Epidemiology Commons^™

Predictors Of Condom Use Among High School Students In North Carolina, Danielle Cierra Robinson

Walden Dissertations and Doctoral Studies

The spread of sexually transmitted diseases is a major ongoing public health issue in North Carolina. Adolescents between the ages of 13 and 19 years have consistently contributed to this trend. Researchers have found that condom use among high school students has decreased. High school students continue to engage in sex with multiple partners, with lack of knowledge about sexually transmitted diseases, even though sex education and prevention programs have been recommended. The purpose of this quantitative study was to evaluate the predictors of condom use among adolescents. The socioecological model theoretical framework was applied to guide this research involving …

Socioeconomic And Sociocultural Factors Associated With Parenting Choice And Fertility Experience Among Lesbian And Nonlesbian Women, Annette Silvia

Walden Dissertations and Doctoral Studies

Minorities including lesbians may face disparities that contribute to minority stress, which leads to adverse health outcomes. The purpose of this social epidemiology study was to examine the association between insured status, perceived stress, and parental status among lesbians and nonlesbians. The theoretical foundation was minority stress, and the design was quantitative with a convenience sample of women aged 18 years and older. Data on demographics, perceived stress, fertility quality of life, and lesbian identity disclosure were collected via online survey. Among the 314 respondents, 102 self-selected as lesbian (49% parents), and 212 self-selected as nonlesbian (73.1% parents). More than …

Predictors Of Hiv Testing Among African American Men Who Have Sex With Men, Jeanette Marie Higgins

Walden Dissertations and Doctoral Studies

Human immunodeficiency virus (HIV) infections affect more than 1.2 million people living in the United States and disproportionately affect African Americans (AA) men who have sex with men (MSM). The numbers of those who have HIV infections are likely higher due to lack of HIV testing by all individuals living at risk for HIV in the United States. Prior research has been inconclusive in determining the exact cause of the disparity among AA MSM. Therefore, the purpose of this quantitative secondary data study was to explore barriers to HIV testing within the AA MSM population. The sample for this study …

Demographic, Environmental, And Clinical Variables Associated With Dengue In Saint Lucia, Brendan Lee

Walden Dissertations and Doctoral Studies

Dengue is the most important arboviral disease of public health concern on the world stage. In Saint Lucia, the disease has been endemic for years. Little research has been published on the specific epidemiology of dengue in Saint Lucia, and this study sought to identify the risk factors associated with the disease specific to the island. This study was underpinned by ecological theory, which is used to explain the possible relationships between risk factors and the occurrence of dengue. This three-manuscript study was used to evaluate the relationship between demographic, environmental, and clinical variables and the occurrence of dengue as …

Accuracy Of Death Certificate Data In Reporting Suicide In The United States, Miland Ned Palmer

Walden Dissertations and Doctoral Studies

Suicide is one of the leading causes of death in the United States. Death certificates are currently being used by public health professionals and policy makers as a main source of public health surveillance data on suicide. The accuracy of death certificates in tracking and reporting suicides has not been well quantified or evaluated in the United States. Death certificates from other countries have been found to under-report suicide. The purpose of this study was to evaluate the accuracy of death certificates in reporting suicides in the United States. The National Violence Death Reporting System (NVDRS) collects information on all …

Demographics, Naloxone Accessibility, And Repeat Opioid Overdose In The United States, Craig Hamp Booker

Walden Dissertations and Doctoral Studies

Approximately 2.1 million people in the United States suffer from opioid use disorder, and over 47,600 people die from opioid-related overdoses each year. Opioid overdose is often treated with naloxone, a quick-acting medication that counteracts the effects of an overdose. This quantitative, correlational study was conducted to determine whether demographics (gender, age, and race) and naloxone accessibility were predictors of repeat opioid overdose in a Tennessee county in the United States. The study was developed and conducted using principles of the diffusion of innovations theory. Descriptive and inferential analyses were conducted using secondary, county-level data (n = 967) from emergency …

Family Rejection And Unprotected Sex Inlatino Gay Men, Juan Alejandro De Llano Montano

Walden Dissertations and Doctoral Studies

The present work explored the role of family rejection on the sexual behavior of Latino gay men under the guidance of the minority stress model. Family rejection was analyzed as a distal stressor, self-esteem as a proximal stressor, and unprotected sex as the outcome. The hypotheses were tested using regression, mediation, and multiple regression of secondary data from the Latino men who have sex with men (MSM) community involvement project. The results suggested that family rejection is a weak predictor of low self-esteem and engaging in receptive unprotected sex with more partners. Low self-esteem did not mediate the relationship between …

Neighborhood Factors, Depression, And Body Mass Index Among Patients With Lupus In Georgia, Aisha L. Hill

Walden Dissertations and Doctoral Studies

Elevated BMI (overweight and obesity) is a common health-related issue and affects more than half of the lupus population. Weight issues lead to additional health-related issues, such as heart disease and disabilities in the lupus population. To address the shortage of research focusing on this specific issue in the lupus population, one approach is a novel outlook on how neighborhood factors have the capability of determining or altering behaviors, such as physical activity, healthy eating, and healthy social relationships. Another variable to consider is depression and its capability of altering interactions, relationships, self-esteem, or even the inflammatory state of the …

Risks For Hiv Infection Among Adolescent Girls And Young Women In Mozambique, Isabelle Casavant

Walden Dissertations and Doctoral Studies

Adolescent girls and young women (AGYW) living in Sub-Saharan African countries constitute 17% of the population, yet they account for one third of all new human immunodeficiency virus (HIV) infections. To prevent HIV infections among AGYW, it is necessary to understand why they are disproportionally infected. The purpose of the dissertation was to identify risk for HIV among AGYW living in a southern district of Mozambique. The analysis was driven by the Modified Socio Ecological Model and performed using a quantitative dataset collected for the Chokwe Combination Prevention of HIV (N=3354). Logistic regression analysis was conducted to assess whether an …

Predictors Of The Health Effects Of Marijuana Use On The Hepatic Function, Makafui Kokou Gbogbo

Walden Dissertations and Doctoral Studies

The quantity of marijuana use, the length of time it was used, and the age of initiation of the drug are at the core of the discussions about the potential health effects of marijuana use on the liver. Results of recent studies regarding how the drug affects human health have resulted in a number of conflicting conclusions. Nevertheless, based on these findings, marijuana users are being denied liver transplants. The objective of this study was to identify predictors of the health effects of marijuana on the liver and provide guidance in the care management of marijuana users. To address the …

The Association Between Central Line Insertion Practices And Central Line-Associated Bloodstream Infections, Mona Elgowainy

Walden Dissertations and Doctoral Studies

Healthcare-associated infections, specifically central line-associated bloodstream infections (CLABSI), continue to remain a serious public health concern in the United States. Though CLABSI can often be prevented, healthcare professionals struggle to have a positive impact on CLABSI rates. The primary purpose of this study was to determine whether CLIP Bundle adherence has an impact on CLABSI standardized infection ratio (SIR) rates in various patient care areas in California. The research questions were focused on assessing whether there was an association between patient care areas, CLABSI rates, and CLIP Bundle adherence scores. A quantitative, cross-sectional study design utilizing secondary data was used …

Factors Associated With Flu Vaccination Status Among Older Hispanics In The United States, William Esteban Toledo Velazquez

Walden Dissertations and Doctoral Studies

AbstractOlder Hispanics in the United States are less likely to be vaccinated with the flu vaccine compared to older White Americans, despite being at higher risk of influenza-associated deaths and hospitalizations. A quantitative cross-sectional study based on the social ecological model was carried out to evaluate the influence of several sociodemographic and health factors on flu vaccination status among elderly Hispanic individuals in the United States. Logistic regression analyses were conducted using secondary data collected from 95,414 elderly Hispanic and White American 2018 Behavioral Risk Factor Surveillance System participants. Multivariate logistic regressions controlling for other variables revealed health care coverage …

The Relationship Between Cervical Cancer And Women Living With Disabilities In Kentucky, Carolyn Akakpo

Walden Dissertations and Doctoral Studies

AbstractDespite many national interventions, cervical cancer (CC) rates persist, and in Kentucky (KY), CC incidence rates are on the rise. Additionally, women with disabilities face more barriers to secondary prevention and healthcare access, have more known risks, and experience more health disparities than women without disabilities. Given that 1 in 4 persons live with a disability, the purpose of this observational, cross-sectional, quantitative study was to explore the relationship between CC and women with disabilities as evidenced by reproductive cancer discharges from inpatient hospital (IHD) and outpatient services databases (OSD) so as to compare population-specific differences from social determinants of …

Risk Factors For Polysubstance Abuse: A National Secondary Data Analysis Study, Dakota Mcmurray

Walden Dissertations and Doctoral Studies

Substance abuse is a serious public health problem in the United States and globally. Abuse of more than one substance is considered polysubstance abuse and can cause more harm than abuse of only one substance. Polysubstance abuse compounds the problems of addiction because of the variety of substances that may be used and the resulting side effects. This quantitative cross-sectional secondary data analysis, guided by the socio-ecological theory, assessed patient characteristics and how predictive they were for polysubstance abuse. The study sample of 986 patients was analyzed by binomial logistic regression to assess the association between patient-related factors and polysubstance …

Access To Healthcare For American Indians Residing In The Northeast United States, Kristine D. Thomas-Jones

Walden Dissertations and Doctoral Studies

Urban American Indians/Alaskan Natives (AIs/ANs) have limited access to health care in comparison to non-Hispanic Whites (NHWs), which furthers health disparities for indigenous communities. The purpose of this quantitative, nonexperimental study, which was guided by the socioecological model, was to examine the relationship between access to health care and healthcare utilization among urban AIs/ANs and urban NHWs in the Northeast United States. The research questions addressed the difference in access to healthcare based on health insurance, difference in healthcare utilization, and whether there is an association between health care access and health care utilization for AIs in the Northeast United …

Prostate Cancer Screening Intention Among African American Males Ages 40 To 65 Years, Paul L. Johnson

Walden Dissertations and Doctoral Studies

African American men are at a higher risk of developing and dying from prostate cancer (PCa) compared with any other race or ethnic group. Despite prostate cancer screening (PCS) recommendations, African American men are less likely to be screened for PCa compared with any other race or ethnic group. The purpose of this study was to identify factors that influence the intentions of African American men to obtain a PCS. A nonexperimental cross-sectional research design was used to identify factors associated with the intention to obtain PCS. The theoretical framework for the study was the social-ecological model which posits that …

Hiv Prevention: Pre-Exposure Prophylaxis, Sexual Decision Making, Risk Taking, And Condoms, Jonathan D. Spencer

Walden Dissertations and Doctoral Studies

HIV is an infectious disease that continues to have new cases each year within high-risk populations, such as men who have sex with men (MSM). To help in the fight against new HIV infections within the MSM population, new medications such as pre-exposure prophylaxis (PrEP) are being used. The purpose of this cross-sectional online survey study was to address whether PrEP use had any relationship with (a) sexual decision-making, (b) risk-taking, and (c) condom use in the MSM population 18-64 years of age, after controlling for socioeconomic status, race, and age while using the behavioral disinhibition and risk compensation models. …

Association Of Adaptive Early Phase Study Design And Late Phase Study Results In Oncology, Donna Elise Levy

Walden Dissertations and Doctoral Studies

This quantitative study assessed the association of the design methods used for early phase oncology studies (adaptive versus traditional) and the outcome of late stage clinical trials. Differences by cancer type and by drug classification were also assessed. The theoretical and conceptual frameworks used were the general systems theory and the design and evaluation of complex interventions, respectively. Units of analysis were individual oncology studies in the ClinicalTrials.gov database and Bayesian logistic modeling was applied on a random sample of 381 studies initiated after November 1999 to December 2016. When assessing study design and outcome, there were lower odds of …

The Long-Term Health-Related Outcomes Of Breast Ironing In Cameroon, Norbert Nicholas Njume Nkwelle

Walden Dissertations and Doctoral Studies

Breast ironing (BI) practice is a common practice in Cameroon. Most villages and towns continue with BI because they believe it constitutes a positive cultural lifestyle. However, public health officials and other advocates have branded BI as a harmful traditional practice because of the traumatic impact it has on the women who experience it. The purpose of this quasi-experimental study was to examine the perceived long-term health-related outcomes of BI and the quality of life changes on these women. Underpinning this study was the betrayal theory of trauma. A survey was used to collect data from 230 women. Descriptive analysis …

Toxic Air Discharge And Infant Mortality: Effects Of Community Size And Socioeconomics, Khabira Salter

Walden Dissertations and Doctoral Studies

Living in counties where manufacturers release environmental toxins, such as those tracked by the Environmental Protection Agency's (EPA) toxic release inventory (TRI), may elevate infants' health risks. Because infant mortality (IM) is a strong indicator of a population's health status, it is an important topic in public health research. The purpose of this research was to examine the potential relationships between IM, community size, and factors related to mothers' SES in counties where more than 25,000 pounds of annual toxic air releases occur. The dependent variable was IM per 1,000 live births in a given community for each of the …

Impact Of Community Factors On The Donor Quality Score In Liver Transplantation, Giovanna Saracino

Walden Dissertations and Doctoral Studies

An increasing prevalence of metabolic syndrome and obesity has been linked to the rise in transplant indication for cryptogenic cirrhosis and nonalcoholic fatty liver disease (NAFLD), creating a growing challenge to public health. NAFLD liver transplant (LT) candidates are listed with low priority, and their waiting mortality is high. The impact of community/geographic factors on donor risk models is unknown. The purpose of this study was to develop a parsimonious donor risk-adjusted model tailored to NAFLD recipients by assessing the impact of donor, recipient, transplant, and external factors on graft survival. The theoretical framework was the social ecological model. Secondary …

Factors Affecting Breastfeeding In Preterm Infants, Evangeline Starks Glover

Walden Dissertations and Doctoral Studies

Even though initiation of breastfeeding among term and preterm infants has increased, the incidence and duration among preterm infants continues to lag because of the unique challenges of breastfeeding preterm infants. African American mothers have the lowest rates of breastfeeding initiation and duration, and their preterm infants are less likely to receive breast milk while in the neonatal intensive care unit. The objective of this cross-€sectional quantitative study was to evaluate the relationship between breastfeeding and maternal sociodemographic factors as well as medical and obstetrical conditions for infants born between 32-€37 weeks gestational age in South Carolina from 2009 to …

Health Awareness On High Blood Pressure, High Cholesterol, And Risk For Cardiovascular Disease, Innocent Bibi

Walden Dissertations and Doctoral Studies

Cardiovascular disease (CVD) is responsible for 25% of the annual deaths in the United States and represents a major public health burden, as patients often require screening and lifestyle changes related to multiple risk factors such as high blood pressure and high cholesterol. The purpose of this quantitative correlational study was to determine if there was a statistically significant association between high blood pressure and high cholesterol awareness (prevention and management) and cardiovascular health outcomes (angina pectoris, coronary heart disease, and heart attack). The theoretical framework that guided this study was the health belief model. Data from adults over the …

A Conflictive Triuvirate Consruct Of Epidemiologic Systems Failure, Ngozi Lois Ulinwa

Walden Dissertations and Doctoral Studies

Epidemiologic systems failure (ESF) is a major hurdle in minimizing the spread of infectious diseases during outbreaks. The reasons for ESF include the technical limitation of personnel handling epidemic crises, strictly defined health policies that limit the actions of epidemiologists, and personal perspective's reservations towards the intentions of health agencies. The purpose of this triumvirate mixed-methods case study was to examine factors of infectious disease control mechanisms useful for determining ESF. Three juxtaposed pre-emptive factors (technical [T], organizational [O], and personal [P] perspectives were used to determine how the multiple perspectives inquiring systems and fuzzy logic revealed factors causing ESF …

Efficacy Of A Minnesota Statute Enacted To Reduce Inflicted Traumatic Brain Injuries, Jonathan K. James

Walden Dissertations and Doctoral Studies

This quantitative research is on the efficacy of Minnesota Statute 144.574 enacted in 2005 in response to the growing awareness of behavior leading to inflicted Traumatic Brain Injuries (iTBI) in infants and children. The model for this research is grounded in the Theory of Reasoned Action wherein the education of new parents which graphically explains the physiologic changes to the structural architecture of the brain post-trauma, paired with their signature on a social contract (SC), demonstrated a reduction in incidence. Because the enacted statute does not include the signing of a SC, nor does it require face-to-face education as in …

Beliefs And Opinions Of Low-Income Residents Living In A Food Desert In A Gulf Coast State, Kimberly Lakeidra Willis

Walden Dissertations and Doctoral Studies

This study was an investigation of the access problem to fresh and affordable fruits and vegetables and how limited access influenced the beliefs and opinions of residents of a food desert as designated by United States Department of Agriculture. Many researchers have documented that price, availability, and transportation are barriers to fruit and vegetable consumption, particularly among low-income individuals. Researchers in other studies have concluded that these barriers are further exacerbated by an individual's distance from a supermarket or grocery store. However, much less information is available regarding the beliefs and opinions about life in a food desert and how …

"Exploring Telehealth Feasibility For Hiv Status In Individuals Aged 17 To 34 In Southwestern Nigeria", Michael Funso Olaniyi

Walden Dissertations and Doctoral Studies

Abstract

The use of smart phones among young people in Southwestern Nigeria has grown since the early 1990'€™s while traditional healthcare access had continued to deteriorate. HIV care centers have been concentrated in large cities, but earlier studies had shown higher prevalence of HIV in rural areas that constituted a larger portion of the population. However, existing studies had not adequately explored the use of mobile phones to supplement traditional healthcare access. The purpose of this study was to assess the feasibility of telehealth for healthcare access among individuals aged 17-34 with positive HIV status and those at high risk …

Relationship Between Elevated Blood Pressure/Hypertension In Military Personnel And The Stress Of Combat Deployment, Stephen James Pinkerton

Walden Dissertations and Doctoral Studies

Few studies about elevated blood pressure in the U.S. military exist in which researchers examined exposure to combat and its association with elevated blood pressure. The purpose of this quantitative research was to describe the extent of association between those who were exposed to combat deployment, were 40 or older, and were overweight or obese and had elevated blood pressure for U.S. military personnel who deployed to an area of declared combat between 2012 and 2017. The conceptual basis of this research was best represented by the determinants of health model. Chi-square correlation revealed that being older (equal to or …

Leptin Level Variance In Adults With And Without Cancer, Vilisa Chatman-Terry

Walden Dissertations and Doctoral Studies

Abstract

In 2018, health statistics revealed that, despite the many preventive measures established,

cancer was the second leading cause of death in the United States and the leading cause

of death in 22 states, exceeded only by heart disease. With obesity/leptin levels reaching

pandemic levels worldwide, and cancer having a well-known association with obesity,

both chronic diseases represent a large proportion of public health challenges. Guided by

the social ecological model, the purpose of this cross-sectional, quantitative study was to

examine if a significant difference exists in leptin levels among adults with different

types of obesity-associated and common cancers and …

The Effectiveness Of Two Types Of Adjunct Acupuncture Exposures On In Vitro Fertilization Outcomes, Lindsey Vacovsky

Walden Dissertations and Doctoral Studies

One out of every 8 couples experiences infertility. Few publications exist examining the association between the addition of adjunctive therapies when applied to the in vitro fertilization (IVF) procedure and pregnancy outcome. The purpose of this study was to compare the effectiveness of 2 types of adjunct acupuncture exposures on IVF outcomes by applying the concept of the epidemiology triad. The association between the type of adjunct acupuncture exposure received (the independent variable) and pregnancy (the outcome) was determined via binary logistic regression using SPSS software. Medical records of women having received the IVF procedure along with adjunct acupuncture were …