning, which occurs through the interaction with the environment. The study had a quantitative research design …

Assessing The Risk Of Developing Liver Cancer Among Adults In The United States, Magbor Oben

Walden Dissertations and Doctoral Studies

The risk of developing liver cancer among adults in the United States remains asignificant threat due to an increasing prevalence of the disease. Despite the identification of some biological, environmental, and socioeconomic risk factors, uncertainty exists as to the role of sociodemographic factors. In this study, participants (N=27,804), age 18 and over, were assessed for liver cancer outcome specific to three factors liver disease, insurance coverage, and access to healthcare. With the person-centered care model as the framework, data from the 2016 National Health and Interview Surveys were subjected to the selection criteria and quantitatively analyzed using binary logistic regression. …

Domestic Abuse Against Men In Kenya, Catherine W. Kigaya

Walden Dissertations and Doctoral Studies

Domestic violence, also known as intimate partner violence (IPV), is prevalent globally and causes severe physical, psychological, and social harm to victims. The purpose of this quantitative cross-sectional study was to highlight the predictors of physical and sexual IPV among men in Kenya and examine the influence of media in seeking help. These factors were explored through the lens of the socio-ecological model and the social learning theory. The 2014 Demographic Health Survey archival data obtained through in-depth interviews were used to answer the research questions. Dependent variables were physical abuse, sexual abuse, and seeking help while independent variables were …